U.S. DEPARTMENT OF STATE
94/12/19 Remarks: "Bring Cairo Home" Conference

1. Opening Remarks by Undersecretary Tim Wirth
2. Remarks of Secretary Donna Shalala
3. Statement of David M. Gardiner

Thank you for coming to what should be one of the most exciting days of 1994. I suspect for all of us who were in Cairo nothing will be asexciting as that extraordinary ten day period of time, which is perhapsbest summarized by Bishop Moore. The wonderful Bishop of New York wasin my office about three weeks ago and we were talking about a varietyof things. As all of you know he been involved in a variety of civil rights activities and homeless issues, and so on. At the end of the session he said something like, "Oh by the way, what we all did as a world together in Cairo was so extraordinarily important. I've been through lots of experiences and a long and very interesting life. I've learned that from time to time God touches earth, and that was one of them." I thought that was about as good a summary of the sense of future, the sense of direction, the sense of ideal, the sense of shared goals that came out of Cairo. We all came home with an extraordinarily euphoric feeling. It is now of course, extraordinarily important that we make sure that Cairo be followed up and become a reality. The purpose of our being together today is to start to think about implementing the ICPD Program of Action--bringing Cairo home. What we have attempted to do for today is to set up a very rich day that I think will provide us with the opportunity both to think about our immediate responsibilities and to think about some long term trends that we in the United States must be considering. We will discuss how best to address the challenges presented by the Program of Action--keeping in mind that challenges for us in the United States are quite different from challenges that are faced elsewhere in the world, but in most cases there are enormous parallels.

We essentially have two parallel purposes today. The first is to look very specifically at the Cairo document and to try to come out of today's deliberations and discussions with a sense of the kinds of steps we in the United States ought to be doing both domestically and internationally to implement Cairo. We have a number of panels this morning that are focused very specifically on a whole series of those issues, and we hope to garner an enormous number of very good ideas and perspectives on what we ought to do. While those workshops are going on around the building, individuals and NGOs will be providing testimony to a panel. So we have a specific chore and the morning is really focused on that as to where we go from here chapter by chapter, issue by issue.

This afternoon takes on something of a bit of a different flavor, incorporating the mission of the President's Council on Sustainable Development. The President's Council on Sustainable Development, appointed by President Clinton a year and a half ago, has set up a task force on the subject of population and consumption. If we in the United States are serious about sustainable development we have to ask ourselves the question: "What are we trying to sustain, at what level of consumption." Diane Dillion-Ridgley, co-chair of the population and consumption task force, is here with us today. The two roundtables will focus specifically on what recommendations and what steps we should be taking in the United States to become sustainable. Those in turn will be put together and taken to the President's Council on Sustainable Development and will be part we hope of the recommendations which will be reported to the President this summer.

We have about 500 people from at least 15 states with us today, all deeply engaged in public policy at its very best: joining together enormous talent, skills and capacity to take on these two remarkably challenging and important jobs. We have a very good schedule this morning and we are going to begin with introductory and very important comments from a lot of the leadership of the Executive Branch agencies concerned with carrying this out.

Crisis prevention and the challenge of sustainable development are among the great challenges for the remainder of this and into the next century. It is time to retool our approach to national security -- recognizing that our economic and environmental futures are one and the same. And it is these challenges which will determine the future we leave to our children and grandchildren.

We are strong in these convictions. Now we must have the courage to convert our convictions to action and to move these ideals forward. As Americans we bear a heavy burden in this challenge. If America -- and each of us -- does not lead, no one will follow, and it will not happen. Today let us decide to build on and contribute to this momentum toward investing in the greatest resources all nations have for sustainable development -- our people. That is our pledge and that is our common challenge.

Thank you very much.

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Let me thank Tim Wirth for his leadership, his openness and his vision. I was very disappointed that I couldn't join all of you in Cairo. We of course were in the middle of the health care reform discussion and there was just no way to get out of here, but I've gotten very serious and some amusing reports from Sarah Kovner, Felicia Stewart and Susan Newcomer. I'm glad that not only did you do extraordinary work, but it sounds like people had a very good time while they were there.

I also in particular want to congratulate the NGOs as well as my colleagues in the government who helped make it all possible. The administration as a whole, and the Department of Health and Human Services in particular, helped to prepare for Cairo and I think the high quality of the preparation, Tim, reflected your leadership. It would not have been a successful conference if so much work had not gone on before hand. It was really two years of work to make sure that the Cairo document reflected our priorities for economic development, and, more importantly, for human development. When all was said and done, I think the most important thing we learned in Cairo was that the barriers that human beings face are similar throughout the world. Whether we were talking about the need to educate our children, to feed our people or to create more opportunities for women, there was really tremendous agreement about our common challenges and I think our common solutions.

Let me talk a little about the Clinton administration's initiatives for families. Many of you know them individually, but collectively I think they reinforce the core principles that were associated with Cairo, particularly family empowerment and responsibility.

The President's investments in family and children have been among the handful of investments in a zero growth world that we have been able to make, whether it's an expansion of the Head Start Program or the implementation of the family preservation and support program in which we invested almost a billion dollars around the country for comprehensive services targeting at-risk families.

Then there's the expansion of the Earned Income Tax Credit in which we were able to lift millions of working families above the poverty level. The Earned Income Tax Credit is buried in the tax code over at Treasury, but it is one of the most remarkable accomplishments over the last three decades because it essentially takes a family headed by one worker with a couple of kids and lifts them above the poverty line, putting real dollars into their pockets.

Or consider the childhood immunization program that we launched a couple of years ago. We know in this country we have the highest preschool immunization rates that we've ever had-- it is a national record for us. I have promised the President that 90% of the preschool kids in this country by 1996 will be in a system where they will get their most important shots. Which for us is moving from the immunization rates of third world countries into what one would expect for a country as powerful and caring as this one.

We lifted the gag rule, played some role in getting RU486 to the Population Council and are watching with care as the clinical field trials are now going on. We made sure that our family planning policies empower women to make and form decisions. I think in our ability to attract Felicia Stewart from California to head the family planning programs in this government, we at least sent a message that we were serious and that we were prepared to make investments both in terms of money, and in terms of recruiting the most prominent people in the country to lead our efforts.

We've also taken on tough issues like domestic violence, teen pregnancy and child support enforcement. We've made health research for women a very high priority and paid increased attention to a range of women's health issues--from reproductive health to breast cancer, and from Alzheimer's Disease to AIDS, which is increasingly an issue for women.

And, as my good friend Chairman Porter would agree, in the crime bill, the Violence Against Women Act had bipartisan support. For the first time, this country will make a significant statement about domestic violence. We will invest in the training of police officers, judges, and emergency room workers, We will invest in battered women's shelters and in domestic violence prevention programs. Every single one of our Head-Start Centers around the country will deal with the issue of violence, and we will work closely with families.

If I list all of these things together, they are not simply a range of social service programs, but actually a network of support programs for families. They both bring up incomes of families and recognize in particular that working families need decent incomes, child care access, and quality health care services. Nothing more reflects our comprehensive commitment than what we've been able to do in terms of starting the national debate on health care reform, because that very much is a debate about working families and about support for working families. I don't believe we are going to give up on, nor is any member of Congress going to give up on, both the debate and our strategies. Of course, we are also faced with a major debate surrounding the President's welfare reform bill.

But all of these things together are really efforts to support families-

-not simply families at risk, but also low-income families and working families. The fact is, most of the people in this country that do not have health care are working. They get up in the morning, they go to work, and they go into jobs that can't provide health care because health care is too expensive for their employers.

All of these are part of an overall strategy by the administration which I believe is very consistent with the Cairo recommendations. Today we are challenged to do a lot more and I think the test of this country and of our character is going to be in the debates in Congress this year on welfare reform and health care reform. Whether we keep in place or keep moving and make progress in supporting families will be revealed in those debates.

Finally, let me say that there are challenges for all of you and for this country in our relationships with other countries and in our willingness to invest through US aid in reproductive health care and empowerment strategies for women and families. I just returned from Moscow with the Vice President. The Gore-Chernomyrdynian process has a new health committee and the number one priority of the Russians is women's reproductive health issues. The Russians are committed to reducing the number of surgical abortions and increasing access to family planning choices. We are happy to work with them on that. When I reported to the joint commission, the Prime Minister of Russia and Vice President Gore said that they considered the health committee to be the most important thing that we've done this year in terms of working with the Russians to strengthen them in the years ahead. That will be a major initiative led by USAID and HHS which will have a number of different aspects to it, including investments by Americans from the private sector and roles for the NGOs.

The consistency of the message in this country and outside about empowering families and empowering women is what's important. I think we've done it internally in terms of domestic policy. We will continue to fight on. I think that President's new budget will reflect both on the tax side as well as on the investment side his long term commitment to families and to opportunities. Thank you very much.

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Statement of David M. Gardiner at "Bringing Cairo Home: Peace, Prosperity and Democracy" Monday, December 19, 1994

In agreeing recently to the International Conference on Population and Development's Programme of Action, the U.S. Government committed to take the lead--with other developed countries--in modifying unsustainable consumption and production patterns.

We agreed to develop a range of economic, legislative and administrative measures to foster more sustainable resource use and prevent environmental degradation.

I want to challenge the participants in this conference and elsewhere to bring forward new economic, legislative, and administrative ideas and proposals that will foster more sustainable resource use and prevent environmental degradation. Without the hard work which you are going to be doing today, we can never meet the challenge laid out to all in Cairo.

The United States and other developed countries can and should take the lead in achieving sustainable consumption and production patterns for a couple of reasons:

(1) First, our current consumption levels are unmistakably high and have substantial domestic and international environmental consequences.

We are the largest single contributor to the problem of global warming. Today, the U.S. contributes about one-fifth of global greenhouse gas emissions, with just 5 percent of the world population.

There is perhaps no greater symbol of our consumption than our use of energy in this country. Although the U.S. releases less pollution per unit of energy consumed, our overall per capita emission rates are still 18 times that of India and 9 times that of China.

With U.S. population projected to grow faster than most other developed countries, activity levels are inescapably going to rise. We will add nearly 2 million new persons per year through year 2050--an overall increase of 25 percent from today's population base.

And at home, nearly 25 years after the passage of the nation's clean air and clean water laws, we still face domestic environmental challenges. 70 million Americans still live in areas of the country which do not meet national air quality standards. 40% of our rivers and streams are still not clean enough for uses such as fishing or swimming. One in four Americans still live within a few miles of toxic waste site. And, as drinking water emergencies in Milwaukee and Washington, DC, reminded us just last year, our drinking water is not completely safe.

(2) Second, the rest of the world looks to the United States for leadership on economic, environmental and social issues. As the richest and most powerful nation we have a special responsibility and opportunity to chart a new course into the 21st century that other countries will want to emulate. That leadership must begin at home.

We are discovering--and must continue to discover--new, more efficient ways to maintain and increase our standards of living and to fulfill human needs more efficiently.

Producing more efficiently is better for the environment, but it is also profitable. We are developing technologies that use fewer material and resource inputs while polluting less. These technologies are the key to more sustainable patterns of consumption and production at home and abroad.

(3) We are at a crossroads in domestic environmental policy, which will require a new generation of environmental leadership here at home in America if we are to forge a sustainable path into the 21st century.

Many of the techniques which we developed for tackling the environmental problems of the 1970s and 80s are inadequate for the year 2001 and beyond.

In the course of the last two decades, the United States has imposed stringent regulations limiting pollution from the tailpipes of the American automobile, which resulted in sharp improvements in the efficiency and air pollution emissions. But those technological improvements are being overwhelmed by increases in underlying activity levels as there are more Americans, Americans own more cars, and Americans drive more and more each year. Just across the Potomac River in Virginia, where I live, total vehicle miles traveled is growing at 5% per year. That kind of growth will erode the technological gains made in the 1990 Clean Air Act by the beginning of the 21st century.

Moreover, there are very few effective programs in place addressing the total quantity of miles driven or alternative forms of transportation. Unless we can develop a new generation of environmental protection approaches which do not rely solely on traditional command and control regulatory approaches, the detrimental impacts of increased driving will more than offset the beneficial effect of tailpipe standards in reducing the emissions that are the precursors to smog.

So what can we do to shift to more sustainable consumption and production patterns?

I want to offer four ideas.

First, we must launch a new partnership including businesses, individual American citizens, the scientific community, and government to fully integrate our environmental, social and economic approaches into sustainable development.

Businesses will need to act on their growing recognition that sustainable development represents a profitable opportunity to do things cleaner, cheaper, smarter and more efficiently--saving resources that can be reallocated to more productive uses. The most alert companies today are finding incredibly large savings through innovative process modifications, technological advances, and material substitutions that reduce costly inputs as well as the management and liability costs they have typically faced from waste. Administrator Browner recently honored the Dupont Corporation for the VOLUNTARY commitment to reduce their own greenhouse gas emissions by 20 million tons at a savings of 31 million dollars each year. We need other businesses that can follow Dupont's lead.

Individual American citizens can be educated and empowered to make consumer decisions that reward responsible production practices. A range of other behavioral changes, if adopted widely, will help protect and sustain the American lifestyle over the long run--whether changes in driving patterns or recycling choices. And they want to do it. 4 out of 5 Americans describe themselves as environmentalists, and many are already actively recycling or engaging in a personal commitment to sustainable development.

Growing scientific knowledge is increasingly providing us with an opportunity to anticipate and plan for the future, rather than simply to react to it.

Governments at all levels will need to implement changes in regulatory, tax, subsidy and investment policies that better harness the market on behalf of our core economic, environmental and social goals for the nation.

Given the limits of traditional environmental regulation as a policy instrument, we are seriously exploring today how environmental quality can be improved through changes BOTH in government economic and environmental policy.

There are many opportunities to improve both economic and environmental performance. Most simply, government can use its power as a huge purchaser of goods and services to procure environmentally sound products. And this Administration has set in motion a set of policies to promote this.

But we also have opportunities to change government policies that not only impair economic performance, but directly encourage polluting activities.

Second, we must adopt sector-by-sector strategies to better align economic and environmental objectives.

At EPA, Administrator Browner has launched the Common Sense Initiative to take a comprehensive look at how we intersect with each of six industries--petroleum refining, electronics and computers, iron and steel, automobile manufacturing, printing, and metal plating and finishing--to see whether we can accomplish our goals in a smarter, cleaner and cheaper fashion.

We are looking at existing and in-the-pipeline regulations for each. We are looking at permitting, enforcement, reporting requirements and at how we might develop new technologies to do the job better in each industry.

And we are doing it with all the stakeholders at the table--business, state and local environmental agencies, environmentalists, and labor unions.

Working on an industry basis will allow us to optimize control strategies across all environmental media, thereby achieving environmental objectives at the least possible cost.

There are also changes we can make in macro-sectors of the economy:

Agriculture - where shifts in taxpayer investments toward land, chemical, and water conservation practices have yielded important environmental and economic benefits for all Americans.

Transportation - more effective revenue programs, peak pricing of congestion, greater adoption of the polluter-pays-principle.

Energy - which is already being revolutionized as utilities, utility commissioners, and consumers are shifting policies and prices to encourage less pollution-intensive and damaging emissions.

Technology - reduce barriers to innovation, targeted R&D; investment strategies, financing and advocacy support to promote exports of U.S. environmental technologies.

(3) Third, we must change our basic measures of economic success--the gross domestic product measurement counts Exxon Valdez and doesn't count consumption of natural resources.

(4) Fourth, though it is politically sensitive, we must identify opportunities to modify our tax and expenditure policy so that the incentives it sets out are aligned with our objectives.

Probably nowhere does the government have greater influence over the direction of economic activity than through the tax code. Many have suggested that we consider shifting taxation away from activities that the government should want to promote like working and saving, towards activities that the government should want to discourage, i.e., those that generate pollution. It bears consideration and it is clearly something only government can do, albeit with the requisite public support.

But let me give you a more specific example of a recent win-win proposal that we sought to institute through the tax code. President Clinton's Climate Change Action Plan included a proposal to transform the existing tax subsidy for employer-provided free parking into a powerful, more flexible benefit for workers and business.

The current federal tax code strongly encourages employers to offer free parking as a benefit, because it is not taxed. Indeed, businesses today spend (x) dollars providing this benefit to their employees. The system creates an enormous incentive for people to drive to work. That means more people driving at rush hour, more pollution, greater need for larger investments in highway infrastructure.

Our proposal would have required employers to provide the option of a cash-equivalent to the employee in order to maintain the tax deductibility of the offered parking space. It would reverse the current encouragement to drive and leave almost nobody worse off economically.

Conclusion

Integrating our high-consumption, high production economy and our natural environment is complicated enough if one holds the population constant. Adding the dimension of fairly rapid population growth at home and explosive growth abroad makes this a far trickier--and more urgent--enterprise.

We must modify our patterns of production and consumption so they become more sustainable. We can--I believe--do so without sacrificing our quality of life. In fact, if we don't do so, we will undermine our quality of life through environmental degradation and pass on to future generations a world both environmentally and economically ??? than the one we inherited from past generations.

The imperative is clear: we need to do more with less. This will require doing what we do more intelligently, with new technologies and approaches. The government is part of the solution, but not the whole solution. Let's all get on with the challenge. Let's move ahead.

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Prepared Remarks of Amb. Sally Shelton "Bringing Cairo Home" Conference Washington D.C. December 19, 1994

1 am pleased that so many of you have joined us today for what I expect will be a very important set of discussions on some critical issues. My special thanks to Tim Wirth and his colleagues at the State Department for all they have done, and for bringing these issues to the forefront of American diplomacy. I would also like to welcome our colleagues from other agencies, Secretary Shalala from HHS and the Assistant Administrator David Gardiner from EPA, who, by being here, show their commitment to the theme of our meeting, "Bringing Cairo Home."

I was in Cairo, as were a good many of you, and I felt the spirit of consensus and goodwill that overcame the differences and diversity represented there. It's great to have this opportunity to reflect on how we can translate this spirit into action. The Cairo conference, and the process that led up to it, provided a dramatic expression of U.S. leadership --leadership which, rather than imposing values, seeks to work through persuasion and partnership.

Many of you, who are leaders in your communities and organizations, well understand the challenges we face in formulating a new vision of the role of the United States in the post Cold War world. There has also been a great deal of concern in the wake of the November elections about the future role of U.S. assistance programs. Things will be different under a Republican Congress. I'm sure all of you have already seen some of the attacks that have been launched against foreign assistance programs. It has become clear that foreign assistance programs will be under an unprecedented siege during the next year.

These assaults are coming from many quarters--isolationists, budget hawks, some who want to preserve their own piece of the pie, people who believe economic policy alone can cure the ills of the developing world, and those simply looking to grandstand. It is also clear from what we see coming out of the Hill already, that security assistance will probably fare pretty well. Budgets for Israel, Egypt, and probably Russia and the NIS will remain relatively static. This means that our development assistance accounts will face potentially crippling reductions. What is happening here, is that the things that USAID does best, development in countries that really need development, is the most threatened part of our mission.

From the rhetoric I have heard in the last couple of weeks, I realize we have not done a good enough job telling our story. Many believe that foreign assistance programs are simply a waste of money and that they do not serve the best interests of the United States.

First, we must let it be known that our development aid is cost-

effective and that it works. In the last fifty years we have cut infant mortality in half worldwide, and health conditions have improved more in this period than in all previous human history. Foreign assistance has helped increase literacy by 33% in just the last twenty five years. Family planning programs have helped average family size in USAID-

assisted countries to drop by one-third since the 1960s. More than 3 million lives are saved each year through USAID immunization programs, and oral rehydration therapy has saved millions more.

When people say that no country has ever gotten off the dole, we need to point out that nations like Korea, Taiwan, Tunisia, Costa Rica, Botswana, Greece and Belize who are now some of our closest allies and best trading partners, were once beneficiaries of U.S. assistance programs. We need to point out that the Marshall Plan, widely viewed as one of the most successful foreign policy initiatives ever, was only supported by 18% of the American public when it was announced. We need to point out that nations people were quick to write off as "basket-

cases" in the 1960s and 1970s -- nations like Bangladesh, Indonesia and India -- are now showing remarkable progress.

We need to remind people that less than one half of one percent of the U.S. budget is spent on economic and humanitarian assistance. We need to help people understand that foreign assistance is helping create the markets of the future for this nation. Don't be afraid to tell people that U.S. exports to developing and transition nations grew by a remarkable $46 billion in the last three years alone, and that trade translated into an additional 920,000 jobs in the United States. The U.S. exports more to South Korea in one year than we ever gave them in assistance. As people concerned about the future of the world, we must clearly articulate why preventing crises is much cheaper for this nation than dealing with them once they happen. We need to show how development is just such a tool of prevention.

We know development works. But there is a second message that we must communicate. Our aid programs are being designed to be both responsive to countries' needs and consistent with the long-term interests and values of the United States. Our current programs are very much in harmony with Cairo in their emphasis on environmental protection, population stabilization, and the promotion of health, especially for women and children. As in Cairo, we view the education and empowerment of women as fundamental to development and a goal that advances every aspect of a society. The present approach also emphasizes support for NGOs and the private sector, which in so many countries are the building blocks of democracy and the source of entrepreneurship, innovation, and economic growth. While the focus is on population, the Cairo Program of Action is indeed comprehensive in addressing the full range of sustainable development concerns. For USAID, implementation of the Cairo agenda involves the entire agency to one degree or another.

For those of you who are less familiar with USAID programs, I urge you to take time to look over our booklet, Strategies for Sustainable Development, copies of which are available to you today. There is also an overview available of the Agency's ongoing programs and new initiatives in population, health and nutrition and related areas. I would like to take a moment to highlight some of these.

First, central to the Program of Action adopted in Cairo was the call for women's education and empowerment. We are now in the process of developing a girls' and women's education initiative, building on experience we have had with successful models supported by our missions in Guatemala, Malawi, and Nepal. We are also giving greater emphasis to supporting microenterprise programs for women as well as organizations working on their political and legal rights and the prevention of violence against women.

Critical chapters and provisions in the Cairo Program of Action called for a comprehensive concept of reproductive health; improved family planning; maternal health and child survival; and prevention and management of AIDS and other sexually transmitted diseases. In each of these areas, USAID is seeking to be at the cutting edge. That means, to mention just a few things,

-- expanded efforts to ensure family planning that is high quality, responsive to choice, and widely accessible;

-- a comprehensive new initiative for adolescent reproductive health;

-- new efforts to attack the causes of preventable maternal mortality, which include unsafe abortion and lack of basic services to provide emergency care for women with pregnancy-related complications or to provide them with compassionate counseling and family planning services if they so desire;

-- biomedical research to find new technologies to prevent both unwanted pregnancy and sexually transmitted diseases;

-- other kinds of research and demonstration programs to test innovative approaches to delivering reproductive health services; and

-- initiatives to increase awareness of population/environment relationships and to link population and reproductive health programs with environmental management at all levels.

In all of our new initiatives, USAID is seeking to collaborate with a range of governmental and nongovernmental organizations, including many that are represented here today. We know we can't do these things alone. I have just recently come from meetings with other donors in Europe. It is encouraging to find the degree to which our commitments are shared by major donor governments such as the UK, Germany, and Japan, each of whom has made substantial increases in the resources they are providing to implement the Cairo Program of Action. Other stalwarts, such as Norway, Sweden, Denmark, and the Netherlands, will continue to play an important role. France has committed itself to increase its contributions to programs to combat AIDS. All of these donors have far to go, however, in developing their own capacity to manage larger programs, and a number of other donors have yet to increase their commitments at all. While there are many dimensions of Cairo follow-up, these recent encounters have convinced me that the effective engagement of other donors is one of the biggest challenges we have and should continue to be a high priority.

I hope all of you can help convey to the American people the two points I've emphasized today: that foreign assistance works and that it is in this nation's best interests. I hope you can also help extend a similar message to your contacts and colleagues in other countries.

In our discussions today, we will be drawing the connections between the domestic and international sides of the Cairo agenda. These connections are important to USAID. For one thing, as USAID has been seeking to demonstrate in a special series of programs in cities around the country, called "Lessons Without Borders," we have found that many experiences gained in development work abroad can readily be applied here at home. It is also important for us to try to get things right here at home -- whether the issue is our environment and patterns of consumption, equal opportunities for women, reproductive health, or any other aspect of our own development as a society -- if we want to be fully effective overseas.

We have much to discuss in our sessions today, and we certainly won't be able to resolve the challenging issues of giving reality to the recommendations from Cairo. But let's make it a good beginning.

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