Shifting Attitudes in a Changing World

▪ 1998

by Gro Harlem Brundtland Gro Harlem Brundtland is a physician who left medicine to launch a career in politics. During the time she served as prime minister of Norway (February-October 1981, 1986-89, and 1990-96), she was the dominant figure in domestic politics. She is a tireless crusader for such issues as preventive medicine, the environment, and school health. She served as chair of the 1987 UN World Commission on Environment and Development and has been the recipient of numerous awards, including the 1989 Third World Prize for Work on Environmental Issues, the 1990 Indira Gandhi Prize, and the 1992 Onassis Foundation Award. She is currently working on her memoirs.

      It was once said that "almost everything in history almost never happened"—a feeling, perhaps, that many of us have had about our own lives. When we look back, we often find an awkward chain of events that escapes logic, and only by willful disregard of such complicating factors as facts will we succeed in finding anything resembling a pattern or a plan guiding us. In westernized societies, rife with information, it has become increasingly difficult to define and describe the time in which we live. We cannot possibly relate to all of the information competing for our attention, claiming to be relevant, important, and even essential. To the question, "What happened yesterday?" there would be millions of different answers.

      Having spent more than 20 years in public life, 10 of them as prime minister of Norway, I have often been called upon both to pinpoint the challenges we as a society face and to provide solutions for the best ways of tackling them. These occasions have often vied for attention with other events. There is a reason why politicians do not address the nation on the day that those in the Christian world celebrate Christmas or why American politicians do not try to compete for attention with the Super Bowl, the championship game in football. There has to be space for political messages, and there is a time and a place for everything.

      During my formative years, I was accustomed to an orderly progression of events, when topics under discussion seemed much more predictable. That was several decades ago, and the discussion among family, friends, fellow students, and colleagues would be the day's most topical issues—the headline news. At that time the perception was that everyone more or less talked about the same issues. In addition, the media covered the same events, and often the news was shared worldwide. During the 1962 Cuban missile crisis, the 1967 and 1973 Middle East crises, and the frostiest years of the Cold War, eyes and ears were on alert whenever a newspaper headline was viewed or a radio heard. As the old East-West divide largely crumbled, so did the parts of the framework that defined our lives. The welcoming of formerly communist countries seeking membership in NATO and the European Union has become less astonishing, with each step toward integration no longer necessarily a headline news item. Nowadays, international politics seems to attract less serious and sustained attention. Instead, the larger parts of populations concentrate on such events as the Olympic Games, the Super Bowl, or the World Cup in football (soccer). This phenomenon is not limited to the West, however; the British soccer team Manchester United has been virtually adopted as the home team of Singapore. In addition, more countries are establishing sports teams. Although there is nothing inherently wrong with this new focus, it has resulted in a fragmentation of the world's attention.

      This was never truer than in 1997, when the rapid growth of the information industry and the number of Internet connections and E-mail subscriptions all provided us with a 24-hour-a-day avalanche of views and news, and the commercial part of that flow and overflow was growing, inspired and financed by global sales of products. As a result of this information overload, threats to the environment and public health were now perceived as common and not important enough to generate action on the national level. Threats to the environment no longer gathered the widespread attention that prompted proposals for policy changes that would enjoy sustained support over a long period of time.

      Changes in our immediate physical environment were increasingly driven by anonymous processes. "In my next life I want to be the stock market," quipped James Carville, the prime strategist of U.S. Pres. Bill Clinton's 1992 election campaign. We can find people to blame for the smaller accidents and even the somewhat larger accidents, but no one seems to take responsibility for the increasingly more complex forces that gradually change the configuration of our natural surroundings.

      The year 1997 marked the 10th anniversary of the independent commission that I had been called upon to lead—the UN World Commission on Environment and Development, which had released the report "Our Common Future"; the fifth anniversary of the 1992 UN "Earth Summit" in Rio de Janeiro; and the summer that the UN again took stock of world developments. The latter meeting went largely unnoticed, compared with the widespread public attention devoted to the December 1997 conference of the UN Framework Convention on Climate Change in Kyoto, Japan.

      At the Kyoto conference on global warming, it became abundantly clear how complex it has become to work out international agreements relating to the environment because of the economic concerns unique to each country. It is no longer enough to try to prohibit certain activities or to reduce emissions of certain substances. The global challenges of the interlink between the environment and development increasingly bring us to the core of the economic life of states. During the late 1980s we were able, through international agreements, to make deep cuts in emissions harmful to the ozone layer. These reductions were made possible because substitutions had been found for many of the harmful chemicals and, more important, because the harmful substances could be replaced without negative effects on employment and the economies of states.

      Drawing up solutions to environmental problems has become ever more difficult because of the way that everything is connected—investment with employment and fiscal measures with wages. The globalized economy means that even measures applied to one sector in one country could affect global competition. This complexity has also posed a challenge to the way we cooperate internationally.

      Although the threat of global warming has been known to the world for decades and all countries and leaders agree that we need to deal with the problem, we also know that the effects of measures, especially harsh measures taken in some countries, would be nullified if other countries pursued laissez-faire policies. That is the intrinsic nature of global warming. We find ourselves in a prisoner's dilemma. In essence, as demonstrated at Kyoto, the issue of global warming challenges how our political systems work. The foremost challenge for democracies is to gather support for policies that might require immediate sacrifices in order to avoid negative effects for future generations.

      Whereas the UN panel on climate change has found that the emissions of carbon dioxide would have to be cut globally by 60% to stabilize the content of CO₂ in the atmosphere, this path is not feasible for several reasons. Such deep cuts would, in the short-term perspective, cause a breakdown of the world economy. Important and populous low- or medium-income countries are not yet willing to undertake legal commitments about their energy uses. In addition, the state of world technology would not yet permit us to make such a quantum leap.

      We must, however, approach a sustainable energy use and find a solution to the threat of global warming early in the 21st century. Such a commitment would require a degree of shared vision and common responsibilities new to humanity. Success lies in the force of imaginations, among those who can forcefully reject the notion of benign neglect by envisioning what would happen if we fail to act. Although many would welcome the global-warming effect of a warmer summer, few would cheer the arrival of the resultant tropical diseases, especially where there had been none.

      The positive news is that societies have managed to handle and even eliminate a series of grave threats to the human environment and human health. With that perspective, we must conclude that the 20th century has seen enormous gains in human progress, particularly when we look at the combined effect of increased educational opportunities and improved health care, hygiene, and sanitation. As we approach the millennium, we are likely to hear doomsday prophesies about how low we as a species have plunged and why the present is an uncomfortable time in which to live. Although there are hundreds of millions of poor and unfortunate people in all countries of the world, the overall global trend is one of immense human progress.

      Those who have shown special interest in the environment have for a long time encountered a low level of concern among the general public. This malaise changed about 1987—the year that the Earth was voted Planet of the Year and was featured on the front page of Time magazine. During the late 1980s and early '90s, it seemed possible to gather high-profile attention to such long-term and complex issues as global warming, desertification, the vanishing rain forests, and the exponential growth of megacities.

      The Rio "Earth Summit" was the first to be broadcast live on CNN; other networks and media also devoted widespread coverage to the event. Many perceived a growing public awareness and held higher hopes that it would be possible to explain complex issues, gather political support for long-term goals, and implement internationally agreed-upon measures that would be viewed by the public at large as short-term sacrifices. Many single issues gained symbolic effect and brought many people in contact with the environmental movement. The spotted owl controversy in the U.S. was one such issue that led to heated debate between logging interests and biodiversity groups. Thereafter, public interest seemed to fade.

      Unfortunately, catastrophes have frequently catapulted the environment to the centre of world attention, notably the 1978 Amoco Cadiz and 1989 Exxon Valdez oil spills and the chemical tragedies in Bhopal, India (the 1984 leakage of methyl isocyanate from a pesticide plant), and Schweizerhalle, Switz. (the 1986 explosion and fire at the Sandoz AG chemical warehouse), which had disastrous effects and led to serious legal consequences. The 1986 accident at the Chernobyl nuclear power station in the Soviet Union—the gravest of all these industrial calamities—probably contributed significantly to the collapse of the Soviet political system.

      Fortunately, there were few such industrial accidents in 1997—ones that could be traced to imperfections in the development or neglect in the use of technology. A hallmark of the year was, in a sense, what did not happen, and this was a graphic illustration of the present state of development, more so than any actual and highly visible negative event. Although the great forest fires in Indonesia, where burning is an accepted practice for clearing land, attracted worldwide attention and worry, they seemed to be atypical of the problems of our time.

      More important, in the future how will public issues be able to compete for attention with the private sector? Perhaps on the basis of quality. Let us hope that there is a limit to what the average person would like to know about blue jeans or a new face cream. The position of news networks to provide increased coverage of public issues offers some hope in sustaining the public interest in them.

      A decade earlier the word solidarity was avoided by Scandinavians traveling in other industrialized countries because they feared that it might sound like a word with communist overtones and thus offend people. Solidarity in present-day terms means that we all stand to gain if societies are able to harness the collective resources of people regardless of economic position, family background, gender, or race. In addition, by pursuing the common interest, we often also pursue our own self-interest. Solidarity implies reciprocity; during some phases in our life, we might be in need of help and support, whereas at other times we might be in a position to offer support and help to others.

      Solidarity—with the present and with future generations—is at the very core of the concept of sustainable development. We must meet the needs of our own generation without compromising the ability of future generations to meet theirs. We must consider our planet to be on loan from our successors rather than being a gift from our predecessors.

      When David Halberstam wrote The Best and the Brightest in the 1970s, the group described by the title sought to serve in the public sector or in public office attained by election or appointment. During my December 1997 visit to the United States, I was astonished to hear that by a large majority the best and brightest of today were aiming to join the private sector to make individual fortunes. Besides the possibility of wealth, why has there been such a dramatic change? Is there perhaps a sense that many of the public challenges have been resolved? If so, why is the present perceived in this way?

      Never before in history have so many enjoyed such a high standard of living. In addition, general health has improved dramatically, especially in less-developed countries, where in the past 30 years life expectancy has increased by more than one-third and the infant mortality rate has been reduced by more than one-half.

      We have forgotten about the terrible living conditions of a majority of people at the dawn of the 20th century, especially in those cities and countries that today are known for their riches and splendour. Terrible diseases, hunger, and malnutrition blighted countries that are now finding overweight and high cholesterol to be their major health problems.

      What then, besides environmental issues, are the main challenges we face today? On a global scale, underdevelopment, poverty, and health care capture centre stage. The vast majority of human suffering and premature death in the world is poverty-related; the cure is economic and social development.

      Increased globalization has provided new opportunities for growth and progress but at the same time has posed new threats to public health. While the scourge of illegal drugs has been spreading worldwide, new infectious diseases are emerging—among them Ebola hemorrhagic fever, hantavirus, and in late December 1997 bird-to-human influenza in China—and such old diseases as cholera, anthrax, plague, and dengue, once apparently eliminated, have reemerged. In our global society there is no health sanctuary. Solutions, like the problems, have to be global in scope.

      Another primary goal is to make costly treatment available on an equitable basis. There are always people who can pay their way and people who cannot. We are in deep trouble if health is increasingly viewed as a benefit for the rich and unnecessary for the needy.

      The issue of AIDS is particularly relevant. Its prevalence in some parts of Africa is astounding. While traveling through several African countries in October, I was updated on the newest data on the prognosis of that pandemic. The costs and availability of medicines, however, can make AIDS treatment affordable only to the wealthy.

      We must be conscious of the dangers that threaten to widen the health gaps that already exist between the rich and the poor, males and females, and the educated and the uneducated. UN statistics reveal that in some regions of the world, boys receive more calories and vitamins than girls and fewer girls than boys live past adolescence. The education columns of these statistical compendiums reveal that fewer girls than boys enroll in secondary schools and that this gap has increased by graduation. The narrowing of gaps—within as well as between countries—must be our goal.

      The 20th century has been called the century of extremes, one in which human vices reached unfathomable depths—the century of dictators and torture, the Holocaust, ethnic cleansing in Bosnia and Herzegovina, and the bombings of Pearl Harbor and Hiroshima. It was, however, also a century of great progress. Many countries experienced unprecedented economic growth. In the West population growth was stabilized, which allowed social and educational systems to accommodate demands. The situation, however, was different in the countries where population growth exceeded 3% and where it was difficult to see how a cycle of declining living standards and deteriorating environments could be averted.

      Poverty, population growth, inadequate development of human resources, and insufficient public services were linked to a vicious circle in too many parts of the world. Regardless of social and economic conditions, health care for all should be available and affordable. There are no insurmountable obstacles to establishing acceptable standards throughout the world. The obstacles are located in the minds of those people who have the power to set new priorities but fail to do so and the people who can influence national budgets but shirk their duties to humankind.

      During the 1990s a number of UN conferences and other international meetings addressed the environment, health, population, women, and development. These events reinforced the notion that many of our health problems are global in nature and closely linked to the economy and the environment. Such concerns, therefore, can be overcome only by intensified global cooperation and by strong, efficient, and forward-looking international institutions underpinning our common efforts.

      By the turn of the century, almost one-half of humanity will live in urban areas. A failure to manage the urban infrastructure will lead to further mushrooming of settlements having insufficient access to essential facilities such as clean water, sanitation, food supplies, transportation, education, health care, and other public services. We know what that means: overcrowding and a disease pattern linked to poverty and an unhealthy environment.

      The scale and scope of these health care challenges call for societal management and a change to an extremely sophisticated and forward-looking manner. Analyses across sectors are called for—and public health must be the basis for our thinking. The costs of making the wrong decisions or of not making any decisions, with the hope that the invisible hand will straighten things out, will be enormous. Presently, in all countries, successful public-health management is perhaps the most rewarding business.

      Think of it. The greatest profits to society will not come from playing the stock market or downsizing the microchip. The greater good is in devising optimal solutions to problems plaguing the environment, public health, and education and in harnessing the very best of human energies.

      The statement that 1997 was a year of progress might be perceived as an affront to the person who lost his or her job or who suffered for another reason, but humankind made some headway during the year—at least in education. It will never make the headlines that more millions of children went to school this morning than in 1996—but it is the most important thing that happened today.

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