Getting family planning and population back on track

After a generation of partial neglect, renewed attention is being paid to population and voluntary family planning. Realistic access to family planning is a prerequisite for women's autonomy. For the individual, family, society, and our fragile planet, family planning has great power.

Population and climate change: who will the grand convergence leave behind?

For many developing countries, investments in health have proved a great success. The LancetCommission “Global health 2035: a world converging within a generation”1 and the 2014 Gates annual letter2 envision the possibility of a “grand convergence” by which more countries will have a child mortality rate as low as 15 per 1000 livebirths in 20 years time. We wish to draw attention to the special case of the least developed countries, which on present evidence are likely to be excluded from such a convergence.

Population and Climate Change: Empowering 100 Million Women

Meeting the world’s need for family planning is a human right and a climate imperative. Wherever women have been given information and access to family planning, birth rates have fallen – even in poor, low-literate societies like Bangladesh or conservative religious countries such as Iran.

"Big issues deserve bold responses" Les grandes questions meritent des responses audacieuses: la population et le changement climatique au Sahel

Parts of Africa have the most rapid population growth in the world. Recent studies by climatologists suggest that, in coming decades, ecologically vulnerable areas of Africa, including the Sahel will be exposed to the harshest adverse effects of global warming. The threat hanging over parts of sub-Saharan Africa is extreme. Fortunately, there are evidence-based achievable policies which can greatly ameliorate what would otherwise be a slowly unfolding catastrophe of stunning magnitude. But to succeed such measures must be taken immediately and on a large scale.

Big issues deserve bold responses: Population and climate change in the Sahel

Parts  of  Africa  have  the  most  rapid  population growth in the world. Recent studies by climatologists  suggest  that,  in  coming  decades, ecologically vulnerable areas of Africa, including the Sahel will be exposed to the harshest adverse effects of global warming. The threat hanging over parts of sub-Saharan Africa is extreme. Fortunately,  there are evidence-based achievable policies which can greatly ameliorate what would otherwise  be  a  slowly  unfolding  catastrophe  of stunning magnitude. But to succeed such measures must be taken immediately and on a large scale.

The Sahel: A Malthusian Challenge?

The population of the least developed countries of the Sahel will more than triple from 100 million to 340 million by 2050, and new research projects that today’s extreme temperatures will become the norm by mid-century. The region is characterized by poverty, illiteracy, weak infrastructure, failed states, widespread conflict, and an abysmal status of women. Scenarios beyond 2050 demonstrate that, without urgent and significant action today, the Sahel could become the first part of planet earth that suffers large-scale starvation and escalating conflict as a growing human population outruns diminishing natural resources. National governments and the international community can do a great deal to ameliorate this unfolding disaster if they put in place immediate policies and investments to help communities adapt to climate change, make family planning realistically available, and improve the status of girls and women. Implementing evidence-based action now will be an order of magnitude more humane and cost-effective than confronting disaster later. However, action will challenge some long held development paradigms of economists, demographers, and humanitarian organizations. If the crisis unfolding in the Sahel can help bridge the current intellectual chasm between the economic commitment to seemingly endless growth and the threat seen by some biologists and ecologists that human activity is bringing about irreversible damage to the biosphere, then it may be possible also to begin to solve this same formidable problem at a global level.

 Published in Environmental & Resource Economics 2013: 55(4), 501-512.

Do Economists Have Frequent Sex?

Last year a member of the World Bank professional staff gave a lecture on development in Africa on the UC Berkeley campus. His audience asked him about rapid population growth in that continent. He immediately dismissed the question, saying that population growth did not need any special attention. It would look after itself. He was voicing an uncritical interpretation of the demographic transition, a “theory” which has as much evidence to support it as the fictitious Da Vinci Code, and like the Da Vinci Code it remains perennially popular.

Crisis in the Sahel: Possible Solutions and the Consequences of Inaction

A report following the OASIS Conference (Organizing to Advance Solutions in the Sahel) hosted by the University of California, Berkeley and African Institute for Development Policy in Berkeley on September 21, 2012.
The goal of this report is to start building a network of scientists and policy makers committed to helping the Sahel address its population, environment, and food security challenges. A compelling body of evidence is needed to inform people in governments and relevant local institutions, humanitarian organizations, foreign aid agencies, philanthropic institutions, and national security agencies concerning the startling challenges facing this neglected and highly vulnerable region.

Why Bold Policies for Family Planning are Needed Now

Last spring at a Technology, Entertainment, Design (TED) talk in Berlin, Melinda Gates used this phrase, “The most transformative thing you can do is to give people access to birth control.” She expressed similar sentiments at the London Summit on Family Planning on July 11, 2012, as did the British Prime Minister David Cameron, and Andrew Mitchell who was then Secretary of State for the Department for International Development, the British equivalent of United States Agency for International Development. The London Summit represented a new focus on international family planning after nearly 20 years of collapsed budgets. It set the goal of halving the number of women with an unmet need for family planning in the world’s poor counties in the next 8 years — that is, helping 120 million out of an estimated 222 million women worldwide with an unmet need for family planning. Donor governments and foundations pledged US$2625 million dollars over the next 8 years to reach this goal. Governments of the target countries, especially India, committed another US$2 billion. This renaissance in international family planning is exceedingly welcome, but if it is to succeed, it must pay particular attention to the least developed countries (LDCs).

Published in: Contraception (Article In Press) 

Niger: Too Little, Too Late

Niger—with the world’s fastest growing population, its highest total fertility rate (TFR), a small and diminishing amount of arable land, low annual rainfall, a high level of malnutrition, extremely low levels of education, gross gen- der inequities and an uncertain future in the face of climate change—is the most extreme example of a catastrophe that is likely to overtake the Sahel. The policies chosen by Niger’s government and the international community to reduce rapid population growth and the speed with which they are implemented are of the utmost importance. In this comment, we review the problems posed by Niger’s rapid population growth and the policy options proposed to confront it.

Are the population policies of India and China responsible for the fertility decline?

In the 1970s, policy-makers in both India and China, convinced that reducing population growth was critical for ending poverty, instituted coercive population policies. Yet fertility had already been declining in both countries before the population policies were instituted. In China, the total fertility rate (TFR) had already fallen to 2.9 before the institution of the One-Child Policy. In India, fertility continued to decline at roughly the same rate before, during and after ‘The Emergency’. Regardless of government mandates, couples in both countries before the policies and since have shown a desire to reduce their family size and when given access to family planning, have voluntarily limited the number of children they chose to have.

THE POPULATION FACTOR: How does it relate to climate change?

The human contribution to climate change is driven primarily by high per capita consumption in the North. The poorest 1 billion people living on a dollar or two a day contribute only 3 per cent of the world’s total carbon footprint, yet the loss of healthy life-years resulting from global warming could be as much as 500 times greater in Africa than in Europe (McMichael et al., 2008). It is also true that 99 per cent of the projected 1-4 billion increase in global population that will occur between now and 2050 will take place in the least developed countries with the smallest carbon footprints.  At first sight, the inequity that the nations of the North have caused over 90 per cent of global warming but suffer fewest of its adverse effects, combined with the asymmetry in population growth between the South and the North, seems to create an impossibly difficult background for policy discussions between countries and national groupings. The countries of the North could not ask the 2 billion people of the South living on one or two dollars a day to either slow economic growth or have fewer children in order to slow global warming.

But if we frame the discussion at the level of individual needs rather than national interests, then a totally different picture emerges. Surveys demonstrate that there is a large unmet need for family planning in both developed and developing regions, and analysis shows that meeting the unmet need for family planning and preventing unintended pregnancies – whether women are rich or poor – is one of the most cost- effective ways of slowing global warming. It has the potential to benefit hundreds of millions of individuals, to help the whole planet slow greenhouse gas accumulation and facilitate countries in adapting to climate change. As the failure of the 2009 United Nations Climate Change Conference in Copenhagen demonstrated, people do not want to consume less: they do, however, want fewer children. At the individual level, the link between climate change and family planning is a win-win strategy. But, for reasons just set out, it is also the climate strategy most likely to be misunderstood, corrupted deliberately or rejected out of hand, by those with strong feelings about human sexuality and the autonomy of women, as well as those promoting access to family planning.

Published by the Bixby Center for Population, Health and Sustainability, at the University of California, Berkeley.

The theoretical and political framing of the population factor in development

The silence about population growth in recent decades has hindered the ability of those concerned with ecological change, resource scarcity, health and educational systems, national security, and other global challenges to look with maximum objectivity at the problems they confront. Two central questions about population—(i) is population growth a problem? and (2) what causes fertility decline?—are often intertwined; if people think the second question implies possible coercion, or fear of upsetting cultures, they can be reluctant to talk about the first. The classic and economic theories explaining the demographic transition assume that couples want many children and they make decisions to have a smaller family when some socio-economic change occurs. However, there are numerous anomalies to this explanation. This paper suggests that the societal changes are neither necessary nor sufficient for family size to fall. Many barriers of non-evidence-based restrictive medical rules, cost, misinformation and social traditions exist between women and the fertility regulation methods and correct information they need to manage their family size. When these barriers are reduced, birth rates tend to decline. Many of the barriers reflect a patriarchal desire to control women, which can be largely explained by evolutionary biology. The theoretical explanations of fertility should (i) attach more weight to the many barriers to voluntary fertility regulation, (ii) recognize that a latent desire to control fertility may be far more prevalent among women than previously understood, and (iii) appreciate that women implicitly and rationally make benefit–cost analyses based on the information they have, wanting modern family planning only after they understand it is a safe option. Once it is understood that fertility can be lowered by purely voluntary means, comfort with talking about the population factor in development will rise.

Published in: Phil. Trans. R. Soc. B October 27, 2009 364:3101-3113;

Editoral for ‘The impact of population growth on tomorrow’s world'

An international group of 42 scientists met at the University of California, Berkeley on 23–24 January 2009 to discuss The World in 2050, and how global changes in the human population might change our future.

The papers prepared for the Forum are published as a theme issue of the Philosophical Transactions of the Royal Society B.

Published in Phil. Trans. R. Soc. B 2009 364, 2975-2976

Freedom Closes the Gap

We found ourselves strongly disagreeing with a recent editorial in Contraception by Wells et al. when they asserted, “Thirty years ago, our approach to uncontrolled population growth in developing countries was to flood them with contraceptives. After millions of dollars without making an appreciable dent, we have come to understand that improving contraceptive practice is more dependent on women’s literacy and education than on the actual access to contraceptives”. We also asked why those who are often warm friends and who work together with a common enthusiasm to improve all aspects of family planning can also end up adopting profoundly different explanations of why family size falls. We all accept that modern contraception improves the health of women and their families and that it is central to the autonomy of women in modern societies, yet for half a century, family planning has been riven by this deep and sometimes counterproductive fault line. On one side are those who emphasize that easy access to modern contraception, backed by honest information, helps drive up the contraceptive prevalence rate. On the other side are those who assert that changes in socio-economic factors are a prerequisite for greater contraceptive use.

Printed in Contraception. 77: 389-390. 2008

Review of Connolly’s Fatal Misconception: The Struggle to Control World Population

Matthew Connelly’s Fatal Misconception is a paradox. It provides a dangerously misleading description of the history of international family planning programs in the twentieth century. Connelly has been industrious in his research, however, and in the process he has illuminated, albeit unintentionally, one of the core intellectual issues in international family planning that over time scarred governmental efforts to slow population growth.

Published in Population Development Review, September 2008, 262-268