is an awful lot of information available in this country, and we keep setting up one commission after another, to belabor the obvious facts, and we do not move from that point.

It is a convenient way to avoid doing anything about these issues. I am completely optimistic about this country, but I think it is time we contended with some of these issues, and there are plenty of good people, public and private, to do it.

Thank you.

Chairman GLENN. Thank you, Dr. Knowles. [Information referred to follows:]

INTERDEPENDENCE AND GLOBAL CRISES

(By John H. Knowles, M.D.)1

We live in the most perilous of times. The turbulence increases as we approach the last quarter of the century. The interdependence of all people and all nations finds us contending with the most complex global issues in the history of man: money, markets, and inflation; defense, deterrence, and detente; resources, raw materials, and energy; pollution, ecology, and weather modification; population and urban congestion; inequality, unemployment and increasing disparities in the distribution of income and wealth; famine prevention, poverty, and food production; genocide, discriminatory violence, and human degradation; drugs and terrorism; the world's annual arms expenditure of $250 billion; nuclear power; the oceans, and outer space.

Having somehow weathered the storms of Vietnam and Watergate, we are now reeling under the terror of double digit inflation, and we are desperately worried about the future of our energy supplies. Our role in world affairs seems to have shifted from being decisive to being crucial. The mass-media assault us on a daily basis with man's inhumanity to man. Will we go out with a whimper or a bang? Where is the promise of America? Shall we retreat, put our fingers in our ears, and duck, or shall we meet the complexities and great issues of the times with hope, energy, and optimism?

When I first arrived in New York in 1972, Nelson Rockefeller spoke to me of his plans to form a national commission which would examine the major national and international issues besetting our country. The idea was a natural outgrowth of work he had instituted with the New York State Legislature on the Role of a Modern State in a Changing World in 1972. In 1973, the President urged that the New York State study be enlarged to encompass a national commission-bipartisan and broadly representative. With the encouragement of the minority and majority leadership of Congress, the national Commission on Critical Choices for Americans was organized. Ex-officio members at that time were Gerald Ford, Henry Kissinger, George Schultz, Mike Mansfield, Hugh Scott, Thomas P. O'Neill, and John J. Rhodes. Commission members included Ivan Allen, Jr., Daniel J. Boorstin, Ernest L. Boyer, Norman Borlaug, Nancy Hanks, Clarence B. Joves, Sol Linowitz, Daniel Moynihan, Ed Logue, Paul McCracken, Wilson Riles, Edward Teller, George D. Woods, Bess Myerson, Lane Kirkland, William J. Ronan, and William Paley.

The aim of the Commission is to analyze the major problems besetting us and offer critical choices for the long-range future—to 1985 and 2000—so that more Americans can decide their own futures. Our assignment is to examine the ideas and forces which move our nation and the world; to identify some of the critical areas of concern and to suggest desirable and realistic objectives for Americans to seek and policy approaches for our government to consider implementing. Taken to the extreme, should the United States adopt a philosophy of "Fortress America" or a philosophy of full interdependence or something inbetween-and how?

It is a large order! We are looking at energy, worldwide food, population and health problems, the supply and use of raw materials, the world economic system, issues of national security and peace, and the quality of life here at home. 1 President, The Rockefeller Foundation.

No issue is being studied in isolation, and interdependence is the key theme of the Commission-the interdependence and interrelatedness of all knowledge and of human welfare. It is an exciting and worthwhile venture, and I fervently hope that the results of its deliberations will be of value to our country. Many meetings have already been held, position papers commissioned, and distinguished advisers enlisted. Over the coming months some of the Commission members will speak at the Cooper Union Forum: Edward Teller on energy, Ernest Boyer on education, William Ronan on transportation, Ed Logue on urban problems, and, if you can stand it, I will return to speak on the elements of and choices involved in formulating a long-range domestic health policy. The Commission will report to the American people in 1976 our Bicentennial-an appropriate time for renewal and rededication.

Tonight I would like to speak to some of the issues we are reviewing on one of the panels of the Commission: Food, Health, World Population, and Quality of Life. We might start with a reading from Genesis which was originally put down sometime between the 9th and 5th century:

"So God created man in his own image, in the image of God created he him; male and female created he them.

And God blessed them, and God said unto them, Be Fruitful, and multiply, and replenish the earth, and subdue it; and have dominion over the fish of the sea, and over the fowl of the air, and over every living thing that moveth upon the earth." 2

POPULATION

By the time of Jesus, the world's population was 250 million-having grown from an estimated 5 million people 10,000 years before Christ. God's mandate was written at a time when numbers were necessary for survival-for food gathering and for security against a harsh environment inimicably laden with lurking predators (both human and animal) dread disease, and cruel climatic conditions.

By 1830 the world's population had expanded to 1 billion. One hundred years later, in 1930, the population had doubled to 2 billion. In 1964 there were 3 billion. By 1980, or before, the population will have again doubled to 4 billion in a 50-year period. Twenty-five years from now, at present growth rates of 2 percent, the world's population will have nearly doubled still again to somewhere around 8 billion. And, at present growth rates, some 600 years from now there will be only 1 square foot on this planet for each person to stand on (if one includes the polar ice caps). The annual percentage increase in population had grown from 0.04 in the year one A.D. to 2.1 percent in 1974-the greatest increase in growth coming in this century, due to a marked decrease in death rates as famine, disease, and even wars came increasingly under control.

Clearly, infinite population growth is impossible on the finite space of our planet. In 1798, Thomas Robert Malthus wrote "An Essay on the Principle of Population," which is pertinent to this day. Let me quote him directly :

"I think I may fairly make two postulata. First, That food is necessary to the existence of man.

"Secondly, That the passion between the sexes is necessary and will remain nearly in its present state...

Assuming then, my postulata as granted, I say, that the power of population is indefinitely greater than the power in the earth to produce subsistence for

man.

Population, when unchecked, increases in a geometrical ratio. Subsistence increases only in an arithmetical ratio."

The result of the inequality between population growth and food production was inevitable and population growth would be checked only by famine, pestilence, and war. As Malthus said:

"The vices of mankind are active and able ministers of depopulation. They are the precursors in the great army of destruction; and often finish the dreadful work themselves. But should they fail in this war of extermination, sickly seasons, epidemics, pestilence, and plague, advance in terrific array, and sweep off their thousands and ten thousands. Should success be still incomplete, gigantic inevitable famine stalks in the rear, and with one mighty blow, levels the population with the food of the world."

2 Genesis 1:26-28, King James version of the Bible.

Malthusian predictions have already come true in many parts of the world where thousands (and even millions) have, and are, dying from epidemic disease, famine and malnutrition, and repeated wars of extermination. Man's numbers are outstripping his wisdom, and life inexorably cheapens in its abundance. In God's image of man this was never meant to be.

The world's population is destined to double to around 8 billion over the next 25 to 30 years. Each day, the world adds 200,000 more people for breakfast-and 75 to 80 million each year! India adds 1 million more people to feed, house, and clothe each 28 days—an increase of 13 million people per year. Over 2.5 billion, or about 70 percent of the world's people, live in the less-developed countries, with 50 to 80 percent of them (average about 70 percent) in rural areas, living on subsidence agriculture, with per capita incomes of $50 to $200 per year. In many of these countries unemployment or underemployment may reach 30 percent, and by 1980 it is estimated that there may be as many as 1 billion of these "marginal men" living in a state of what Clifford Geertz has called "agitated stagnancy." A significant proportion of these people are malnourished (60 percent), underdeveloped physically, and poorly educated: 30 percent illiteracy in Latin America, 60 percent in Asia, and 80 percent in tropical Africa. Twenty percent are estimated to be starving at this moment. One-half their population is below child-rearing age and 40 to 45 percent are less than 15 years old. At present growth rates of roughly 2.5 percent, their population will more than double, to 6.5 billion, by the year 2000. Of the more than 100 poor or developing countries, some 30 form the so-called "Fourth World"-countries like Haiti, Niger, Bankladesh, India, the Philippines, and the Central American stateswhich contains one-fourth of the world's population, or some 900 million people. They are heavily dependent on food and energy imports, as well as aid in developing their own agricultural and energy production. Others of the LDC's, called the "Third World," have much greater potential for development and self-sufficiency-countries such as Brazil and Zaire.

FOOD

It is estimated that the world's basic food crops must increase by 4 percent per year, or double, in the next 18 years and quadruple in the next 36 years if the world's food supply is to: 1) keep up with the expansion of population and 2) simultaneously provide additional food to improve the grossly inadequate nutritional status of the one-third to one-half of the world's people who suffer from hunger or nutritional deprivation. In order to achieve such production goals, the new seeds of the Green Revolution (wheat, rice, etc.) must be planted on substantially more than the present 7 percent of the 1.6 billion acres of cultivated lands in the less-developed areas of the world on which they are planted now. Considerable amounts of fertilizer and water are needed in order to achieve high productivity. In India, 75 percent of the arable land is without irrigation. In addition, if India were to use a comparable amount of fertilizer per acre to that used in the Netherlands, India alone (with 560 million people) would consume one-half of the world's present output of fertilizer! Massive increase in the use of fertilizers and nondegradable pesticides carries with it the probability of adverse ecological effects: nitrate poisoning, eutrophication, and destruction of wildlife. The dependence of fertilizer production on naphtha or natural gas raises other immediate and potentially catastrophic effects which will be mentioned later.

The availability of water is becoming an increasingly serious problem-not only relating to the pressing need to find new sources, but also to the uncertainty of dependence on existing seasonal supplies. For example, there is evidence that due to cooling of the Northern Hemisphere, the monsoons of the large parts of the world are now moving southward-from Hokkaido in Japan, from the northwestern part of India, and from sub-Saharan Africa as the Sahara desert moves southward in some areas at a rate of 30 miles per year. This could have a devastating effect in existing areas of high agricultural productivity which are now heavily dependent on seasonal rainfall. From Mexico to Afghanistan, the principal constraint on the spread of high-yielding wheats has been limited water supplies. Soviet efforts to expand domestic food supplies have been slowed by the scarcity of water. Protracted negotiation concerning the use of rivers and river systems which share or cross national boundaries have become intense over the past decade-between Israel and the Arab countries for the Jordan

River water, India and Pakistan for the Indus water, and the Sudan and the United Arab Republic for the Nile water. The FAO estimates that the global demand for water will increase 240 percent by the end of the century.

During the period 1970-1973, the world demand for food continued its 4 percent annual increase, due both to increasing population and increasing affluence. With increasing affluence, the demand for high-quality protein increases. Simultaneously, there has developed increased difficulty in expanding the supplies of three major protein sources: beef, soybeans, and fish. In the case of beef, the world's grazing lands are almost fully utilized, and although improved grasses and range management may raise productivity, no more than one calf per cow can yet be produced each year. As for soybeans, the United States, which produces two-thirds of the world's crop, has achieved about a 1 percent increase in yield per acre per year since 1940 (while corn yields have increased 4 percent annually) and 85 percent of a four-fold increase in total production of soybeans has come from expanding the land planted. Today, one in every 6 acres of U.S. cropland is planted with soybeans. Between 1950 and 1970, the tonnage of the world's fish catch increased rapidly-from 21 to 70 million tons. Since 1970, however, the world's tonnage has decreased steadily to an estimated 62 million tons in 1973, and the per capita availability of fish declined by 16 percent during the three-year period. Prices have increased dramatically as increasing demand has outstripped supplies.

The world's grain trade has also reached a precarious position, due to a potentially serious imbalance between supply and demand. In 1973 the United States and Canada exported 88 million metric tons, and Australia exported 7 million metric tons (mmt) of grain. The major net importers were Latin America (4 mmt), Western Europe (21 mmt), Eastern Europe and the USSR (27 mmt), Africa (4 mmt), and Asia (39 mmt). This arrangement of who exported and who imported began in 1950 and intensified. At an earlier timebetween 1934-1938-all the countries listed, except Western Europe, were net exporters. The biggest single event of 1972 was the importation by Russia of 28 million tons of grain of which 18 million tons came from the United States. As a result, the price of hamburger in the United States skyrocketed at the supermarket counter. Parenthetically, world dependence on North America for food could be hazardous, for crop failure due to blight or drought could have devastating effects worldwide. Note the recent decrease in corn, wheat, and soybean production due to adverse climatic changes in the U.S. Recall that the United States and Canada share the same Great Plains which was once called the Great Desert.

The precarious state of the world's grain reserves is reflected in the following figures in 1961 there were 154 million metric tons of surplus grain (plus a potential of 68 mmt representing U.S. idled cropland) or enough for 95 days of reserves as a share of annual world grain consumption. In 1974 it is projected that reserve stocks will drop to 105 mmt (similar to 1973) and 29 days of reserves (with no idled U.S. cropland)—the lowest figures in the past 15 years. Despite record crops in the U.S., Russia, India, and China, the world's food reserves have not been rebuilt. As expected, the prices of the world's major food commodities have skyrocketed.

Food scarcity has jolted the world, as the inexorable expansion of the world's population proceeds apace. The explosive demand for declining food supplies has resulted in marked price increases only in the past several years. Change in climatic conditions, increasingly scarce water supplies, and the demand and frank need for increasing quantities of fertilizer and pesticides fraught with ecological hazards have brought us close to the brink of a Malthusian disaster. Enter the energy crisis!

OIL AND OPEC

The straw that may break the world's back was the decision by the Organization of Petroleum Exporting Countries (OPEC) to increase the price of oil. As a result, their oil revenues will increase from $14.5 billion in 1972, to $75 billion in 1974. The non-oil exporting, developing countries will have to pay $15 billion for their oil imports in 1974, as contrasted with $3.7 in 1972 and $5.2 billion in 1973 (based on $8.18 per barrel of crude oil Persian Gulf). In addition to this, the developing countries face a tripling of the prices for wheat and fertilizers— price increases caused by scarcity (not economic sanctions) of world supplies of

food and fertilizer (wheat now between $5.50–$6.00 per bushel and urea at $250 per ton—a tripling of prices over the past two years).

Because of price rises in food, fertilizer, and petroleum products, the developing countries which do not export oil will have to pay $15 billion more for these essentials in 1974 than in 1973-an amount five times the total net U.S. development assistance in 1972, and double the $8 billion total of all development assistance from industrial countries during 1972! (The world is also spending $250 billion annually on arms and “defense"!) Of the $15 billion, $10 billion is due to the increased price of oil, and the rest to food and fertilizer imports.

Fertilizer prices (nitrogenous and phosphate) are in short supply with rising prices a result of: 1) rapidly rising world demand due to food shortages (noted above) and the increasing use of fertilizer intensive miracle grains and 2) a cut back in production caused by the oil shortage (Japan has apparently reduced its exports to Southeast Asia already). India, with 523 million people in 1970, may be short 500,000 tons of fertilizer in 1974-the amount needed to increase production by 5 million tons of grain. A simple rule of thumb is that each ton of wheat feeds 5 people for one year; therefore 25 million people could be without expected food due to lack of fertilizer-this in a country which is adding 13 million people a year to its population. (We have already mentioned the southward movement of the monsoons and the possibility of a new drought cycle in India and the fact that 75 percent of India's arable land is without irrigation!) Most important is the effect that the recent scarcities and skyrocketing prices will have on the thirty very poor countries of the world, such as India, Bangladesh, Central America and Sahelian Africa. These countries contain some 900 million people who are now in desperate need of aid and face an increased import bill of $3 billion for essentials due to the recent rise in prices. Additional capital with which to increase domestic food and energy production is also desperately needed. (It should be recalled that some of the OPEC countries are desperately in need of development funds-Nigeria, with 60 million people, Indonesia, with 126 million, and Ecuador, with 6 million, stand to gain much needed income as members of OPEC.)

As of 1974, oil prices had quadrupled and the OPEC countries will accumulate $75 billion of foreign funds in this year alone. At this rate the OPEC countries could accumulate $650 billion in 5 years and $1.2 trillion by 1985. The international reserves of gold and foreign exchange owned by the United States are $14 billion at this writing! Coupled with the tripling of food and fertilizer prices, oil prices are a major source of worldwide inflation and international monetary instability. Worldwide inflation and depression has become a dire threat. How will the OPEC countries use their immense, new found wealth-will they buy more arms? Will they invest in the real estate and industries of other countries? Will they develop their own countries to help their own people? Will they give massive aid to developing countries? Will they help to stabilize international monetary affairs and avoid worldwide inflation and depression?

HEALTH

Let us turn for a moment to the health of the world's people:-nearly 800 million people infested with hookworm-one-quarter of the world's population; 400 million people with trachoma-the viral disease causing blindness; between 200 and 300 million people with schistosomiasis; 40 million people with onchocerciasis ("river blindness"); a resurgence of malaria (25 million cases in a recent year)—and in Africa with a population of 270 million, 206 million live in areas without antimalarial measures and the disease causes an estimated 1 million deaths annually in children less than 14 years old-and in Sri Lanka after the banning of the use of DDT some 1.5 million cases of malaria were reported between 1968 and 1970; smallpox, tuberculosis (40 million cases), poliomyelitis, measles (90 million cases in a recent year), whooping cough (70 million), and tetanus all preventable through immunization, continue to stalk the world.

But the greatest killer of all is the pneumonia-diarrhea-malnutrition complex. Of 60 million annual deaths on our planet, 30 million occur in children under 5 years of age and half of these are due to the invasion of ordinarily harmless bacteria and viruses due to a weakening of the body's defenses due to malnutrition. The pneumonia-diarrhea complex can be prevented, but only by removing