The 1994 International Conference on Population and Development (ICPD) embraced a new concept for global population and development initiatives. After much lively debate, delegates from 179 nations achieved consensus on a new approach--a new paradigm. It became clear in Cairo that a new approach was needed, one that recognizes that human needs and aspirations are an integral part of the choices we make to attack rapid population growth, poverty, and environmental degradation. More holistic approaches are needed, ones that treat people--especially women--not only as receptors of family planning, but as directors of their own reproductive decisions, empowering and enabling them to improve their lives and health.

The new paradigm emphasizes public health, education, and empowerment as the key elements of human development in contrast to a more simplistic effort to promote and distribute contraceptive commodities and to target reproductive decision-making alone. The conferees recognized that smaller families and slower population growth depend not so much on "control" but on free choice--an idea borne out by thirty years of experience that most women, given the power to choose, and the means to act on their decisions will have fewer children than their forebears did.

However, as is always the case, a consensus is not the same thing as unanimous agreement. When the subject is freedom for women to make their own reproductive choices, there are those who oppose that right and those who do not trust women and their families to "do the right thing." At the recent Hague Forum, we once again heard staunch opposition to sexuality education, and to reproductive self-determination for teens and young adults.

In the last few years, a so-called "parental rights" movement has worked to undermine sexuality education and deprive young people of information about and access to sexual and reproductive health services. Sometimes focused on condom access and sexuality education in schools, a well-organized force has often stymied efforts to provide honest information and blocked skill-building approaches that would serve teens well. At The Hague, we witnessed a new spin on an old argument. Opponents seem to have dropped "parental rights," replacing it with a new term, "family involvement." While all of us would like to see families support the choices that women and young make, that support must be voluntary--not mandated. The realities of individual lives do not lend themselves to the legislation of morality.

Although the Programme of Action does not address access to abortion where it is illegal, it does call for medically sound practices where it is legal, and for assistance to women who have been injured while seeking illegal abortions. As we all know, the unrelenting anti-choice forces continue to undermine abortion rights wherever they exist. At The Hague, we witnessed a effort to depict emergency contraception as abortion, and to suggest that maternal mortality is not reduced when safe, legal abortion is made available. Although these claims are patently absurd, I do not believe that we have heard the last of them.

At The Hague Forum there was general agreement that the HIV pandemic was underestimated at Cairo. If we are to overcome AIDS and other sexually transmitted diseases, we must continue to fight for honest and effective educational programs, and access to services for the young.

Those of us in the United States have a special responsibility to set an example of common sense and leadership. Tragically, the United Nations is a favorite target for energized right wing forces, whose intellectual contribution to the debate consists of not paying our dues and backing down on our global commitments.

In his recent announcement that he would campaign for the White House, Nixon appointee and TV pundit, Patrick Buchanan referred to the United Nations as "the carpenters of the New World Order." Inveighing against economic globalism, immigration, affirmative action, and abortion, and calling for the return of "moral leadership," Buchanan said, "America is not some polyglot boarding house for the world; this land is our land, this home is our home."

While it may be easy to disregard Mr. Buchanan's weak attempt to construct a populist platform, the fact is that many Americans believe that we are too involved in global issues. Many believe, for example, that the U.S. budget currently contains ten times the amount actually allocated to foreign aid. When polled, a majority believe that foreign aid is more than 10 percent, and when asked what it should be, the consensus is 4-5 percent. In fact it is less than 1 percent!

The good news is that the Cairo principles remain sound and the Programme of Action continues to provide a practical road map for all who labor to improve the health and welfare of women and families, foster economic development, reduce population growth, and protect the fragile ecology of our planet.

Clearly, there is a great longing in the world for progress on these issues. Since Cairo the human rights movement has gathered force, as can be seen in the plans of action that were formulated at the 1995 World Summit for Social Development; at the 1995 Fourth World Conference on Women; at the 1996 Second United Nations Conference on Human Settlements; and at the 1996 World Food Summit. At all of these meetings, there was growing awareness that our world is becoming ever more interdependent. Global trade and commerce have increasingly linked economic systems, and interactive communication systems are making possible new levels of understanding and partnerships. The international movement to foster human development is a bright new trend and a very hopeful development.

Those of us in the population and development community can be proud of our accomplishments and continue our work secure in the knowledge that the Cairo consensus is working and will ultimately prevail.