Intended for healthcare professionals

Editorials

Contrasting views on human population growth

BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7215.931 (Published 09 October 1999) Cite this as: BMJ 1999;319:931

One wisdom justifies complacency: the other demands action now

  1. A J McMichael, professor (t.mcmichael{at}lshtm.ac.uk),
  2. J Guillebaud, medical director (j.guillebaud{at}lineone.net),
  3. Maurice King, honorary research fellow
  1. Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT
  2. Margaret Pyke Family Planning Centre, London W1P 1LB
  3. University of Leeds, Leeds LS7 9JT

    World population reaches 6 billion on 12 October, according to the best guess of demographers. It has tripled in a single lifetime, is projected to increase by half as much again next century, and, if current declines in fertility falter, could yet double. We have heard such statistics before, to the point of population crisis fatigue Yet we are living through a spectacular phenomenon in demographic history. Three quarters of the 1000-fold increase in human numbers since agriculture emerged 10 000 years ago has occurred during this past century—75% of the absolute increase in 1% of the time.

    The size of the human population is an important determinant of its condition. It is increasingly the combination of human numbers with levels of consumption and types of technology that determines the impact on the environment—and whether that impact exceeds the local or global carrying capacity. Humanity's response to this population surge is one crucial test of its wisdom. Put simply, there are two “wisdoms.”

    The first wisdom denies that population increase is a cause for alarm. This view is common on the neoliberal right: complacent, consumerist, and laissez faire. Although population has been increasing a little faster than globally averaged grain yields per person since the mid-1980s, this wisdom expects that technical advance will “fix it.” Education, particularly female education, combined with economic development will bring fertility down to replacement levels fast enough. Increasing agricultural productivity, boosted by genetically modified foods, provides the surest route to reducing rural poverty and malnutrition. The increasing global inequality will right itself, in a world which will collectively reach the consumption levels of California. Global warming, if confirmed, can be adapted to. Regional crises of demographic entrapment (see below) are not anticipated, Malthus has been proved wrong, the human rights edifice remains unflawed and paramount, and China's one child families are an unjustifiable aberration. Humanity is safe in the hands of the United Nations.

    The second wisdom is not confident of science's ability to double global grain production sustainably. It suspects that large parts of sub-Saharan Africa (where population is set to more than triple) and south Asia (set to almost double) may already be demographically trapped1—that is, without indefinite food aid, are committed to a future of starvation and slaughter.2 It also suspects that the human psyche cannot accept constraining reproduction and, indeed, imposes taboos on attempts to do so. This second viewpoint identifies population growth as the unrecognised multiplier of most major world problems: the persistence of inequality, poverty, and malnutrition; resource shortages; ecological disruption and environmental pollution; the loss of biodiversity and wildlife habitats; and conflict and violence. Even natural disasters like floods are made worse because population pressure forces more people to live in vulnerable locations—such as areas prone to periodic inundation.

    This second wisdom is crucially concerned with time. Though it advocates female education and empowerment, it cannot see such advances, nor general economic development, reducing fertility fast enough. It concludes that if human rights are indeed to be preserved then population control—planned measures to stabilise and eventually reduce human numbers—must be rehabilitated: the unplanned alternative outcomes are worse. The form of those measures requires debate by the human rights movement, since there are other “Chinas” facing catastrophic population growth, leading to starvation and slaughter. Some argue that for a transitional period there must be a “one child world.” If the South is to constrain its fertility then the North must moderate its resource consumption. This second wisdom, then, is alarmed, leftist, frugal, doubtful of the adequacy of free markets, and green. It lacks faith in the United Nations system.

    As well as the prospect of intensifying various local subsistence crises is the real possibility that we are beginning to overload the whole biosphere. 3 4 Incipient climate change may be the best early indicator; other large scale physical, biotic, and ecological systems are also showing strain.5 Therefore we need to respond at both levels—to avoid regional subsistence crises, and to make industrialisation and economic development both generalisable and sustainable on a finite planet.

    In this issue of the BMJ King argues provocatively that much of the first wisdom is incarcerated in a “population policy” lockstep from which academic demography, development economics, the charitable foundations, the UN agencies, and the major journals dare not break ranks. He argues that this lockstep is fostered by the United States—because it recognises that if the South is expected to reduce fertility then the North (and particularly the United States) has to reduce consumption.

    We invite you to make up your own mind on this. Meanwhile, dialogue should be opened on the existence, recognition, and avoidance of local demographic entrapment and of our exceeding of the biosphere's carrying capacity. To duck the issue, through apathy, ignorance, or uncritical optimism, is to opt for the default position—the first wisdom.

    So what next? Should demographers broaden their discipline and include research into entrapment? Learned societies and research funding agencies are reminded that taboos are detrimental to learning. We hope that the BMJ will receive many communications on such issues as: the tensions between sustainable development, economic growth, and employment; human rights in the face of demographic pressures; humankind's reasonable share of the world's natural resources and habitats; more user-friendly, safe, long term, and “forgettable” contraceptive technologies, freely or cheaply available and uninhibitedly advertised6; and state of the art (often peer provided) age specific sexual health education for the young. We need vigorous initiatives in both North and South, with vastly increased funding to ensure that everybody in the world who wants contraception can actually get it.

    Politics, it has been said, is health, and health is politics. Here, in the politics of population, as we charge past the 6 billion mark, we have both on the largest possible scale.

    References

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