Trusting in a better future: the global environment facility.

Individual countries acting alone cannot solve environmental problems that span national borders. The Global Environment Facility (GEF) was created in 1991 to serve as a mechanism for international cooperation in the funding of grants to address concerns in four areas of the global environment: biological diversity, climate change, international waters, and ozone layer depletion. To date, more than 500 projects have been funded with over $2 billion of GEF funds and another $5 billion leveraged from public and private sources, including $2 billion in matching funds from developing countries.

S @5 e* --6.6 S Spheres of Influence * Trusting in a Better Future has been allocated to more than 240 climate change projects, matched by more than $5 billion in cofinancing. From 1991 to mid-2000, she says, the GEF approved grants totaling $852 million for 82 energy efficiency and renewable energy projects in 49 countries.
Although only a few projects have been completed and results are difficult to quantify, it's clear that such projects often translate into indirect and unplanned benefits, especially if they fit a natural niche in the country's economic market. For example, in Costa Rica a wind energy system was funded and begun but has yet to be finished, says Alan Miller, the team leader for climate change and ozone at the GEF. "It wasn't a success in itself, but by bringing attention to the fact that Costa Rica was a good location for wind power, private companies came in and built several projects," he says. "This is exactly what the GEF is trying to do. It's a change agent that works to transform the market." Miller says that climate change programs are always framed around market questions while other project areas such as biodiversity have a harder time emphasizing markets. The political and economic complexity of each renewable project differs. Local market conditions and investments must be taken into consideration, which means that often the most efficient energy source may not be the one funded. For example, for electricity production in a developed country, the combined-cycle gas turbine is currently often the most efficient technology. A developing country would probably buy such equipment rather than develop an alternative technology such as solar thermal power plants that might be more suitable in the long term and encourage internal investment. Miller says making such project choices are difficult for the GEF, but that developing countries are facing difficult choices too about what their economies and infrastructures will look like in the future.
Miller stresses that the GEF is a small organization that does not execute or directly oversee the projects that it funds. Instead, the three implementing agencies perform those tasks and act as intermediaries between members of a project and the GEF. "We should be in the field more, observing and learning," he says, adding, "We are now in the process of building more trust between the agencies." Healthy Skepticism Although there are clearly environmental health effects from the global issues the GEF targets, there are no formal interlinkages between GEF projects and health issues. Nowhere in the treaties are health outcomes specifically discussed in depth, according to James Listorti, a public health specialist at the World Bank. "It's not in the mandate of the GEF," he says. He adds that all the stakeholders involved in the funding process have their own viewpoints, understandably, but none of them are specifically dedicated to health.
While at the GEF, Listorti investigated the environmental health dimensions of climate change and ozone depletion. He feels strongly that the seriousness of the indirect health effects of climate change and ozone depletion far outweighs that of the direct effects. Addressing the indirect health effects VOLUME 108 1 NUMBER 7 July 2000 * Environmental Health Perspectives A 318 Spheres of Influence * Trusting in a Better Future means focusing on water, sanitation, transportation, and housing and urban development. In addition to direct risks from storms and floods, changing climate also can be linked to the changing face of disease, with once-conquered diseases reestablishing themselves and new diseases emerging as a result of vector migration and other factors. According to Swift, this year the GEF has built alliances in the health community, including some with dermatologists and ophthalmologists to investigate human health problems associated with exposure to ultraviolet radiation as a result of ozone depletion. She adds that the facility is "increasingly emphasizing the connections between human health and persistent organic pollutants, which are being addressed in several new GEF projects." NGOs have a strong advisory role at the GEF, but do not have veto power over decisions. The GEF-NGO Network consists of approximately 400 NGOs and is currently administered and coordinated by Monitor International, an Annapolis, Maryland-based NGO focused on lake water quality. David Read Barker, the president of Monitor International, says that the network has two major goals: to influence the GEF to become more effective in achieving its goal of involving people to protect the environment as a means of improving their livelihood, and to monitor and evaluate GEF-funded projects while promoting public participation.
Although U.S. funding for environmental projects is frequently influenced by the politics ofWashington, DC, government agencies are generally supportive of the goals of the GEF. Thomas Laughlin, deputy director of international affairs at the National Oceanic and Atmospheric Administration, is the contact for international waters projects at the GEF. He says, "On balance, things are going well after a rocky start. The GEF has focused on the main problem areas and is taking an ecosystem[-style], integrated approach to very complex problems." That seems to be the general verdict, and one that a small and ambitious agent of change can grow with.

W. Conard Holton
Taking Protests to the Bank Downtown Washington, DC, may have been paralyzed last April by people protesting the International Monetary Fund (IMF) and the World Bank, but the organizations still held their spring meeting. The protests, organized by the umbrella organization Mobilization for Global Justice, drew perhaps 10,000 participants from over 100 organizations, who picketed with signs bearing slogans such as Defund the Fund, Break the Bank, and Dump the Debt. The protestors pronounced the IMF and the World Bank to be negligent in alleviating global poverty and promoting sustainable development, and accused the organizations of exacerbating social and environmental decline instead.
While the protestors outside the meeting argued that the means by which funds are disbursed to projects in developing countries hurt the poor because they come with so many strings attached, inside the meeting delegates from developing nations were worrying that IMF money could dry up. The shouts of the protestors may have helped to lead to measures approved at the meeting to streamline debt procedures and expedite debt relief for poor countries. The official communique issued at the end of the meeting acknowledged that the growing debate over the future of the IMF and the World Bank "reflects a concern that the benefits the world economy is deriving from freer trade and more integrated and deeper international capital markets are not reaching everyone." Although Global Environment Facility (GEF) projects are administered by the World Bank, the protests did not take aim at the GEF specifically. In fact, Soren Ambrose, a policy analyst with one of the protest groups, 50 Years Is Enough, said, "We're not focused on the GEF so there's really not much to say about it." David Read Barker, president of Monitor International, which coordinates nongovernmental organizations' interaction with the GEF, was disappointed in the protests. "We have an altogether different relationship with the World Bank and want to work closer with it," he said. "I was hoping the protestors could communicate [some important points], but it all seemed superficial and full of propaganda." -W.  (PCOS) is a common syndrome that accounts for over 70% of cases of anovulatory infertility. The prototypical clinical features are hyperandrogenism and chronic anovulation. Many women with PCOS are insulin resistant and at increased risk for type 2 diabetes. There may also be an increased risk of cardiovascular disease. The relationship of these metabolic effects to the etiology of PCOS is not defined. Familial clustering of cases suggests a genetic component but a clear mode of inheritance has not been delineated. There is probably also an environmental component to the initiation and/or progression of PCOS. Intervention strategies include manipulation of diet and lifestyle, treatment of hyperandrogenism and treatment of insulin resistance.
Session topics include: Historical perspective of PCOS, Epidemiology of PCOS, Reproductive abnormalities in PCOS, Diagnostic criteria for PCOS, Animal models of PCOs, Metabolic abnormalities and their relationship to PCOS, Genetics and environmental influences on PCOS, and intervention and prevention strategies.
For more information on the meeting, to present a poster, to apply for a young investigator travel award or to register for the meeting (no registration fee) send your name, affiliation, address, email address and phone number to: Jerry Heindel, (919)