GLOBAL POPULATION GROWTH - IS IT SUSTAINABLE? MEETING OF THE PARLIAMENTARY AND SCIENTIFIC COMMITTEE ON MONDAY 22ND OCTOBER 2007

Dr Malcolm Potts MB, BChir, FRCOG Bixby Professor Population, Family Planning and Maternal Health, University of California, Berkeley

Is population growth a every decade. Petroleum geologists problem? suggest oil production could peak as early as 2020. Perhaps less profligate Global population grows more rapidly use and alternative sources of energy now (217,000 more births than deaths will keep pace with demand, but if each day) than in the 1960s (165,000 they do not the world economy could more). Rapid population growth used spiral downwards. to command wide attention, but today it meets a collective yawn. Some scientists suggest that human activity exceeded the Earth’s capacity Ninety-nine per cent of the projected to support it in 1985. Such predictions In Kenya, prior to Cairo, when family growth in population by 2050 will have wide margins of error and even planning was emphasised, the TFR fell take place in the developing world. bringing today’s global population to from 8 to below 5. After Cairo, family Already 1.2 billion lack access to clean western standards of consumption and planning budgets dropped, unwanted water. By 2025 a staggering 3 billion pollution would probably exceed the births doubled, and the fall in the TFR people will be short of water. world’s resources. In 1993, a stalled. The population in 2050 could Population Summit of 60 national be 83 million instead of 44 million. Population projections depend on scientific academies, including the Unless there is a renaissance of interest calculating the total fertility rate (TFR) Royal Society, issued a sombre and investment in family planning, – the average number of children a warning, “science and technology may Kenya will become a failed state, like woman will have over her fertile life, not be able to prevent irreversible Somalia and the Congo. based on current age-specific fertility degradation and continued poverty for rates. The Ethiopian TFR is 5.4. The Last year, the All Party Parliamentary much of the world.” The Academies population has multiplied 15 times Group on Population, Development recommended “zero population since 1900 and unless family planning and Reproductive Health held hearings growth within the lifetime of our receives more attention it will reach on the impact of population growth on children.” 145 million in 2050. Already, 8 the Millennium Development Goals. million Ethiopians depend on external Unfortunately, a year later the After taking a great deal of expert food aid. Niger has a TFR of 8. Four International Conference on evidence, they concluded that it is out of 10 children are malnourished Population and Development in Cairo “difficult or impossible” to achieve the and 84% of adults are illiterate. If the did not listen to the world’s scientists. MDGs in high fertility countries. TFR falls to 3.6 the population will Women advocates “redefined” If population growth is a problem can grow from 14 million today to 50 population, framing anything to do anything be done about it? million in 2050: if it remains constant with “population” as intrinsically there will be 80 million. coercive, and even the word In the 1960s offering family planning “demographic” became politically to lower birth rates in the absence of For the 2 billion people living on 50p incorrect. Compelling evidence of the socio-economic improvements was a day or less, future population growth success of family planning dubbed “wishful thinking”. Now we is unsustainable. The rich also face programmes was ignored, or criticised know that socio-economic changes are formidable problems. World Bank as “target driven”. It was asserted that not a prerequisite for dropping the projections suggest a four-fold increase fertility decline would occur when birth rate. In fact, some countries in the global domestic product in the holistic social and health goals were cannot get out of poverty unless next 50 years. Past growth has reached. population growth is slowed. As a depended on doubling oil output result of rapid population growth,

18 Science in Parliament Vol 65 No 1 Spring 2008 developing countries need 2 million lack of access to contraception, not a which now has more women than more teachers annually, just to hold desire for bigger families which is men in universities, and, along with class size constant. driving the disparity. Family planning much slower population growth, is is often over-medicalised raising likely to be increasingly stable. Iran Slowing population growth pays what innumerable, unnecessary obstacles demonstrates that a pack of oral has been called a demographic between women and the methods they contraceptives and access to voluntary dividend. Individuals with smaller need. Providers, fearful a woman sterilisation can help start a social families have more income to invest might be pregnant, often refuse revolution from within. Ultimately, the and a rapid fall in the birth rate contraceptive advice unless she is Pill is mightier than the sword. produces a relatively large work force. menstruating when she visits the When all the other parameters are clinic. Reasons for hope fixed demographic changes by The wonderful discovery of the past themselves pushed the savings rate in India and Iran Taiwan higher than in the US or 50 years has been that people all over France where the birth rate fell more India was the first nation to develop a the world want voluntary family slowly. It is precisely the countries that national population policy, but it still planning. Tragically, 200 million have been able to slow population grew from 357 million to over one women, almost all in poor countries, growth, which are now undergoing billion in 50 years. The government cannot get access to the choices they rapid economic expansion, and often built a top-down national programme need and deserve. becoming more democratic. around western trained physicians, It is imperative to make as wide a while most of India’s population range of fertility regulation options Jeffrey Sachs writes in The End of growth is in rural areas where there available, through as wide a range of Poverty , “. . . that impoverished are no doctors. Instead of correcting distribution channels as resources families choose to have lots of this shortcoming, Indira Ghandi’s permit. Priority must be given to children.” But, the decision to have a government used coercive measures to ensuring modern contraceptives and child is not like choosing to buy a car, meet demographic targets, leading to the information people need to use where the person balances their election defeat in 1977. The Islamic them. Government services are finances against their perceived need. Republic of Iran was one of the last overloaded, have weak logistics and Sex is often irrational and passionate, countries to confront rapid population lack incentives, and the very poor tend and human beings have sexual growth. In 1988, Ayatollah Khomeini to use the private/informal health intercourse up to a thousand times was pursuaded to adopt a national sector. As the All Party Report points more frequently than is necessary to family planning policy: contraceptive out, an emphasis on Sector-Wide conceive the children they want. factories were built, every newlywed Approaches (SWAps) in foreign aid Having a child is not a single decision couple is required to attend family misses some of the poorest and most made one night to turn fertility on , but planning instruction, and vulnerable groups. a difficult, consistent, prolonged appropriately trained health workers struggle to turn fertility off . are stationed in the rural areas. Iranian As the world’s scientific academies Impoverished families have “lots of family size fell from six to two - as foresaw a decade and a half ago, and children” not because they want them, rapidly as in China, but without any as the All Party Group reiterated in but because they do not have access to coercion. January this year, without a significant modern contraceptives to turn fertility slowing of population growth we face off. The 9/11 Commission Report called “a “irreversible degradation of the natural large, steadily increasing population of environment and continued poverty Over the past decade the disparities in young men [is] a sure prescription for for much of the world.” Building on family size between rich and poor in social turbulence.” Pakistan, which the All Party Report, there is no better developing countries have increased – never had a well-organised family place in the world to make this implying less education for the planning programme, will more than happen than here, in the mother of children of the poor, more hunger, double its population by 2050 and Parliaments. more women dying and more infants become increasingly violent. Iran, dying. The poor use contraception less, but the statistics also show that The Report of Hearings by the All Party Group on Population, Development and they have a much greater unmet need Reproductive Health (Return of the Population Growth factor: Its Impact upon the for family planning, suggesting it is Millennium Development Goals) is on the web at www.appg-popdevrh.org.uk

Science in Parliament Vol 65 No 1 Spring 2008 19