WASHINGTON, June 2 — The following is a transcript of the keynote address given by Nils Daulaire, M.D., M.P.H., president and CEO of the Global Health Council, at the organization’s 31st annual international conference, “Youth and Health: Generation on the Edge.” Today a billion young people – the largest generation in history – are preparing to make their leap into adulthood, with another billion right behind them. Our proceedings over the next three days will explore some of their health risks – and what together we can do about them. This conference is about our common future. Too often, youth are defined in terms of the problems they face rather than by their strengths and the opportunities for change and advancement they represent. They are in fact the best available resource we have to address the most significant challenges we face as a globe.
Let’s face it: they are not exactly getting a finished product. Their challenge is to make this world better, more just and healthier. And for anyone who is prepared to listen, young people provide pretty clear guidance on what it is they need from the rest of us to make that happen.
- First, they want and need durable links with trusting and trusted adults;
- Second, they want to be heard, appreciated and engaged rather than just lectured to;
- Third, they need information about the major risks and opportunities they are facing, and the skills to navigate them;
- Fourth, they need friendly access to the best educational, vocational and health services their respective societies and communities can provide;
- Fifth, they need safe and secure environments in which they can develop their skills and their livelihoods, build their relationships, and have some fun in the process;
- And finally, they want it straight — without the double- talk. They question the obvious – the assumptions we take for granted. They inspire the rest of us to face our own challenges with our heads up – with courage and integrity, and without hypocrisy.
Which brings me to the part of my welcoming remarks that I wish was not necessary. But I would be derelict in my responsibilities as President of your Council if I did not address the issue most of you are aware of, the recent withdrawal of support for this conference by the CDC, the U.S. Department of Health and Human Services and the Agency for International Development. Most of you are also aware that this marks the first time in 30 years that the U.S. government is not among the conference’s sponsors. It is important for us to put this change in its appropriate context – straight, without the double talk. For 30 years, countless public health scientists and development professionals from the U. S. government’s technical agencies have been an important part of the Council’s efforts. While we are happy to see some old friends in our midst, we miss our colleagues’ wholehearted presence here today, and look forward to their renewed, full participation sometime very soon.
What could separate our fellow health professionals from the work and ideals of this conference? Certainly not doubts about whether young people are important. And certainly not the science of health and what really works to fight disease and improve their lives. No, it is the politics of health — or more correctly, the exploitation of sensitive global health issues for domestic political purposes – that has kept them away. Let me be clear: the people who have driven a wedge between U.S. public health officials and their colleagues at this conference are not concerned with solving worldwide health threats. Their concerns are elsewhere.
Recently, a million women and men marched in this city to support reproductive rights; some of our members were among the marchers. Their highly visible, election-year protest no doubt troubled many Americans with different views; some of our members were among those who were troubled. That is understandable – and it is not a new issue for any of us.
What was new was the way a small clique of right-wing extremists went about finding a headline-grabbing way to strike back – by attacking HHS and USAID for participating in this international conference. Not one person in that clique has ever spent a day in clinic in a developing country. Or an hour at this conference – face to face with anyone of you – to understand the service you give daily to those in need. And they have clearly never spent a minute reflecting on the global cost in human lives that might result from acting out their Washington-centric political games.
No, these extremists limited their research to finding – on our preliminary conference program – two organizations they consider objectionable because they will not bow to their hard-line anti- abortion positions. The wide-ranging work of IPPF and UNFPA includes programs that are, from a public-health services standpoint, well worth sharing and discussing. They belong in this conference. But this clique condemns these organizations because one has not been willing to agree to the so-called Mexico City Policy – also known as the Global Gag Rule – and the other continues to work with humane health programs in China, despite the Chinese government’s lamentable policies. These extremists deliberately distorted the realities of these organizations’ participation at this conference, and cited another that is not even still on the program, in order to give their attacks news-making potency. They were not interested in the facts then, and after their stories surfaced and we sought to correct their misimpressions, they just shouted all the louder.
They did not want the facts. They wanted a weapon – a wedge.
Like extremists everywhere, they wanted to remove any possibility of a moderate middle ground. They wanted to disrupt the civil dialogue required for real understanding, which often results in thoughtful compromise. They wanted to discredit those who champion openness, because fair and thoughtful debate threatens their intention to separate reproductive health out from the rest of the global health agenda. And we will not let that happen. As if we could responsibly discuss youth without including reproductive health.
For a health professional, this is outrageous. But we should not be surprised — because that’s what extremists do.
What was surprising — and deeply disappointing — was that our government’s health-policy leaders did not respond with the truth. After all, the leaders of HHS, CDC and USAID are not strangers to this conference. Three years ago, the Secretary of HHS addressed us and participated in our dialogue on women’s health around the world. He was greeted with respect and his words were listened to. Two years ago, the Administrator of USAID shared with us his agency’s work in addressing humanitarian and political crises. He was greeted with respect and his words were listened to. Last year, the Director of CDC came here as we were discussing environmental change and talked about the SARS outbreak that was then raging. She was greeted with respect and her words were listened to.
As has been the practice of this conference for 30 years, we listened, we engaged, we learned, and we shared — in order to improve health. Yet, when their agencies’ participation in this conference was attacked by these extremists, two government agencies and the premier public health institution in the country – perhaps the world – quickly bowed to election-year political pressure. They sacrificed the principles of participation and respectful dialogue to spurious allegations. In doing so, they gave strength to those who would divide us, and they undercut the Global Health Council’s long tradition of openness, inclusiveness and service. They ignored the evidence and their own experience, and they bolted.
Just yesterday, half a mile from here, President Bush said that it is wrong to exclude somebody “simply because they don’t share a certain faith.” I could not agree more. But what then is this all about if not about sharing a certain faith – a faith in evidence and the free exchange of ideas? This is deeply uncomfortable. The Council and our members hold the history and the contributions of these agencies in high regard. But we have a responsibility to stand up and challenge those who hold positions of public trust when they are wrong – and on this, they are wrong. And challenge them we will, not because of our one conference, but because of who might be next. In the end, the great difference between youth and age is youth’s disinterest in hearing what can’t be done, what ought not to even be attempted, what is too idealistic to expect of reality, what ought not even be dreamed. That is something we can all use as our model, for the next three days, and for the rest of our lives.
It is not too much to ask that those to whom public trust has been given adhere to facts and to principle – to stand up for what’s right – to defend the people who are at risk when ideologues play politics with health policy. It’s not too much to ask. We all know that human beings sometimes fall short – that politics is messy – but there are times when nothing but principle will do, when too many compromises and capitulations threaten to destroy the integrity of the process irrevocably. Then principles are revealed as the essential underpinnings of government, of society, of our lives together – and the lack of principles as the beginning of a slippery slope to a world none of us would wish our children to live in. It is time to say to those who would stifle debate and dialogue, and to those in power who would allow them to prevail: have you no shame?
This is not a game for us as it is for those whose lives are politics. We are at a disadvantage when it comes to dealing with extremists – we are not in the mudslinging business. By training and avocation, we are public health scientists for whom the facts and the diversity of ideas have never been expendable commodities.
We are in the caring business — the global health business. The business of understanding disease and its determinants, and helping to lay out the responses that actually work in the field. We have important work to do. The Global Health Council’s more than 300 institutional members, our professional members from over 100 countries, and the more than 1500 practitioners and students who are here this week, are no strangers to adversity. We would meet in a tent if we needed to. We will bring together different views and perspectives of all those with experiences and viewpoints to share. We will include all who care to engage and to help, whatever their political and religious views; there is no litmus test for membership in our mission. We will find the common ground on which we can move forward — to address the needs of those whose very lives depend on our passion and our integrity. On some things, we will agree to disagree.
We will reflect on what we know, what we only seem to know and what we desperately still need to know. We will do our best to be what our young people need us to be. And in the end, we will go wherever the evidence takes us — as uncomfortable at times as that may be. That is what the Council has done for the last 30 years. What we will do for the next 30 years. We will not be deterred, and we will not be gagged.