In South Africa on this very day, Dr. Malcolm Potts, Bixby Professor in the School of Public Health at UC-Berkeley has just delivered a bombshell of a speech to a packed crowd of distinguished health professionals representing more than half of the world’s population. Prior to its delivery, Dr. Potts and I spoke about some of the most salient implications and data in his talk, intimations of which he had imparted several years before in our public broadcasting feature film documentary “No Vacancy.” The timing for Dr. Potts’ speech today could not be more eerie. Just yesterday, October 31st, the United Nations officially declared that the human population had hit 7 billion. That definitely puts a new face on the Halloween mask of human nature.
Michael Tobias (MT): Malcolm, you and your wife, as I understand it, enjoyed the birth of your sixth grandchild recently. As an MD who has dedicated his life to mitigating the environmental and human rights-related fall-out from the population explosion, it would seem that even those who know only too well for whom the bell tolls, are inextricably part of the problem.
Dr. Malcolm Potts (MP): Well, yes, in truth, we are talking about an issue that directly involves each one of us personally. And it’s true that last month my wife and I had our sixth grandchild, Charles. There is every reason to think that baby Charles could live into the 22nd century. But Charles will grow up in an increasingly bipolar world - manic levels of consumption in the North and depressing levels of poverty, illiteracy and violence in the South.
MT: The world has tripled in human numbers since you and I were born. In the most economically marginalized of nations, particularly parts of Africa, life expectancy has increased by some 20 years. That’s all medically well and good. But what about the fact so many billions of our kind are perpetuating, in effect, misery, not only for themselves, but for the environment as a whole?
MP: Michael, our medical successes have a cost. For the first time in literally billions of years of the Earth’s history the activity of one species – our own – has come to dominate the complex biological systems on which all life depends. Indeed, we may have reached already a point where the world’s use of resources and concurrent production of pollutants is jeopardizing the welfare of all our children and grandchildren.
MT: The Sixth Extinction Spasm we have unleashed.
MP: Yes. As a medical student at Cambridge I also studied zoology – now half a century later, one in four of the mammalian species I studied is threatened with extinction. The world as a whole is 50 times as rich as it was when my grandparents were born. Yet, over one billion people continue to live on US$1.25 per day, or less. Unbridled consumption in developed nations, along with continued rapid population growth in the least developed parts of the world, will set off a vicious spiral of ecological destruction and conflict over diminishing resources, bringing misery on a scale never before seen.
MT: United Nations demographic spreadsheets strike of a certain chaos. What are we to make of the vast gulf between the high versus low projections for future human populations?
MP: Prudent decisions about consumption in the North, combined with slowing rapid population growth through voluntary family planning and investing in the education of girls and young women, in the South could open the door to a biologically sustainable, more prosperous and peaceful planet with spectacular increases in human well-being. Instead of a world approaching 16 billion – the upper UN estimate for 2100 – we could have a world of just over 6 billion, the low UN estimate.
MT: What is the key to unlocking this draconian puzzle?
MP: Surveys demonstrate that meeting the unmet need for family planning and preventing unintended pregnancies among the rich, while improving access to family planning in the South and slowing population growth lays a foundation for building needed adaptive strategies to cope with global warming.
MT: Unintended pregnancies translate into per capita carbon emissions. That’s clearly one instance where family planning lowers the temperature, literally.
MP: Well, if you consider that there are 3.1 million unintended pregnancies in the US annually and American carbon emissions average 20 tons a year per person, where life expectancy is 78 years, then an individual’s lifetime emissions add up to a staggering 1,560 tons. A careful evaluation of a federally funded program to subsidize the high cost of family planning in California has shown that averting 100,000 births through voluntary family planning saves 156 million tons of carbon emissions, worth US$3.12 billion on today’s carbon trading market.
MT: What about in the South?
MP: It is estimated that perhaps one quarter of the 1.2 billion pregnancies that occurred in the South between 1990 and 2000 were unintended. If we start, as we must, with the right of a woman to manage her family size, then even in developing countries, the volume of carbon abatement from averting unintended pregnancies becomes significant. In India where there are an estimated 3.5 million unintended births annually, meeting the unmet need for family planning would avert 195 million tons of carbon.
MT: And in Africa?
MP: In the Sahara desert, rapid population growth and global warming are on an especially dramatic collision course. Rapid population growth, global warming, poor governance, and a low status of women and lack of access to family planning are combining in a perfect storm that could lead to unprecedented levels of starvation, escalating conflict and massive waves of migration.
MT: According to data from the Climate Institute, the number of environmental refugees is projected to swell to nearly 200 million by mid-century.
MP: In the Sahel, sixty million of the world’s most forgotten people doggedly attempt to scratch a living from a hostile environment. Unless family size falls in that region, there could be 200 million people by 2050. Today, 46 per cent of children In Niger are growth retarded. The stunted growth of a child carries a life-long penalty in brain development. I see a mega-catastrophe unfolding in the Sahel. The evidence is simple and obvious. The population of much of the region is growing more rapidly than the food supply and in many cases more rapidly than the economy.
MT: And the actual global warming estimates for the region?
MP: One estimate for global warming is that today’s maximum temperatures in the Sahel will become the average by 2050 – and today’s extreme temperatures can exceed 115 degrees Fahrenheit. The crops will wither and the cattle die. The worst drought in 60 years is hitting the Horn of Africa,12 million people are already hungry. The Dadaab camp in Kenya was built for 90,000 houses and 400,000 refugees. 1,500 additional women and children arrive every day. The misery of subsistence in a refugee camp will be multiplied many times as millions of people migrate to survive. It is always the children and women who suffer most.
MT: The Darfurs of the world.
MP: Yes. There will be more Darfurs in coming decades.
MT: So what’s the answer?
MP: A new vision based on scientific evidence, even if some of the conclusions are uncomfortable.
MT: Uncomfortable, “inconvenient,” and frightening.
MP: Yes, but it is essential to enable individuals and couples to make voluntary decisions on whether and when to have a child. We need to meet the proven, and in some places growing, unmet need for family planning. We must set about dismantling the many tangible and intangible barriers that all too often confront women who wish to delay the next pregnancy, curtail childbearing altogether, or terminate an unintended pregnancy.
MT: I recall that in the mid-1990s when I was doing research in parts of East and West Africa, modern forms of contraceptives were either inaccessible or unaffordable. How difficult is it across Africa for women to obtain contraceptives in 2011?
MP: In Africa only 3 per cent of women can afford the full cost of modern contraception. In Europe and America there are commercial but no scientific reasons for keeping oral contraceptives on prescription. In Madagascar oral contraceptives are refused to women who do not have one child, while in Tanzania those with five children are told not to take them – there is no science behind either rule.
MT: That suggests to me of demonstrably little compassion. And then there is the continuing problem of child marriage?
MP: Absolutely. There must be comprehensive policy imperatives to end child marriage. Demographers calculate that increasing the age of marriage by five years reduces population growth by 15 to 20 per cent. In Niger, where the average age of marriage is under 16, one in five women have 10 or more children. Globally, 25,000 under-age girls are married every day.
MT: That’s a mind-boggling number, and the data, as I understand it, also segues tragically into educational gaps, deficits, as well as spousal abuse.
MP: Yes, and most child brides either never go to school, or drop out when they marry. Compared with mature women, these girls are twice as likely to be beaten by their husbands and five times as likely to die in childbirth.
MT: You’re meeting with dignitaries throughout Africa. What progress are you seeing?
MP: Fortunately, even seemingly conservative societies may be near a cultural tipping point. The Bixby Center for Population, Health and Sustainability at Berkeley has an NIH supported project in Northern Nigeria close to the border with Niger and subject to the ecology of the Sahel. It is a Hausa-speaking, polygamous society, and in the project area the average age of marriage is 14.5 years. With Nigerian colleagues we are supporting girls and providing a modest cash payment to keep them in secondary school.
MT: How do those girls’ parents feel about it?
MP: The parents decided they wanted the money to go directly to the school, even though keeping their daughters in school is a drain on their limited disposable income. For just over $30 a year between 82 and 92 per cent of girls are remaining in school. We calculate that the total cost of reaching 50 per cent of the adolescent girls in Niger would cost $15 million. This would be a genuine revolution – and it is achievable and affordable.
MT: OK. Let’s assume that there is a fast learning curve and unmet needs for family planning are served. What about the allegedly unmet needs of consumption?
MP: Exactly. While there is a large unmet need for family planning, there seems to be no significant unmet need for consuming less. However, changes in economic policy are inescapable if our children are to inherit a stable, sustainable world.
MT: The question remains: How do we accomplish that?
MP: We must cap and then slowly reduce those types of consumption that deplete non-renewable resources, destroy biodiversity and increase greenhouse gases. We can still value and continue to grow the types of consumption that enable everyone to flourish. We must find better ways to measure wealth than the misleading GDP metric.
MT: So, in the end, we’re speaking both fertility and economics which, in one combination or another either spell doom, or hope for the global environment, right?
MP: Definitely. And when it comes to both the economic and demographic decisions that will determine the fate of the world at the end of this century, time is of the essence. The policies that nations and the international community need to begin negotiating should enhance equity and individual autonomy and well-being, and they must be based on justice for the contemporary world and for future generations.
MT: Quixotic thinking?
MP: This is no mission impossible. For example, we must explore using carbon credits to fund family planning. Family planning has too much political baggage for such an idea to fly in the North, but it might be worth exploring in the South – and the reward could be hundreds of millions of dollars – perhaps billions - to help some of the poorest and most vulnerable groups of women and their families in the world.
MT: A “carbon for condoms” plan, like your colleague Professor John Harte has suggested – whereby developing nations work with wealthier countries to provide funding for contraception, while reducing financial support or incentives for carbon emissions.
MP: Carbon for Condoms. It has a nice ring to it. I hope people will explore all these options, because unless access to family planning is improved, age of the first birth raised and rapid population growth slowed, then the future for the babies born today in much of the Sahel is starvation, feeding by the international community in refugee camps, living in slums, or walking south to other countries, where they may not always be welcome. If we can contribute to solving the first two of these huge problems we will also help ameliorate the third and fourth – the risk of escalating conflict, possibly permanent escalation, if one even ventures to imagine the ecological calamity that nuclear war would unleash.
MT: And you seem to be convinced that family planning is a key to preventing such calamity?
MP: Look, Michael, as you well know there is an increasing body of evidence that family size falls when the numerous barriers to contraception and safe abortion are removed, even in poor and illiterate societies. Policy makers need to understand that birth rates can and should be slowed by improving access to voluntary family planning. The international community also needs to understand that in any of the countries with a low age of marriage it is imperative to invest in girls and raise the age of the first birth.
MT: We don’t hear our political candidates talking about these things, why not?
MP: All I can tell you is this: policy makers need to understand that when the right of parents to decide the number of their children is respected, then a welcome side effect of preventing unintended pregnancies will be a modest but useful contribution to slowing global warming in lesser developed regions of the world and a significant impact in the North, especially in the USA. While investing in family planning and in girls and young women will not by itself bring peace or development to the high fertility countries, not investing in family planning and in girls and young women makes survival and peace impossible.
MT: That’s a message I hope will resonate with everyone. Thanks, Malcolm.
A very special thanks to the Bixby Center for Population, Health and Sustainability; to Dr. Martha Campbell; to Bob Gillespie; to the Hausa-Fulani people in Northern Nigeria, Terry Lo, Griselda Kondo, Daniel Perlman, PhD, and Courtney E. Henderson, M.P.H.
Copyright 2011 by Michael Charles Tobias/Jane Gray Morrison/Dancing Star Foundation. Special Thanks to Jane Delson.
