An Old Problem for a New Century: International Approaches to the Elimination of Lead Poisoning

K.W. James Rochow

[Editors' Note: In June 1992, at the United Nations Conference on Environment and Development (UNCED) in Rio de Janeiro, the nations of the world formally endorsed the concept of sustainable development and agreed to a plan of action for achieving it. One of those nations was the United States. In August 2002, at the World Summit on Sustainable Development, these nations will gather in Johannesburg to review progress in the 10-year period since UNCED and to identify steps that need to be taken next. In anticipation of the Rio + 10 summit conference, Prof. John C. Dernbach is editing a book that assesses progress that the United States has made on sustainable development in the past 10 years and recommends next steps. The book is comprised of chapters on various subjects by experts from around the country. This Article appears as a chapter in that book. Further information on the book is available at www.eli.org or by calling 1-800-433-5120 or 202-939-3844.]

James Rochow is Project Director for the Alliance to End Childhood Lead Poisoning, where he directs the Alliance's project on global phase-out of leaded gasoline and provides input on legal issues, regulatory enforcement, and development of legal strategies. His international experience includes work as an environmental expert on the staff of the United Nations (U.N.) Economic and Social Commission for Asia and the Pacific (ESCAP) in Tokyo and Bangkok, as a Japan Foundation Fellow, and as a University of Pittsburgh East Asian Studies Fellow.

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Introduction

Lead poisoning, as a mirror of the persistence of its stolid and elemental agent,¹ has remained a serious threat to health and development for centuries, indeed millennia.² The failure of modern societies to solve even this abundantly documented problem "with both causes and cures known" has given rise to repeated prophecies of social doom.³ The obverse opportunity presented by the World Summit on Sustainable Development (WSSD) process⁴ is to establish a Global Lead Initiative (GLI) that will presently reduce and ultimately eliminate this long-standing worldwide threat. While the conquest of lead poisoning will constitute a signal victory in itself, its concrete achievement should also serve as an optimism-engendering model of international cooperation adaptable to solving other threats to sustainable development. In order to achieve this precedential victory, it is essential that the United States maintains and intensifies its leadership role on lead poisoning prevention in an internationalized context.⁵

The GLI should be designed to complete worldwide leaded gasoline phase-out⁶ on an expedited basis and to use the momentum from that success to address the multiple other sources of lead exposure. Modeled on proven processes such as the Summit of the Americas, the project should initially convene a technical advisory group to work in partnership with identified government focal points, as well as nongovernmental organizations (NGOs) and the private sector, to prepare action plans for phase-out that include milestones and time lines for national action. The United States should support the GLI and such complementary activities as the development of an international network dedicated to raising public awareness and exchanging best practices for phase-out and prevention, including those based on U.S. experience.

Particularly because of the country's diversity, solving the lead poisoning problem in the United States itself requires placing solutions in an internationalized context. [32 ELR 10957] Community-based needs and resources assessments, for example, should attend to international and extra-community causes of toxics exposure including product importation, childhood exposure in other locales, and cultural practices such as home remedies and cosmetics.

Lead, Sustainability, and the WSSD Process

Lead Poisoning Prevention Is a Critical Element of Sustainable Development

The characteristics of lead poisoning and pollution make its prevention an essential component of sustainable development. Lead is an elemental toxin that, once dispersed, persists and accumulates in the environment. Although lead exposure causes or contributes to a multitude of diseases and disabilities among all age groups, it particularly interferes, even at low levels, with the development of intellectual capacity and motor skills in children—the world's future. Human exposure to lead continues to impose these immense individual and social costs by impairing the quality of life, learning ability, and productivity of tens of millions of people throughout the world.⁷ Lead remains a principal contaminant of the world's environment.⁸

Protection of generations of children and of the social and natural environment from the long-lasting harmful effects of lead dispersion fits squarely within classic definitions of sustainable development based on future orientation and the protection of posterity.⁹ Within that forward-looking framework, sustainable development must encompass interrelated issues—such as equity, the restoration of the environment, and the development of human and social resources—that go beyond the provision of basic human needs narrowly defined and limited.¹⁰

Notably, lead poisoning has been recognized as a core environmental justice issue almost from the inception of the movement.¹¹ Although no country (developed or developing) can be complacent about the problem, lead poisoning and pollution is typically more acute in the developing world.¹² The flow of lead-containing products and waste from the developed to the developing world exacerbates the problem and underscores the injustice that perpetuates it.¹³ In the United States, lead poisoning is concentrated with ever increasing disproportion in lower income neighborhoods and communities of color.¹⁴

The World Commission on Environment and Development, commonly known as the Brundtland Commission, emphasized that in order to achieve sustainable development in its full dimensions, an operational definition of the conceptmust include programmatic approaches and arrangements to achieve sustainability.¹⁵ In its chapter devoted to institutional arrangements, the Brundtland Commission's report delineated an interdisciplinary approach to decisionmaking that broadens institutional perspectives and integrates economic and environmental concerns in the service of preventing problems before they occur rather than attempting to cure or abate them after the fact.¹⁶ Because the developmental effects of lead poisoning in children and other vulnerable populations are essentially incurable, lead poisoning requires prevention through the identification, control, and elimination of exposure sources, rather than "cure" through the tracking and necessarily ineffectual treatment of victims.¹⁷ The multiplicity of sources of lead exposure dictate that preventive solutions based on source control in turn demand a coordinated interdisciplinary approach that engages environmental, housing, health, transportation, and other agencies and expertise.¹⁸

The improvement in program operations and institutional effectiveness that achieving sustainable development requires exemplify sustainability's larger benefits. Other examples related to lead poisoning prevention include the provision of community-based employment in the lead hazard control and abatement industry and the opportunity for positive political leadership.¹⁹

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The International Community Has Committed Itself to Phase-Out and Prevention

Since the 1992 United Nations Conference on Environment and Development (Rio Conference), the international community has repeatedly reaffirmed lead poisoning prevention, beginning with leaded gasoline phase-out, as a sustainable development priority.²⁰ Although Agenda 21 does not explicitly mention lead poisoning prevention and pollution, the Commission on Sustainable Development (CSD) explicated the role of lead poisoning prevention in vindicating the principles of Agenda 21. The second CSD meeting, in 1994, addressed Agenda 21 chapters particularly relevant to lead, most notably toxics and human health (but also including fresh water and hazardous wastes). Reflecting the start of serious attention to the international lead poisoning problem, representatives of the then-recently concluded "Global Dimensions of Lead Poisoning: The First International Prevention Conference" presented a resolution urging the CSD to "call[s] on countries to take appropriate action to phase out leaded gasoline for domestic use and export . . . to phase out the use of lead solder in food tins . . . and to take other appropriate action to reduce lead exposures."²¹ The second CSD meeting adopted language in its toxics section that explicitly recognized the "severe health impacts of human exposures to lead" and endorsed ongoing "efforts to reduce human exposure to lead."²²

Subsequent CSD meetings addressed other Agenda 21 chapters relevant to lead poisoning prevention. Most notably, the ninth CSD meeting, in its consideration of the sectoral themes of energy and atmosphere, emphasized the need to complete the worldwide phase-out of leaded gasoline expeditiously as a prerequisite to "promoting the use of cleaner fuels and transport equipment."²³

The process set in place by the United Nations Human Settlements Programme's Habitat II Conference (Habitat II) also represented an important catalyst for placing lead poisoning prevention as a priority for concerted international action.²⁴ Particularly concerned with the urban environment, Habitat II emphasized the need for prompt global phase-out of leaded gasoline, calling point blank for "eliminating as soon as possible the use of lead in gasoline."²⁵ By stressing the need to share knowledge and experience in the elimination of leaded gasoline and utilization of clean fuels,²⁶ Habitat II recognized both the instructive experiences of the United States and other countries in ultimately successful phase-out and the relationship between phase-out, clean fuels, and broader transportation and air quality issues.²⁷

At Habitat II, the World Bank prominently endorsed the expedited completion of worldwide phase-out and has played a leadership role on this particular issue ever since.²⁸ The U.S. government also strongly advocated phase-out at Habitat II and in subsequent council sessions. During the 1999 session for example, Habitat II adopted the U.S.-sponsored resolution calling on "all Governments to incorporate . . . into their national policies . . . a strategy to phase out leaded petrol and to manage the uncontrolled exposure to lead from other sources, or where possible, eliminate it."²⁹

A mutually reinforcing variety of other international and regional processes have reiterated the priority of the international commitment to lead poisoning prevention, beginning with leaded gasoline phase-out. These include: European Conference of Ministers of Transport (ECMT); Organization for Economic Cooperation and Development (OECD); and G7/8 Environment Ministers' Meetings.³⁰ The Summit of the Americas, in particular, established an exemplary process to address phase-out, one that adumbrated the WSSD.³¹

The first summit (the 1994 Miami Summit) produced a Declaration of Principles and Plan of Action (Plan of Action) that, among other things, mandated a Partnership for Pollution Prevention Initiative to advance cooperative activities to develop and push forward the implementation of international agreements and principles such as Agenda 21.³² Specifically, the Plan of Action required (not merely recommended) signatory governments to "address environmental priorities such as . . . lead contamination develop and implement national action plans to phase out lead in gasoline [and] convene a meeting of technical experts . . . to develop a framework for cooperative partnership . . . initially focused on . . . the impacts of lead contamination [32 ELR 10959] from gasoline and other sources."³³ This technical advisory group worked as a component of this partnership with identified government focal points, as well as NGOs, multilateral institutions, and the private sector, to prepare action plans for phase-out including milestones and time lines for national action.

Resulting from another initiative at the 1994 Miami Summit, a specialized Summit on Sustainable Development (1996 Bolivia Summit) allowed for extended civil society participation in the Summit of the Americas and associated preparatory processes.³⁴ Governments, including the United States, and international organizations, including the World Bank, pushed the process forward, including translating the initial structure into a fully funded project.

The WSSD Process Should Translate Phase-Out and Prevention Commitments Into Action

The extraordinary consensual commitment to phase-out and prevention made and reiterated by the international community over the past decade represents a prerequisite for effective action, but does not substitute for it. The continuing severity of lead poisoning and pollution in the world testifies to the fact that commitments have not been matched with an equivalence of effective action.³⁵ Consequently, the need now is to implement, monitor, and enforce the global commitment to phase-out and prevention, not to engender repetitive language and redundant studies that by inadvertence or design serve as an excuse for inaction.³⁶

The need to translate linguistic commitment into action to achieve phase-out and prevention comports with the focus of the WSSD as it has evolved. In WSSD preparation, general agreement was reached that the WSSD process should concentrate on delineating, endorsing, and supporting action programs to achieve significant measurable progress on sustainable development,³⁷ rather than proliferating declarations, statements of principle, and institutions.³⁸ In structuring these action programs, the WSSD process should focus on a selected set of topics that particularly bear on environment and sustainable development. The interrelated topics—health and environment, water, and energy are among those suggested³⁹—should in turn serve as the basis for identifying specific issues within them for priority action.

Lead poisoning prevention initiatives, beginning with the expedited completion of worldwide phase-out, should provide a core issue within the WSSD's focus on such topics as health and environment, and energy and air pollution. Because we know the sources of lead poisoning and how to control virtually all of them,⁴⁰ phase-out and prevention efforts provide a particularly urgent need and rich opportunity for implementing action propelled by the WSSD. Specifically, completing global leaded gasoline phase-out defines a concrete goal eminently achievable based on accumulated successes in the United States and elsewhere and conducted according to a schedule with implementation milestones and end dates for completion.

The WSSD process emphasizes a partnership approach that is particularly well-suited to accomplish specific goals such as worldwide phase-out.⁴¹ The resulting partnership [32 ELR 10960] initiatives should include representatives from all levels of government, as well as from civil society and business. Such partnerships envisaged by the WSSD process are self-contained and self-executing: they will require agreement only from the Parties involved and are outside the negotiation of document language among states that constitute the official preparatory meetings. Embodying the desired "outcomes" of the WSSD, the partnerships should be aimed at "practical steps for the realization of global sustainable development objectives and relevant 'Millennium targets'" and should be "tangible, result-oriented and include mechanisms for monitoring progress in their implementation."⁴²

The Need for Internationalized Approaches to Phase-Out and Prevention

Lead poisoning and pollution fits within traditional definitions of international environmental problems because lead emissions and discharges from industrial activity, mobile sources, and particulate dispersion can cross national boundaries.⁴³ The landmark case in the law of transboundary pollution—Trail Smelter⁴⁴—involved emissions and discharges from a Canadian lead and zinc smelter that caused pollution and damaged crops in the state of Washington.

The commerce between nations in the many consumer and household products still containing lead and the traffic in lead-containing waste including discarded batteries and computer components is likewise international by strict definition. It is true that sources of lead exposure are often highly localized and can vary considerably from locality to locality: their ultimate origin, however, can often be traced back to these streams of commerce. While the cottage industry of "cracking" used batteries discarded by the developed world to extract lead and other saleable constituents in the household environment is a severely local phenomenon in the literal sense, it is quintessentially international, particularly in the context of sustainable development.⁴⁵

More expansively, local action must be viewed as part of the reinforcing international dynamic necessary to solve the lead poisoning problem, one that engages all levels of organizations and sectors.⁴⁶ Local action includes the worldwide exchange of best practices—technical applications and innovative policies—that have proven successful at the community and national levels. Modern means of electronic communication have enabled such "interlocal" exchanges to be conducted freely across national boundaries and have added yet another dimension to the internationalized context of solutions.⁴⁷ Much emphasis has properly been placed in international fora over the past decades on the primacy of local action,⁴⁸ but localization can represent a piety that camouflages inaction and exploitation unless placed within an extra-local context.⁴⁹

Conversely, even the resolution of issues and problems most susceptible to action at the national level must be viewed in a more dynamic context. In order to be effective, leaded gasoline phase-out must be based on a national decision and program. Individual consumer choice means nothing when only leaded gasoline is available at the pumps, and little when unleaded fuel is priced more highly than leaded gasoline. Appropriate national decisions, in any event, do not take place in a vacuum. The experience of successful national phase-out efforts indicates the key role typically played by some internationalized combination of a "squeeze" play between local advocates and international pressure in tandem with technical assistance.⁵⁰

The United States Must Play a Leadership Role in Phase-Out and Prevention

The nature of the problem itself, the expressed international commitment to solve it, and the special opportunity provided by the WSSD to fulfill those commitments, necessitate that the United States maintain and enhance its role in promoting and supporting worldwide phase-out and prevention initiatives.

In the broader geopolitical context, an additional advantage of such leadership is the opportunity it provides to counter the pervasive image of the United States as a "Lone Ranger" of cowboy unilateralism in international affairs.⁵¹ It is by now common but still cogent wisdom that the post-September 11, 2001, U.S. initiative to rally the international community to fight terrorism paves the way for, and indeed demands, complementary initiatives to rally the international community cooperatively behind solutions to key environment, health, and sustainable development problems facing the world.⁵²

Even if it were otherwise disposed to do so, the United States cannot ignore the internationalized aspects of lead [32 ELR 10961] poisoning. The focus of the U.S. problem in distressed and minority communities generally mirrors the disproportionately severe and unjust concentration of the problem in the developing world.⁵³ The diversity of the U.S. population inherently internationalizes the problem. Children and others immigrating into the United States may have already contracted lead poisoning.⁵⁴ Home remedies, folk practices, cultural artifacts, and home country products may contain lead.⁵⁵ Often, communities in the United States retain fossilized practices, including lead-unsafe ones, that have been discarded or prohibited in countries of origin.⁵⁶

Agenda 21 emphasized the responsibility of developed countries to provide support and technical assistance to developing countries to help achieve sustainable development.⁵⁷ Fortunately, U.S. domestic efforts have been relatively successful in addressing the lead poisoning problem. The U.S. instructive experience, including setbacks as well as successes, provides a sound basis for developing adaptable models to advance international solutions.

U.S. Experience Can Provide a Basis for Internationalized Solutions

The key principles that inform lead poisoning prevention programs can help distill and clarify key lessons and reference points from U.S. experience applicable to internationalized solutions. This summary analysis will concentrate on four program elements: prevention; priority-based action; interdisciplinary approach; and public awareness and community involvement.

Prevention

The United States has succeeded to a significant degree in the essential task of establishing an effective lead poisoning prevention program: moving from the medical case management model that relies on the after-the-fact identification, tracking, and attempted treatment of victims to a prevention model that focuses on identification, control, and elimination of the sources of lead exposure themselves.⁵⁸ As previously noted, the fact that lead poisoning is essentially incurable, coupled with the availability of practical control remedies for virtually all sources of lead exposure, makes anything less than source control solutions ineffectual, even irresponsible.

Because of their reliance on the medical case management model, lead poisoning prevention programs in the United States historically have constituted a misnomer, inviting quotation marks around "prevention."⁵⁹ Like all paradigms, the medical case management model is difficult to transform.⁶⁰ For issues governed by the model, the focus is on funding to support medical research and data collection to refine knowledge continuously, rather than resources to take present preventive action based on knowledge thresholds.⁶¹ As a part of the paradigm, health departments historically retained the exclusive responsibility for lead poisoning prevention programs in the United States.⁶² Even in documents informed by sustainable development, "health"—and by extension, the jurisdiction and mission of health departments and agencies themselves—tends to be characterized by the provision of medical services and the development of medical infrastructure to diagnose and treat disease pathologies.⁶³

In 1990, the U.S. Environmental Protection Agency (EPA) sponsored the Primary Prevention Strategies (PPS) Project to change the paradigm by delineating and catalyzing the development of lead poisoning prevention programs in the United States.⁶⁴ Encouraged by the generally perceived need to focus on source control solutions through primary prevention strategies and the specific recognition of lead poisoning caused by the reservoir of lead-based paint in the U.S. housing environment,⁶⁵ the U.S. Congress passed the Residential Lead-Based Paint Hazard Reduction Act of 1992 (Title X).⁶⁶ Title X is significant because its exclusive attention to controlling systematically a single crucial source of lead exposures (lead-based paint) marked the first major legislation at any level in the United States that comprised an actionable (although not comprehensive) framework for source control programs.⁶⁷

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While Title X has indeed promoted increased source control actions and the rhetoric of primary prevention now prevails in programmatic efforts to fight lead poisoning, the effort to institutionalize prevention remains an incomplete success.⁶⁸ Despite the drive for prevention, U.S. programs still often remain lodged in health departments and still too often consist of efforts to screen children for lead poisoning. In effect, most programs use lead-poisoned children as canaries were used in old coal mines: as a kind of sacrificial trigger for the dramatic revelation of a problem.⁶⁹ In the developing world, approaches to childhood lead poisoning typically are still conceived in the medical case management model, based on the provision of clinical services and medical surveys.⁷⁰ This is particularly unfortunate, since the ubiquity of toxics and the scarcity of resources in much of the developing world underscore the need to concentrate programmatic resources on source control solutions as an efficient priority.⁷¹ Source control solutions can also present opportunities for addressing toxic sources additional to lead in a coherent community-based effort.⁷²

Priority-Based Action

Because of the multiplicity of lead sources resulting from the widespread use of lead-containing products and processes, accomplishing prevention through source control requires a priority-based approach based both on the actual and potential harm caused by a specific source and the opportunities for its control and elimination. Although it has often been characterized by fortuity rather than orderly dispatch, U.S. efforts to combat lead poisoning have generally maintained a proper priority approach to source control.

By the time of the Rio Conference, the United States had essentially completed leaded gasoline phase-out, although the legal deadline was December 31, 1995.⁷³ Even in the earlier stages of the U.S. phase-out process, surveys began to demonstrate the very close correlation between the sharp decline in the blood lead levels of U.S. children and the phase-out of leaded gasoline.⁷⁴ Phase-out saved millions—more likely, billions—of dollars in health, as well as vehicle maintenance, costs.⁷⁵ The phase-out process took two decades and provides a rich store of instructive experience that allows countries to telescope phase-out drastically.⁷⁶ Most importantly, the experience of the United States and other countries dictates that phase-out occurs "overnight" because the simultaneous availability of both leaded and unleaded gasoline inevitably causes a significant amount of misfueling at the pump (even one pumping of leaded gasoline in a vehicle can disable its emissions control system and catalytic converter).⁷⁷

The fact that 85% of the gasoline currently produced in the world is unleaded has given rise to an unwarranted complacency. Leaded gasoline is still extensively used in some regions—particularly Africa and the Middle East—and there are laggard countries in almost every region.⁷⁸ Time is critical, because every day's continued use of unleaded gasoline adds to the reservoir of dispersed lead in the environment that ultimately must be addressed.⁷⁹ Vehicle miles traveled are predicted to increase significantly by 2010, especially in the developing world.⁸⁰

In the United States, as the preceding discussion of Title X indicates,⁸¹ hazards in the housing environment from lead-based paint now constitute the preponderant source of lead exposures. Lead-based paint was banned for residential [32 ELR 10963] application in the United States in 1978,⁸² while as stated leaded gasoline was not eliminated until 1996. The enormous residue of lead-based paint in the housing environment of the United States—even today, almost one-half of the U.S. housing stock contains some lead-based paint⁸³—proved such a critical threat to children's health that renewed attention to that source of exposure resulted in the passage of Title X in 1992 and continuing follow-up efforts.⁸⁴

It is becoming increasingly apparent that exposures from lead-based paint are more of a problem internationally than heretofore assumed. The White Lead (Painting) Convention—adopted in November 1921, and subsequently ratified by a miscellany of 62 countries—has been widely publicized as an early advance in the fight against lead poisoning.⁸⁵ The treaty merely banned lead-based paint manufactured from white pigments and in any event completely lacks enforcement provisions. The use of paint is actually rising owing to modernization trends in developing countries and notions of decorative fashionability, especially in countries that historically have not used paint. While the U.S. experience hardly represents a seamless progression from one priority source to another, it does hold the lesson that phasing out leaded gasoline is but a first step, however essential, toward lead poisoning prevention and that the momentum generated by successful phase-out should be used to address other sources of exposure on a priority basis.⁸⁶

Interdisciplinary Approach

As a result of the variety of sources of lead in the environment and of populations affected, both the problem of lead poisoning and its solutions cut across disciplines and agency jurisdiction—environment, housing, health, children's welfare, transportation, community planning, and many others. Title X harnesses EPA and the Department of Housing and Urban Development (HUD) to a cooperative framework: in some cases, such as enforcement, conferring joint authority on EPA and HUD; in others, such as standard setting, devolving duties on one or the other agency. Title X confers supporting roles in research and review on federal agencies concerned with health.⁸⁷ The U.S. government also constituted an informal interagency task force to coordinate efforts in implementing Title X and executing lead poisoning prevention programs. This task force ended up a forum for agencies to inform one another of the status of their programs, but has failed to spark coordinated, much less integrated, programmatic activity for prevention.⁸⁸

The degree of coordination mandated by Title X at the federal level between environmental, housing, and health agencies has not been systemically mimicked at the state and local levels, where bureaucratic contention (turf fighting) based on different missions and competition for scarcer resources too often impedes progress toward prevention.⁸⁹ The problem of lack of a coordinated interdisciplinary approach is endemic in the international system. The representatives of the housing ministries that attended Habitat II by and large were not accustomed, nor prepared, to deal with the issues of urban pollution and environmental health that formed an essential part of the Habitat II agenda.⁹⁰ Few, if any, countries have made attempts to integrate approaches to phase-out and prevention under the operational principles of the Brundtland Commission report.⁹¹ NGOs, in particular, need to play a critical role in fostering these integrated approaches by themselves enlisting interdisciplinary participation in their own activities and by advocating breaking down bureaucratic barriers between government agencies.

Public Awareness and Community Involvement

While raising public awareness is a prerequisite to developing and sustaining effective policies and programs, if conducted improperly it also can prove counterproductive. Too often, in the United States and elsewhere, programs have relied on traditional public health education that emphasizes ameliorative practices based on individual actions and personal hygiene, such as good nutritional practices. Unfortunately, this approach often encourages blaming the victims of environmental diseases for allegedly irresponsible conduct and poor parenting rather than concentrating on elimination of the objective sources and pathways ofexposure that cause the disease in the first place.⁹² The potential for "blaming the victim" is particularly pronounced when, like [32 ELR 10964] lead poisoning, the locus of the disease is in impoverished neighborhoods and communities of color.

The goal of public awareness campaigns should be to engage community-based groups directly in solutions based on source control and as a constituency of support for prevention programs. Community needs and resources assessments are one proven tool to evaluate the sources of toxics in a community and the resources available in the community itself to contribute to solutions. Such an assessment, adapted from a model U.S. Agency for International Development (USAID) designed for application in developing countries, was conducted in the Anacostia section of Washington, D.C.⁹³ This illustrates the desirability and inevitability of internationalized solutions and the irony that can attach to them. In a reversed situation, community groups from inner U.S. cities lobbied developing country representatives at Habitat II to endorse proposed language embodying priority commitments to phase-out and prevention.⁹⁴ In essence, solutions that involve community groups reflect the kind of partnerships the WSSD is promoting and the kind of best practices that should be writ large among NGOs and others through interlocal communication.⁹⁵

Recommendations: U.S. Role in Worldwide Phase-Out and Prevention

Support the GLI

The United States should support adoption of a GLI at the WSSD and play a leadership role in implementing it thereafter. The GLI should be designed to complete worldwide leaded gasoline phase-out⁹⁶ on an expedited basis and to use the momentum from that success to address the multiple other sources of lead exposure. Modeled on proven processes such as the Summit of the Americas, the project should expeditiously convene a technical advisory group to work in partnership with identified government focal points, as well as NGOs and the private sector, to prepare action plans for phase-out that include milestones and time lines for national action. Mandating, not merely recommending, the formation of the technical advisory process and funding, not merely morally encouraging, the GLI as a sustained project are essential to the success of the initiative.

Participate in Complementary Actions and Activities

The United States should continue to support the global phase-out of leaded gasoline in all relevant international fora as a top priority for the global environment. As part of recommendations for improved governance, the United States should support a process conducted by the CSD or an institutional equivalent providing for regular national transparent reporting of progress toward phase-out and prevention. Such reporting should include technical indicators (source and human population data) and measures of policy progress.

Form Partnerships for Prevention

The United States should form partnerships with U.S. NGOs to undertake a concerted international campaign in support of the GLI. The United States should help support the development of a global network dedicated to the exchange of best practices for phase-out and prevention.

Support Internationalized Solutions

The United States should encourage and support community needs and resources assessments for lead and other toxics in U.S. communities most at risk. These community needs and resource assessments should include attention to extra-community causes of lead poisoning, including product importation, childhood exposure in other locales, and cultural practices such as home remedies and cosmetics.

U.S. NGOs and community-based organizations should develop pilot projects focused on linking local lead poisoning and toxics problems to internationalized circumstances, processes, and solutions, and in this effort should partner with NGOs from other countries.

Look to the Future

The United States should conduct technical assistance projects that utilize instructive U.S. experience to promote the identification and control of sources of lead exposure (such as lead-based paint) additional to leaded gasoline. The United States should ratify the Basel Convention on the Control of Transboundary Movements of Hazardous Wastes and Their Disposal and prohibit the export of lead containing wastes, particularly lead acid batteries.⁹⁷ The GLI should identify, and the United States should reinforce, integrated solutions to lead poisoning linked to broader issues. Replacements for leaded gasoline, for example, should serve as an opportunity to advance fuel harmonization and clean fuel alternatives.

1. Lead is a heavy metal, a "couch potato" of an element, that once dispersed by human activity, tends to settle in the vicinity of its anthropogenic source. See PRIMO LEVI, THE PERIODIC TABLE 79-95 (1984). But see ALLIANCE TO END CHILDHOOD LEAD POISONING AND ENVIRONMENTAL DEFENSE FUND, GLOBAL DIMENSIONING OF LEAD POISONING: AN INITIAL ANALYSIS 12 (1994), available at http://www.globalleadnet.org/publications/alliance_pubs/globaldimensions.cfm (last visited Apr. 10, 2002) [hereinafter GLOBAL DIMENSIONS REPORT] ("A certain fraction of lead dispersed by human activity scatters more widely. Evidence of such long-range transport includes such phenomena as the enhanced levels of lead found in snows in Greenland.").

2. Because of its numerous qualities and various uses, lead has been mined and utilized in human artifacts and products since its discovery over 5,000 years ago. See Jane S. Lin-Fu, Modern History of Lead Poisoning: A Century of Discovery and Rediscovery, in HUMAN LEAD EXPOSURE 23, 24 (Herbert L. Needleman ed., 1992). In a Faustian bargain, lead is also a toxin that once released contaminates the environment and causes a multitude of adverse effects on human health and social development. Although lead is a naturally occurring element, the historical absence of free lead in the biosphere prevented humans from developing an immunity to it. See Ann Platt McGinn, Reducing Our Toxic Burden, in STATE OF THE WORLD 2002, at 75, 81 (Worldwatch Inst. 2002).

3. Most famously, Rene Dubos stated that "the problem is so well defined, so neatly packaged, with both causes and cures known, that if we don't eliminate this social crime, our society deserves all the disasters that have been forecast for it." Rene Dubos, Remarks at the First National Conference on Childhood Lead Poisoning (1969), reprinted in Mark W. Oberle, Lead Poisoning: A Preventable Childhood Disease of the Slum, 165 SCIENCE 991, 992 (1969).

4. The United Nations has established the practice of reviewing the extraordinary set of major issue conferences it held during the 1990s—beginning with the 1992 Conference on Environment and Development (Rio Conference) and ending with the Second Conference on Human Settlements (Habitat II) in Istanbul, in 1996—at five-year intervals. See, e.g., OFFICE OF POLICY DEVELOPMENT AND RESEARCH, U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT, UNITED STATES — HABITAT II: PROGRESS REPORT (2001). The WSSD (August 26-September 4, 2001 in Johannesburg, South Africa) is the 10-year review of the Rio Conference. See Ten-year Review of Progress Achieved in the Implementation of the Outcome of the United Nations Conference on Environment and Development, G.A. Res. 9848, U.N. GAOR, 55th Sess., at 2, U.N. Doc. A/RES/55/199 (2000). The WSSD process as used in this Article includes the preparatory process and follow-up to it as well as the summit itself.

5. This Article uses "internationalized" rather than "international" to emphasize that the dynamic needed of solutions to worldwide lead poisoning transcends the more narrow and literal definitions of inter-national. See ALLEN L. SPRINGER, THE INTERNATIONAL LAW OF POLLUTION: PROTECTING THE GLOBAL ENVIRONMENT IN A WORLD OF SOVEREIGN STATES 31-62 (1983).

6. The term "leaded gasoline phase-out" (or phase-out of leaded gasoline) is preferable to the term "phase-out of lead in gasoline" because the former phrase retains the often desirable option of replacement of leaded gasoline by alternative fuels.

7. See ALLIANCE TO END CHILDHOOD LEAD POISONING, INTERNATIONAL ACTION PLAN FOR PREVENTING LEAD POISONING 1 (3d ed. 2001), available at http://www.globalleadnet.org/policy_leg/policy/intlactionplan.cfm (last visited Apr. 10, 2002) [hereinafter ACTION PLAN].

8. See GLOBAL DIMENSIONS REPORT, supra note 1, at iii, 5, 61.

9. The World Commission on Environment and Development, chaired by Gro Harlem Brundtland, prepared Our Common Future as part of the preparation for the Rio Conference. The book has become the benchmark reference for the concept of sustainable development. Its definition of the term emphasizes protection of posterity and intergenerational equity: development that meets the needs of the present without compromising the ability of future generations to meet their own needs. WORLD COMMISSION ON ENVIRONMENT AND DEVELOPMENT, OUR COMMON FUTURE 43 (1987) [hereinafter BRUNDTLAND COMMISSION REPORT].

10. See, e.g., Gary Gardner, The Challenge for Johannesburg: Creating a More Secure World, in STATE OF THE WORLD 2002, supra note 2, at 3, 4; see also ANDY CRUMP, DICTIONARY OF ENVIRONMENT AND DEVELOPMENT: PEOPLE, PLACES, IDEAS, AND ORGANIZATIONS 235 (1993).

11. Robert R. Kuehn, A Taxonomy of Environmental Justice, 30 ELR 10681, 10696 (Sept. 2000); Robert Bullard, Environmental Justice: Strategies for Creating Healthy and Sustainable Communities, Lecture at Mercer University (Jan. 20, 1999), at http://www.law.mercer.edu/elaw/rbullard.htm (last visited Feb. 28, 2002); Analia Penchaszadeh, The Beginning: Environmental Justice in the United States, at http://www.risingtide.nl/greenpepper/envracism/beginning.html (last visited Feb. 28, 2002); ACTION PLAN, supra note 7, at 48.

12. See GLOBAL DIMENSIONS REPORT, supra note 1, at ii, iii, 37, 41, 42.

13. E.g., BASEL ACTION NETWORK AND SILICON VALLEY TOXICS COALITION, EXPORTING HARM: THE HIGH-TECH TRASHING OF ASIA 29 (2002).

14. Centers for Disease Control (CDC) and Prevention, Update: Blood Lead Levels—United States, 1991-1994, 46 MORBIDITY & MORTALITY WKLY. REP. 141, 141-46 (1997). See supra note 11 and accompanying text. International Human Rights Law Group, Statement to the U.N. Commission on Human Rights Regarding Item 6 of the Provisional Agenda: Racism, Racial Discrimination, Xenophobia and All Forms of Discrimination (Apr. 1999), at http://www.preamble.org/OngoingProjects/EEJ&H/unstatement.html (last visited Feb. 28, 2002) (on file with author).

15. BRUNDTLAND COMMISSION REPORT, supra note 9, at 43-46 (describing the broad concept of sustainable development).

16. Id. at 20, 314-19 (describing the necessary shift of policy targeting from effects to sources).

17. The fact that the symptoms of lead poisoning are often subtle and sub-clinical means that a medical approach would be largely ineffectual even if it were otherwise warranted. Joel Schwartz, Lead, Blood Pressure, and Cardiovascular Disease, in HUMAN LEAD EXPOSURE, supra note 2, at 223, 234, 240. See also Bruce Lanphear et al., Cognitive Deficits Associated With Blood Lead Concentrations < 10 microgram/dL in U.S. Children and Adolescents, 115 PUB. HEALTH 521, 521-29 (Nov./Dec. 2000).

18. ACTION PLAN, supra note 7, at 5, 20.

19. Id. at 2-3, 46-7.

20. Alliance to End Childhood Lead Poisoning, Lead Commitments in Key International Agreements (Background Paper) (July 1999), at http://www.globalleadnet.org/policy_leg/policy/commits.cfm (on file with author). See infra note 38.

21. ALLIANCE TO END CHILDHOOD LEAD POISONING, GLOBAL DIMENSIONING OF LEAD POISONING: THE FIRST INTERNATIONAL PREVENTION CONFERENCE — FINAL REPORT 64 (1994), available at http://www.globalleadnet.org/resources/events/gdlp1994/finalconf report.cfm (on file with author).

22. U.N. ESCOR, 1994 Sess., Supp. No. 15, P169, U.N. Doc. E/CN.17/1994/20 (1994) (CSD's report on the second session).

23. U.N. ESCOR, 2001 Sess., Supp. No. 9, P25, U.N. Doc. E/CN.17/2001/19 (2001) (CSD's report on the ninth session).

24. The Habitat II Conference was held in Istanbul, Turkey, from June 3-14, 1996. Just as the Stockholm Conference on the Environment preceded Rio by two decades, Habitat II was held 20 years after the first Habitat Conference was held in Vancouver, British Columbia. Habitat II adopted the global plan of action entitled the Habitat Agenda. U.N. GAOR, Report of the United Nations Conference on Human Settlements (Habitat II), Istanbul, June 3-14, 1996, U.N. Doc. A/CONF.165/14 (1996) [hereinafter Habitat Agenda].

25. Id. P43(bb).

26. Id. P146(e).

27. See infra note 90 and accompanying text.

28. Press Release, World Bank, World Bank Recommends Global Phase-Out of Leaded Gasoline: Eliminating Leaded Gas Reduces Health Risks (May 18, 1996), available at http://www.worldbank.org/html/extdr/extme/gaspr.htm (last visited Apr. 10, 2002); World Bank, Regional Conference on the Phasing Out of Leaded Gasoline in SubSaharan Africa: Declaration of Dakar (June 28, 2001) at http://www.worldbank.org/cleanair/caiafrica/africaenglish/learningactivities/dakar/conclusions/declaration/english.pdf (last visited Apr. 10, 2002).

29. Report of the Commission on Human Settlements on the Work of Its Seventeenth Session, May 5-14, 1999, U.N. GAOR 54th Sess., Annex A, Resolution 17/12, at 21, U.N. Doc A/54/8 (1999) (elimination of the use of lead in petrol); Press Release, Alliance to End Childhood Lead Poisoning, Habitat Resolution Calls for Eliminating Leaded Gasoline: Alliance Urges Follow-Up Action to Take Advantage of This Important Step in the Fight Against Lead Poisoning (May 1999), available at http://www.globalleadnet.org/docs/Press_Release_for_Habitat_Resolution_3.doc (last visited Apr. 10, 2002).

30. See supra note 20.

31. See the official website for the Summit of the Americas, http://www.summit-americas.org/eng/summitprocess.htm (last visited Apr. 10, 2002) (describing the summit process as a series of hemispheric meetings, addresses economic, social, and political concerns in the Americas) [hereinafter Summit of the Americas].

32. Miami Plan of Action, Summit of the Americas, § 23 (Dec. 11, 1994), at http://www.summit-americas.org/miamiplan.htm#23 (last visited Apr. 10, 2002).

33. Id.

34. Summit of the Americas, supra note 31. Side events at the various Summit of the Americas also facilitated increased interaction among civil society, government, and private sector participants. ALLIANCE TO END CHILDHOOD LEAD POISONING, PREVENTING LEAD POISONING IN THE AMERICAS: HEALTH, ENVIRONMENT, AND SUSTAINABLE DEVELOPMENT 1 (1998), available at http://www.globalleadnet.org/publications/alliance_pubs/index.cfm (last visited Apr. 10, 2002).

35. See infra notes 90-91 and accompanying text.

36. Lead has been called the most studied of toxins. See ALLIANCE TO END CHILDHOOD LEAD POISONING, MYTHS AND REALITIES OF PHASING OUT LEADED GASOLINE 1 (1997), available at http://www.globalleadnet.org/publications/alliance_pubs/myths.cfm (last visited Apr. 10, 2002) [hereinafter MYTHS AND REALITIES]. While refinement of our knowledge of its harmful effects at even very low levels is necessary, the overwhelming weight of existing research supports the harmful effects of lead exposure. Consequently, no further studies are needed to support such actions as leaded gasoline phase-out. Incredibly, government officials and others can still be heard making arguments that we need studies of lead poisoning's effects in their own country before they can take action. See, e.g., Dr. Supat Wangwongwatana, Remarks at the Alliance to End Childhood Lead Poisoning's 1999 Bangkok, Thailand, Workshop—Achieving the Benefits of Lead Poisoning Prevention: Toward a Regional Framework for Asia (Feb. 4, 1999) (indicating that in Thailand's phase-out process, the Thai government felt politically compelled to perform a limited blood lead level survey of Thai children to demonstrate the effects of lead on Thai children); cf. MYTHS AND REALITIES, supra, at 2.

37. This implementation-oriented approach comports with the evolving approach urged in a number of WSSD preparatory documents. E.g., U.N. ESCOR, IMPLEMENTING AGENDA 21: REPORT OF THE U.N. SECRETARY-GENERAL, § VIII, U.N. Doc. E/CN.17/2002/PC.2/7 (Dec. 19, 2001) [hereinafter SECRETARY-GENERAL'S REPORT].

38. See U.N. GAOR, Report of the United Nations Conference on Environment and Development: Rio Declaration on Environment and Development, U.N. Doc. A/CONF.151/26 (Vol. I, Annex I) (1992) [hereinafter Rio Declaration]; U.N. Conference on Environment and Development, Agenda 21, U.N. Doc. A/CONF.151/26 (1992) [hereinafter Agenda 21]; U.N. ESCOR, Org. Sess. for 1993, U.N. Doc E/1993/207 (establishing the CSD). This Article does not address institutional reform per se, but does note that the CSD process as constituted reviewed different chapters and themes of Agenda 21 on a year-by-year basis. This process effectively precluded the monitoring and evaluation of progress on implementing Agenda 21. See Institutional Arrangements to Follow Up the United Nations Conference on Environment and Development, G.A. Res 47/191, 47 U.N. GAOR (93d plen. mtg.), P12, U.N. Doc A/RES/47/191 (1992); U.N. ESCOR, Adoption of a Multi-Year Thematic Programme of Work for the Commission: Report of the Secretary General, U.N. Doc. E/CN.17/1993/5, June 1, 1993. But see Agenda 21, supra, at ch. 40 (Vol. III); U.N. ESCOR, Commission on Sustainable Development: Report on the Third Session, Apr. 11-28, 1995, U.N. Doc. E/CN.17/1995/36, § A, pt. 1, PP1-12 (1995); U.N. COMMISSION ON SUSTAINABLE DEVELOPMENT, INDICATORS OF SUSTAINABLE DEVELOPMENT: GUIDELINES AND METHODOLOGIES (2001), available at http://www.un.org/esa/sustdev/indisd/indisd-mg2001.pdf (last visited Apr. 10, 2002) (demonstrating the on-going process of approving and developing sustainable development indicators to aid informed decisionmaking concerning sustainable development).

39. See Posting of Jeffrey Barber, jbarber@igc.org, to citnet-list@lists.citnet.org, (Jan. 21, 2002) (copy on file with author); Posting of Jennifer Crawford, jcrawford@isforum.org, to citnet-list@lists.citnet.org (Jan. 14, 2002) (copy on file with author); Posting of Gary Pupurs, gpupurs@isforum.org, to uspc-news-list@lists.citnet.org (Dec. 10, 2001) (copy on file with author) (detailing discussion fora organized by the Citizens Network for Sustainable Development (CitNet) and the U.S. Citizens Preparatory Committee for the World Summit on Sustainable Development on the topics of Health and Environment, Freshwater, and Energy and Climate Change).

40. See Dubos, supra note 3.

41. The WSSD is expected to result in two types of outcomes—political documents (two expected) and a series of commitments, targets and partnership initiatives for specific actions. WSSD Secretariat, Possible Framework for Strengthening Linkages Between the Expected Outcomes of WSSD (Dec. 2001), at http://www.johannesburgsummit.org/html/documents/strengtheninglinkages.doc (last visited Apr. 10, 2002) [hereinafter Possible Framework]; U.N. Department for Economic and Social Affairs Division for Sustainable Development, Action Agenda Comes Into Sharp Focus as Prepcom II Concludes (Feb. 25, 2002), at http://www.johannesburgsummit.org/html/whats_new/feature_story.html (last visited Apr. 10, 2002); WSSD Secretariat, Proposals for Partnerships/Initiatives to Strengthen the Implementation of Agenda 21 (Feb. 11, 2002), at http://www.johannesburgsummit.org/html/documents/prep2final_papers/list_of_partnerships.doc (last visited Apr. 10, 2002) [hereinafter Proposals for Partnerships/Initiatives].

42. See Possible Framework, supra note 41.

43. E.g., SPRINGER, supra note 5, at 35-39 (discussing the traditional approach to international environmental law).

44. Trail Smelter Case (U.S. v. Can.), 3 R.I.A.A. (1941).

45. A cottage industry is characterized by a lack of separation between the home and work environment. This helps account for the severity of lead poisoning in children in the developing world.

46. ACTION PLAN, supra note 7, at 5, 11, 32.

47. E.g., Global Lead Network web pages, at http://www.globalleadnet.org/resources/forums/index.cfm (representing an online discussion conference); http://www.globalleadnet.org/advocacy/bestpractices/index.cfm (illustrating a best practices database) (both last visited Feb. 28, 2002).

48. Habitat II, for example, emphasized the primacy of local action. See Habitat Agenda, supra note 24, PP177, 178, 212, 237, 238.

49. Unfunded mandates and neo-colonialist exploitation of natural resources constitute examples of the devolution of responsibility absent the concomitant provision of resources to enable local oversight and control. See HARRY M. CAUDILL, NIGHT COMES TO THE CUMBERLANDS: A BIOGRAPHY OF A DEPRESSED AREA (1962).

50. E.g., PARTNERSHIP FOR CLEAN AIR, ACCELERATED LEADED GASOLINE PHASE-OUT IN METRO MANILA, PHILIPPINES: A PARTNERSHIP EFFORT (2001), available at http://www.globalleadnet.org/advocacy/bestpractices/index.cfm (last visited Apr. 10, 2002).

51. E.g., Kirsty Alfredson, CNN ONLINE. Powell Rejects U.S. "Lone Ranger" Danger, (July 26, 2001), at http://www.cnn.com/2001/WORLD/asiapcf/southeast/07/26/vietnam.asean.downer/ (last visited Mar. 4, 2002); Stan Crock, Dubya's Lone Ranger Diplomacy, BUS. WK. ONLINE (Mar. 1, 2001), at http://www.businessweek.com/bwdaily/dnflash/feb2001/nf2001031_151.htm (last visited Mar. 4, 2002).

52. Press Release, Worldwatch Institute, State of the World: More Connected, Less Stable (Jan. 10, 2002) (on file with author).

53. CDC and Prevention, supra note 14; F.G. Hank Hilton, Income, Liberties, Idiosyncrasies, and the Decline of Leaded Gasoline, 1972-1992, 8 J. ENV'T & DEV. 49, 50-51 (1999).

54. J.E. Aronson et al., Elevated Blood Lead Levels Among Internationally Adopted Children—United States, 1998, 49 MORBIDITY & MORTALITY WKLY. REP. 97, 97-100 (2000); Immigration and Naturalization Service, U.S. Department of Justice, 6 ANN. REP. LEGAL IMMIG. FY 2000. tbl. 2, at 6 (2002).

55. GLOBAL DIMENSIONS REPORT, supra note 1, at 17-20.

56. Interview with Dr. Joan Cook Luckhardt, Professor, University of Medicine and Dentistry of New Jersey, Camden, N.J. (Apr. 15, 2002) [hereinafter Luckhardt Interview].

57. Agenda 21, supra note 38, chs. 33, 34.

58. In the vocabulary of public health, the medical case management model embodies secondary prevention—"reaction to and tracking of already poisoning children"—while the source control model exemplifies primary prevention—"control and elimination of sources." ALLIANCE TO END CHILDHOOD LEAD POISONING, CHILDHOOD LEAD POISONING: DEVELOPING PREVENTION PROGRAMS AND MOBILIZING RESOURCES 1 (1994) [hereinafter DEVELOPING PREVENTION PROGRAMS].

59. Luckhardt Interview, supra note 56.

60. THOMAS S. KUHN, THE STRUCTURE OF SCIENTIFIC REVOLUTIONS 144-59 (3d ed. 1996).

61. See Press Release, Mount Sinai School of Medicine, Center for Children's Health and the Environment, Health Scientists Explore Links Between Environmental Toxins and Children's Neurological Disorders (May 24, 1999), available at http://www.childenvironment.org/press/1999-05-24.htm (last visited Apr. 10, 2002).

62. See K.W. James Rochow, A Pound of Prevention, and Ounce of Cure: Paradigm Shifts in Childhood Lead Poisoning Prevention, in LEAD POISONING: EXPOSURE, ABATEMENT, REGULATION 89, 89-95 (Joseph J. Breen & Cindy R. Stroup eds., 1995).

63. Cf. WORLD BANK, WORLD DEVELOPMENT REPORT 1993: INVESTING IN HEALTH 1-16 (1993); WORLD BANK, WORLD DEVELOPMENT REPORT 1992: DEVELOPMENT AND THE ENVIRONMENT 1-24 (1992); SECRETARY-GENERAL'S REPORT, supra note 37.

64. The PPS Project, sponsored by EPA, resulted in a series of three documents intended to provide a framework to catalyze action to develop effective childhood lead poisoning prevention programs. ALLIANCE TO END CHILDHOOD LEAD POISONING, CHILDHOOD LEAD POISONING: BLUEPRINT FOR PREVENTION (1993) [hereinafter BLUEPRINT]; DEVELOPING PREVENTION PROGRAMS, supra note 58; ALLIANCE TO END CHILDHOOD LEAD POISONING, CHILDHOOD LEAD POISONING: RESOURCES FOR PREVENTION (1995).

65. See infra note 83 and accompanying text.

66. The Residential Lead-Based Paint Hazard Reduction Act of 1992, §§ 1001-1061, 42 U.S.C. §§ 4851-4856 (2001) (Title X of the Housing and Community Development Act of 1992) [hereinafter Title X]; see also 24 C.F.R. §§ 58, 889; 40 C.F.R. § 745 (parallel authorities regulating Title X).

67. E.g., Title X § 1018, 42 U.S.C. § 4852d (disclosure of information concerning lead upon transfer of residential property); id. § 1021, 15 U.S.C. § 2682 (training and certification) (Title X amended the Toxic Substances Control Act, 15 U.S.C. §§ 2601-2671, with the addition of Title IV—Lead Exposure Reduction); id. § 1004, 1021, 42 U.S.C. § 4851b, 15 U.S.C. § 2683. The law does not contain any provision for mandatory source control. See also Notice Reducing Allowable Levels of Lead in Lead-Based Paint, 42 Fed. Reg. 44199 (Sept. 1, 1977) (to be codified at 16 C.F.R. § 1303).

68. Title X § 1011, 42 U.S.C. § 4852; Childhood Lead Poisoning Prevention Programs (CLPPP); Notice of Availability of Funds, 66 Fed. Reg. 8795 (Feb. 2, 2001).

69. Alliance to End Childhood Lead Poisoning, The Primary Prevention Taste Test/Categorizing Prevention Activities (Background Paper) (February 2002) (on file with author); BLUEPRINT, supra note 64, at 10.

70. See, e.g., Conference Agenda, International Conference on Lead Poisoning Prevention and Treatment, Bangalore, India (Feb. 8-10, 1999) (on file with author); Dr. Wangwongwatana, supra note 36.

71. E-mail from Thomas Matte, Medical Epidemiologist, National Center for Environmental Health, United States, to Abraham George, Managing Trustee, The George Foundation (Feb. 10, 1999) (on file with author).

72. See infra note 93 and accompanying text.

73. 42 U.S.C. § 7545, ELR STAT. CAA § 211 (Clean Air Act). This provision prohibits the sale of lead as an additive to gasoline after December 31, 1995. See also 40 C.F.R. § 80. This decision marks the final step to banning the addition of lead to gasoline in the United States, which began with the 1970 CAA. See U.N. ENVIRONMENTAL PROGRAMME AND ORGANIZATION FOR ECONOMIC COOPERATION AND DEVELOPMENT, PHASING LEAD OUT OF GASOLINE: AN EXAMINATION OF POLICY APPROACHES IN DIFFERENT COUNTRIES 11 (1999) [hereinafter POLICY APPROACHES]; Jamie Lincoln Kitman, Special Report: The Secret History of Lead, THE NATION, Mar. 20, 2000, at 11, 13. "'Unleaded gasoline' is allowed to contain no more than 5/100ths of a gram of lead per gallon." U.S. EPA, AIR QUALITY FACT SHEET, LEADED GAS PHASE-OUT (1995), available at http://www.epa.gov/Region10/offices/air/leadedga.html (last visited Apr. 10, 2002).

74. NATIONAL ACADEMY OF SCIENCES/NATIONAL RESEARCH COUNCIL, MEASURING LEAD EXPOSURE IN INFANTS, CHILDREN, AND OTHER SENSITIVE POPULATIONS 19 (1993).

75. JOEL SCHWARTZ ET AL., COSTS AND BENEFITS OF REDUCING LEAD IN GASOLINE: FINAL REGULATORY IMPACT ANALYSIS VIII-2 (1985).

76. Japan probably was the first country to phase out leaded gasoline, having done so by 1980. Other countries in the phase-out vanguard include Brazil and Sweden. POLICY APPROACHES, supra note 73, at 1; OFFICE OF INTERNATIONAL AFFAIRS, U.S. EPA, IMPLEMENTER'S GUIDE TO PHASING OUT LEAD IN GASOLINE 44 (1999). In the United States, important pockets of resistance to phase-out remained until the process was virtually completed. The Reagan Administration, for example, tried to retard further phase-out efforts even as they were coming to a successful conclusion. See Kitman, supra note 73, at 11, 37.

77. Press Release, World Bank, Vietnam Switches to Unleaded Gasoline: World Bank Praises Move (July 5, 2001), available at http://www.worldbank.org/developmentnews/stories/html/070501a.htm (last visited Apr. 10, 2002); Press Release, World Bank, Unleaded Gasoline in Bangladesh: An Overnight Success (June 30, 2000), available at http://wbln0018.worldbank.org/news/pressrelease.nsf (last visited Apr. 10, 2002); MANUFACTURERS OF EMISSION CONTROLS ASS'N, THE CASE FOR BANNING LEAD IN GASOLINE 11-13 (1998) (explaining the three proven approaches to leaded gasoline phase-out and the potential for misfueling that each one produces).

78. Alliance to End Childhood Lead Poisoning, Worldwide Phase-Out of Leaded Gasoline: An Environmental Health Priority (Background Paper) (rev. Nov. 2001), at http://www.globalleadnet.org/policy_leg/policy/health.cfm (last visited Apr. 10, 2002).

79. Soil lead concentrations in many major U.S. cities are astronomically high, largely due to the legacy of leaded gasoline use. Howard W. Mielke, Lead in the Inner Cities, AM. SCIENTIST, Jan./Feb. 1999, at 62.

80. Worldwide Phase-Out of Leaded Gasoline, supra note 78.

81. See supra notes 66-69 and accompanying text.

82. One task for the United States is to perfect the ban on lead-based paint and leaded gasoline: lead-based paint is still allowed in industrial, commercial, and marine applications; leaded gasoline is still allowed in aviation, race cars, and agricultural equipment fuel. See GLOBAL DIMENSIONS REPORT, supra note 1, at 17; AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY (ATSDR), TOXICOLOGICAL PROFILE FOR LEAD 372 (1999), available at http://www.atsdr.cdc.gov/toxprofiles/tp13.html (last visited Apr. 10, 2002).

84. E.g., CDC, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, A STRATEGIC PLAN FOR THE ELIMINATION OF CHILDHOOD LEAD POISONING (1991). In 1991, The CDC declared lead poisoning as the "number one environmental health hazard facing American children." There was some dialectical tension between those who gave priority to leaded gasoline phase-out and those who focus on the continuing dangers of lead-based paint. See Samuel P. Hays, The Role of Values in Science and Policy: The Case of Lead, in HUMAN LEAD EXPOSURE, supra note 2, at 267, 269-70.

83. U.S. HUD, SURVEY OF LEAD AND ALLERGENS IN HOUSING: FINAL REPORT, Vol. I, Rev. 6 ES-1, at 37, 38 (2001).

85. White Lead (Painting) Convention, 1921, Nov. 19, 1921, 38 U.N.T.S. 175 (entered into force Aug. 31, 1923), available at http://ilolex.ilo.ch:1567/english/cvlist.htm (last visited Apr. 10, 2002) (Convention No. 13 of the International Labour Organization).

86. The U.S. Consumer Products Safety Commission has continued to address miscellaneous sources of lead exposure in consumer products. E.g., Federal Hazardous Substances Act (FHSA), 15 U.S.C. §§ 1261-1278 (1960 as amended) (bans children's products containing a hazardous amount of lead); Labeling of Hazardous Art Materials Act, 15 U.S.C. § 1277 (1988) (amended the FHSA to require that all require that all art materials be reviewed by a toxicologist for chronic hazards and be labeled appropriately). EPA has issued regulations regarding lead in drinking waters, soil, and other media. E.g., 42 U.S.C. § 300g-6, ELR STAT. SDWA § 1417 (Safe Drinking Water Act); National Primary Drinking Water Regulations, 40 C.F.R. § 141.43.

87. Title X §§ 1051-1056, 42 U.S.C. §§ 4854-4855.

88. This interagency task force stands in contrast to the legislatively mandated task force that produced a set of recommendations elaborating implementation of Title X's provisions. See generally LEAD-BASED PAINT HAZARD REDUCTION AND FINANCING TASK FORCE, PUTTING THE PIECES TOGETHER: CONTROLLING LEAD HAZARDS IN THE NATION'S HOUSING (U.S. Dep't of Hous. & Urban Dev. Report No. HUD-1547-LBP, 1995).

89. Western Center on Law and Policy, Preventing Childhood Lead Poisoning: Identifying and Eliminating Local Barriers to Primary Prevention Strategies (Background Paper) (Nov. 2001), at http://www.wclp.org/ (last visited Apr. 15, 2002).

90. See Luckhardt Interview, supra note 56.

91. See supra notes 14-15 and accompanying text.

92. BLUEPRINT, supra note 64, at 8.

93. ENVIRONMENTAL LAW INST., COMMUNITY ENVIRONMENTAL HEALTH ASSESSMENT WORKBOOK: A GUIDE TO EVALUATING YOUR COMMUNITY'S HEALTH AND FINDING WAYS TO IMPROVE IT (2000).

94. See Luckhardt Interview, supra note 56; see Habitat Agenda, supra note 24, PP42-43.

95. In an experimental side event at the sixth CSD in 1998, the Alliance to End Childhood Lead Poisoning convened a side event that brought local community groups to the United Nations. The event confirmed that despite the pervasive rhetoric of localism in the international system, local groups even in the area of U.N. headquarters were remote from U.N.-related programs and proceedings. Announcement, Alliance to End Childhood Lead Poisoning, Air, Water, Land, Community: Best Practices and Partnerships for Lead Poisoning Prevention (Apr. 23, 1998) (on file with author).

n96See supra note 6 and accompanying text.

97. Basel Convention on the Transboundary Movements of Hazardous Wastes and Their Disposal, Mar. 22, 1989, 28 I.L.M. 649 (entered into force May 5, 1992).