The World Bank, Population Control, and the Liberal Economic Order By Leah Kazar Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of Bachelor of Arts In the Department of History at Brown University Thesis Advisor: Professor Naoko Shibusawa April 7, 2017 Kazar 2 Kazar 3 Acknowledgments Above all, I would like to thank my thesis adviser, Professor Naoko Shibusawa, for guiding me through the thesis writing process. From helping me find a topic to her instrumental role in encouraging me to refine my arguments, Professor Shibusawa has been an invaluable resource and mentor. Indeed, I do not think I would have been able to write this without her. I would also like to thank the members of the K-Team writing group: Aditya Kumar, Mae Rochelle-Verano, Nicolas Montano, Patrick Chung, Ida Yalzadeh, Nicole Sintetos, and Marco McWilliams, whose feedback, encouragement, and snacks have kept me going and helped me write a much more considered and interesting thesis. Additionally, I’d like to thank Bertha at the World Bank Group Archives, who was an excellent resource and great help in finding materials on the World Bank’s population policy over the years. Finally, I would like to thank my parents, who let me talk through potential topics and arguments with them whenever I hit roadblocks in my work. My father also deserves special mention for spending countless hours working to retrieve my thesis notes from an external hard drive after it crashed this fall. The support of my parents in the writing of this thesis, and my education in general, is why I am where I am today. Kazar 4 Kazar 5 Introduction In April of 1977, Dr. R. T. Ravenholt, the director of the U.S. Government’s Office of Population, was in St. Louis to attend the annual meeting of the Population Association of America. While there, Ravenholt dropped a bombshell: in an interview with the St. Louis- Dispatch, he stated that as many as 100 million women worldwide would be sterilized if various U.S.-sponsored population programs met their goals. The Dispatch ran with the headline, “U.S. Goal: Sterilize Millions of World’s Women.”1 Indeed, some of these programs were being executed just down the road from the site of his interview, at the Washington University in St. Louis School of Medicine. There, the medical school hosted trainings on sterilizations as part of the United States Agency for International Development’s (USAID) Program for International Education in Gynecology and Obstetrics (PIEGO). PIEGO facilitated sterilization technique trainings for doctors from around the globe—even when those in their countries of origin rejected the practice.2 Through programs like PIEGO, the United States could work to meet Ravenholt’s lofty population control goals around the world. Ravenholt’s reasoning for why such goals were worthwhile was fourfold. The first was humanitarian: a reduction in the number of people in developing nations would allow their governments to better provide for those who were left, and an increase in the overall standard of living. After all, “Resources divided by population equals well being.”3 The second was the United States’ “moral responsibility” to help solve a problem it had abetted by creating the medical advances that bolstered population increases around the globe. The third was economic: 1 Paul Wagman, “U.S. Goal: Sterilize Millions of World’s Women.” St. Louis Post-Dispatch, April 22, 1977; Box 3; Record Group 286: Records of the United States Agency for International Development; National Archives and Records Administration, College Park, MD, 1. 2 Michael S. Burnhill and Thomas S. Moulding, “Evaluation of the Program for International Education in Gynecolog and Obstetrics,” USAID, September 17, 1976, available at http://pdf.usaid.gov/pdf_docs/Pdaaa502a1.pdf. 3 Paul Wagman, “U.S. Goal: Sterilize Millions of World’s Women,” 1. Kazar 6 population control was necessary in order to maintain “the normal operation of commercial interests around the world.”4 Without a reduction in idle hands whose discontent would otherwise urge them to “rebel against the strong U.S. commercial presence,” U.S. economic hegemony was not secure.5 The fourth reason built off of the third: a continuation of population explosions would result in horrific socioeconomic conditions conducive to revolutions that could be harmful to the United States.6 Using this reasoning as a justification, Ravenholt hoped that U.S. programs would make sterilization available to all of the world’s 570 million fertile women. If population control policies were effective, up to one quarter of them could be sterilized.7 Though Ravenholt’s comments represented how many Western elites viewed the population debate, his position was not met with uniform complacency. Students at the Washington University in St. Louis School of Medicine objected to USAID’s use of their school to train doctors from around the world in techniques they claimed would be used on the poor and disenfranchised in developing countries. Ravenholt dismissed these dissenters as “radicals” who he believed wanted to promote the revolutions he so valiantly sought to prevent.8 These critics, who held that economic development would naturally limit population growth, in turn saw Ravenholt’s claims as outrageous. Highlighting the Cold War context of this debate, some of them countered with the Cuban example, drawing attention to the fact that the nation was deemed overpopulated until the radical reorganization of its economy finally gave resources and jobs to those formerly deemed extraneous. This played into the Cold War “us vs. them” logic of the day, and made it easy for Ravenholt and his ilk to dismiss protestors as “leftists.”9 4 Ibid. 5 Ibid. 6 Ibid. 7 Ibid., p. 6 8 9 Ibid. Kazar 7 Ravenholt ultimately denied that he had ever said such things to the Post Dispatch. He held that he never advocated for one-quarter of the world’s reproduction-age women be sterilized, and emphasized the voluntary nature of U.S. programs’ sterilization efforts.10 An internal USAID memo called the Dispatch article “a deliberate effort to distort the information” that was provided by Ravenholt in his interview, in which he did not speak to the commercial interests of the United States, nor to strict sterilization goals made by the United States government.11 Regardless of whether or not Ravenholt indeed made the statements alleged in the article, this incident highlights the conflicts expressed in the population control debate in the latter half of the 20th century. This thesis will address the themes suggested by this vignette, including those embodied in Ravenholt’s excuses, the ensuing debate, and the context in which this situation occurred. How could people like Ravenholt justify U.S. and Western-led intervention into the population policies of other nations? More specifically, I am interested in how nations like the United States that fashioned themselves as champions of free choice and free markets, and ostensibly abhorred top-down economic planning, could justify their promotion of top-down population policies. Wouldn’t such a position pose a fundamental contradiction? My answer lies in the broader context of the population debate, starting with a more informed definition of capitalism. Though freedom of choice is often the purported modus operandi of capitalism as held by its advocates, capitalism is at its core a system built on the private ownership of the means of production, or capital, that above all else seeks to amplify the gains accrued from capital investments. It is not a system that is built fundamentally on freedom 10 R. T. Ravenholt, Letters: As To Sterilization,St. Louis Post Dispatch, May 3, 1977; Box 3; Record Group 286: Records of the United States Agency for International Development; National Archives and Records Administration, College Park, MD. 11 Douglas H. Huber, memo to Sander Levin, Assistant Administrator, PHA USAID, Department of State from Cholera Research Laboratory DACCA, Department of State, April 26, 1977; Box 3; Record Group 286: Records of the United States Agency for International Development; National Archives and Records Administration, College Park, MD. Kazar 8 for all, nor does it necessarily lend itself to increased choice.12 By viewing the United States and largely U.S.-led institutions like the World Bank as agents of capitalism, rather than free markets, their involvement in promoting population policy can be made more legible. Specifically, they were acting in a way that saw excess population as a resource sink that prevented the capital accumulation that was required by their beliefs about development. I also hope to investigate how and why developing nations’ governments accepted such policies, with the answer lying in the nature of the embedded liberal institutions like the World Bank and internalized beliefs about the nature of modernity. Though dissent did arise to population policies, accompanied by a recognition of their place in agendas of Western- dominated capitalist expansion, it was ultimately ineffective. This failure arose from the unique positioning of embedded liberal institutions like the World Bank, which gave nations reliant on their funding the opportunity to present their grievances but ultimately dismissed them in the context of an overwhelmingly liberal economic ideology. Furthermore, this dominant liberal ideology allowed developing nations, even when rebelling against the excessive capitalism they saw in the West, to internalize onto liberal ideas about what modernity should look like. Consequently, they often implemented their own population programs and extractive economic systems in order to achieve the prosperity promised to them by the West. Overall, population control policies became commonplace because of their relationship to the overwhelming dominance of Western-dominated capitalism and liberalism. Personal Bias and Disclaimer 12 For example, as Thomas Piketty notes in Capital in the 21st Century, capitalism unimpeded naturally tends towards oligarchy and monopoly, leading to the concentration of wealth and a reduction of choices for the vast majority of people.