Speeches and Articles
The U.S. and the World Environment and Health
Remarks by Ambassador Daniel V. Speckhard
Hellenic-American Medical Society
February 25, 2008
(As delivered.)
I am honored tonight to be able to talk to a very distinguished audience about improvements in the health care and environment sectors. I think we put the two together in this talk because they go together in such an important way that you can not actually separate them in terms of their effects on prosperity and the welfare of people.
You perhaps also several weeks ago saw President Bush's remarks in the State of the Union address on both of these as well as many other issues. And more importantly, regardless of what country you come from and what nationality you come from both health and treatment require a constant dialogue discussion and a cooperation between us all if we hope to meet these challenges.
As Americans and as Greeks, we may have very different personal points of views of reference as we think about our relationship to each other and to the rest of the world -- both about the bright, positive face of globalization as well as the more dark and dangerous aspects.
One constant between nations such as ours, has been our ability to come together in the face of adversity – be it following the attacks of 9/11 or working together following this summer's wildfires in the Peloponnese. While we continue our debates on how best to solve political challenges, we won't lose sight of the fundamental values and interests we Americans and Greeks have in common. With this in mind, let me offer two broad topics for discussion this afternoon: First - our efforts to address global health concerns, and second - what we are doing about the environment.
A Shrinking Globe Brings New Health Challenges
In the 1880s, widespread epidemics began first in Europe, then in the United States. In fact, within thirty years, much of the world had become witnesses to the effects of various Polio epidemics. As you well know, these epidemics left scores of victims tragically paralyzed. Another result of the epidemics however was the “great race” – the concerted effort of researchers to search for a vaccine. While questions of global eradication linger, no one can argue the positive impact of those who diligently sought to gain the upper hand on diseases such as Polio and Small Pox. And I am in awe tonight as many of you are the ones who are finding vaccines and cures for many of the world’s diseases.
I think it is fair to say that Americans, Greeks, Asians, Africans, and indeed everyone alive on the planet today is acutely aware that we live in a time when things that happen elsewhere in the world can affect us very directly. Distance and time have been narrowed so that, for the very first time in the human experience, global forces have linked the fate of all people in all countries.
Today we continue to face challenges that require the same determination and motivation of the “great race” – and, indeed they require political and public support if we hope to have similar success. In the medical field alone HIV/AIDs, Tuberculosis, and Avian and Pandemic Influenza pose as threats both to the health of individuals and to the stability of regions. In each of these examples, and in others, the global community shares the responsibility in preparation and protection from future epidemics. This responsibility comes in the form of dialogue, research, education and, of course, funding.
HIV/AIDs
A discussion about global health concerns must begin with HIV/AIDs. Effective prevention is a prerequisite to significant progress against HIV/AIDS; if the number of people newly infected continues to increase, the growing number of people in need of treatment and care - and the growing number of orphans and vulnerable children - will overwhelm the world's ability to respond and to sustain its response.
The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and this program supports the most comprehensive, evidence-based prevention program in the world, targeting interventions based on the specific challenges of each country. PEPFAR supports prevention activities that focus on sexual transmission, mother-to-child transmission, the transmission of HIV through unsafe blood and medical injections, and greater HIV awareness through counseling and testing. The plan is the largest commitment ever, by any nation, for an international health initiative dedicated to a single disease. This program PEPFAR has aided in the prevention of mother-to-child HIV transmission services for women during for more than 10 million pregnancies in 15 focus countries. It has helped provide life-saving antiretroviral treatment for approximately 1.5 million, women and children globally and provided care for more than 6.6 million, including more than 2.7 million vulnerable children as of September 2007. The U.S. Government’s commitment to this plan was recently solidified as a five year, 30 Billion dollar pledge, as the President announced during the State of the Union address. This program and the continued support of other nations is of vital importance in the fight against HIV/AIDs.
I mention this in part, because what I want to talk a little bit about these problems in the context of what I know about the United States and about the administration. Perception creates a lack of focus on some of these issues. and neither the international press nor the Greek press give coverage to the emphasis in the United States on global health and the environment
So I want to give you some details and facts to go along with my rhetoric so that you get the sense that there is a lot behind what I am saying.
Tuberculosis
The challenge with HIV/AIDs, however is far reaching. The number one killer of HIV-infected people is Tuberculosis. According to the World Health Organization, over one third of the world’s population has been exposed to TB, with the rate of new infections occurring at one per second. As with many health concerns, unfortunately many people brush off these figures and attribute them to “only being in the developing world.” This is not the case. In fact, the rate of TB worsened in the previous decade in 18 of the 26 countries in Eastern Europe, according to the W.H.O. In many parts of the world, complacency and poor adherence to accepted TB control practices have created high levels of multi-drug resistant (MDR) and extensively drug resistant (XDR) strains of the disease. Faced with this health threat, in October 2007 the 53 member-states of the World Health Organization’s European Region signed the Berlin Declaration on Tuberculosis. This declaration commits signatories to strengthen political will, civil society involvement and public health systems to combat this disease.
TB has been, and will continue to be, an area of increasingly high priority. U.S. support for TB and TB/HIV initiatives now support care for over 300,000 co-infected people. Amidst the growing concern of drug-resistant strains of TB, especially affecting people who are HIV-positive, it is important that we all continue to working closely together, on domestic, bilateral and multinational initiatives focused on a concerted response to TB. These efforts should strengthen laboratory systems, establish infection-control measures, and expand programs to prevent, diagnose, and manage drug-resistant TB.
Avian and Pandemic Influenza
Another issue of which you all are well aware, is that of the threat of Avian and Pandemic Influenza (API). API is a high probability, high impact event the likelihood of more, not less, common over time. Highly infectious avian influenza has now broken out in 60 nations, and since 2003 more than 300 million poultry have died or been culled. Of the 334 laboratory-confirmed human cases of avian influenza, 205 people have died, a mortality rate of 61 percent.
According to one World Health Organization estimate, a global human pandemic could result in close to 10 million deaths worldwide and staggering economic losses.
Bringing these figures closer to home - Europe's first outbreak of the highly pathogenic avian influenza H5N1 virus in birds occurred in July 2005. Since then, outbreaks of H5N1 have affected wild birds, backyard domestic and commercially raised poultry in more than 20 countries in the region. As you are sure to remember, in the winter of 2005-2006, Turkey saw twelve confirmed cases and four deaths due to H5N1. During that same period, Greece confirmed 33 cases of H5N1 in migratory birds, and individuals with flu-like symptoms arrived at hospitals throughout Greece. The Greek Ministries of Agriculture, Health, Interior, and Rural Development worked well together and with provincial and local authorities to inform and educate the public. Specific initiatives, such as mass feeding along shorelines and wetland areas to keep migratory flocks from areas with higher population density, and engaging local school systems in a grassroots education and warning campaign, were utilized.
As time passes without new cases of H5N1 in Greece, our combined task is to remain vigilant and proactive against the possibility of future outbreaks. In 2005, President Bush announced the creation of the International Partnership on Avian and Pandemic Influenza. With this Partnership, the USG assumed a global leadership role in the effort to combat the spread of API. The global community has responded well, with many continuing to work together on this threat, most recently in the form of the sixth major international conference, in New Delhi in 2007, where representatives of 111 countries and 29 international organizations met to discuss the issues.
With the total USG funding at $629 million dollars for international efforts, we continue to look for others to help us lead the international community. At the conference in New Delhi, only eight nations and the European Community came forward with new pledges for support. We were pleased that the Greek Government was one of those marking its commitment to this cause by pledging funds.
The USG seeks to ensure continued worldwide action on the avian and pandemic influenza. Pledging money and attending conferences are essential steps to start with, however they cannot replace the need to build long-term capacity to deal with threats to both animal and human health from this and other infectious diseases. Continued efforts to improve communication and transparency in reporting outbreaks and in sharing samples for tracking changes in the virus are critical.
Climate Change
Let me turn now briefly to an equally pressing issue – the environment and its effect on climate change. I know your first thought is likely: What does climate change have to do with health? Well as I mentioned earlier it is an important connection that we talked about before. But, also, very likely, your second thought is simply surprise that I chose this example to highlight the U.S. commitment to international engagement in this area. I am well aware that many people are not aware of U.S efforts on the environment . I will ask you to humor me briefly – forget all that you have read or heard about the United States and the environment for just the next few minutes.
Allow me to offer you a fresh look, supported by facts, which gets us beyond old arguments and back to the root of our need to work together on this issue.
We often hear of the global impact of climate change regarding quality of life, but not as often about how it affects public health. Climate change reduces access to fresh water for drinking, sanitation and irrigation. Primary sources of drinking water around the world are rapidly disappearing. Precipitation patterns are changing and droughts are increasing both in duration and frequency. The change in temperature is affecting the habitats of animals and insects, to include disease carrying insects. The result is a relocation of these creatures increases the possibility of health catastrophes, as diseases are introduced into new regions.
I know that there is a widely-held perception in Europe and elsewhere that the U.S. government doesn't really care about climate change. Many people probably still think we have done little or nothing about it since 2001, when a decision was made not to sign the Kyoto Protocol.
These perceptions are wrong, and I want to explain why, in some detail.
The United States is deeply concerned about global warming, and we are doing something about it – nationally, and multilaterally. We are getting results in reducing our own emissions growth, on a par with what Europe and other developed countries are getting, and we have national plans in place to go further. In America, we are using a combination of mandates, incentives, public-private partnerships, and new technology to address climate change. Did you know that since 2001, the United States government has devoted $37 billion to the problem? That is more than any other country. This includes $18 billion to develop new clean technologies, and more than $2.5 billion to research and develop clean coal and even more to develop hydrogen as a source of clean energy.
U.S. government investment, however, is dwarfed by U.S. private sector investment. This is good news because the global economy dwarfs the capacity of any government to manage it. In fact, there is a huge second wave of U.S.-led investment in green technology that is larger, more sustainable, and more far-reaching than the first wave of the 1980s.
Speaking of green technology, you may be interested to know that one of the stars of the EU's "Sustainable Energy Week" activities in Brussels a few weeks ago was a company making an iconic American product right here in Greece: Coca-Cola. As you may know, on January 28, Coca-Cola Hellenic Bottling Company of Greece and another. firm, ContourGlobal, announced plans to reduce CO2 emissions by more than 20% across Hellenic Bottling's production facilities through the development of 15 energy efficient power plants to be in operation by the end of 2009.
As far as emissions - U.S. emissions actually declined in 2006 -- I will say that again – they declined in 2006, and we will continue to work seriously to reduce our "carbon intensity" going forward. In fact, the mandated targets set out in the 2007 U.S. energy law – a law just recently passed at the end of last year -- those targets, if reached, will be on a par with the emissions to be cut under the Kyoto Protocol, if the Kyoto Protocol goals are reached themselves.
So the results of American climate change initiatives have been good -- as good or better than in Europe,. The growth in U.S. emissions has slowed considerably since the 1990's. And between 2000 and 2005, the latest period for which we have comparable UN data, the U.S. and EU-25 experienced roughly the same rate of growth in emissions -- about 1.5 or 1.6 percent. So between 2000 and 2005, per year, the United States had roughly the same percent increase as EU nations. At the same time, however, the U.S. economy has grown by more than the size of Italy, and our population by more than the size of Greece. So there is dramatic growth right now in the U.S.
It is because of the future growth in emissions and largely in the developing world, that we are leading the effort to work with all the world’s largest economies – including major developing nations – to build a new, common framework for the period beyond 2012, through the UN. This is why when we joined the international consensus at the UN meeting in Bali, we insisted on an agreement that includes the developing world, especially China and India. Many of you may have begun to realize that the press did a very poor job in explaining to you what is going on in Bali. The U.S. is not going it alone. We were against, to the very last minute, any proposal to try to exempt China and India from requirements At this point, America and Europe just can't make any meaningful progress on climate change without China and India. The fact is, already this year or next year, China will surpass the United States in total CO2 emissions, and is doing so with a much faster rate of emission growth.
You may also be surprised to know that, according to current projections, while developing countries now account for 43% of CO2 emissions, by 2050 this figure will have increased to more than 60%. These are key reasons why, even if the United States and Europe stop all emissions growth, we won't succeed in solving this problem without China and India drastically reducing their emissions.
For the first time in these UN negotiations, the developing world agreed to consider "measurable, reportable, and verifiable" actions. Grand global targets, in our view, are simply not going to be enough. Far from working against the UN framework, the United States is making practical, realistic preparations for the 2009 talks in Copenhagen, including at the recent Major Economies Meeting (MEM) process in Hawaii. This process will continue to run concurrently with the U.N. process, to include the next Major Economies Meeting session, hosted by France later this spring.
We all care deeply about human development in the world – Jobs, education, health care, safety and security – general well-being. These things only come about through the healthy growth of modern economies. When we talk about “growth” in the developing world – we’re talking about bettering the lives of real people. It is the very act of powering a modern economy that produces greenhouse gases. We do not need to choose to forego economic growth that provides for human development and well-being in the world, in order to avoid producing more emissions. Nor do we need to choose to favor human development, by means of massive increases in greenhouse gases. We have to break the link between economic growth and greenhouse gas emissions. As our mutual efforts close in on this goal, we must continue to acknowledge and address the effects of climate change has already had on our environment. This includes special emphasis on minimizing the impacts it has had on disease and public health.
Conclusion: American Leadership and Alliances
In conclusion, let me reiterate that Americans today are well aware that many of the most important problems affecting our security and prosperity simply cannot be solved without robust international engagement -- through our bilateral ties as well as in regional and global institutions such as the European Union, and the United States, and the United Nations.
America is a diverse, de-centralized country. We pride ourselves on being a country of innovation - empowering those with the best ideas. We have our critics – but we also have an amazing record – ranging from conserving our wilderness areas and wetlands, fighting acid rain, and cleaning our waterways to tackling difficult and challenging health problems and diseases. As you watch our 2008 U.S. President elections with us here in Greece, I would ask you once again to keep an open mind about the kinds of solutions we can come up with, as democratic societies with so much in common, whether the problem is HIV/AIDs or global climate change, or one of a more local or regional focus.
With that, let me once again thank you for the opportunity to be here today.