Nearly two hundred years ago Malthus had already voiced the fear that if populations should outgrow the food supply available to them, famine and death would result. An argument put forward at the time and ever since, namely that he did not allow sufficiently for changes in agricultural practice which in due course increased that supply, is cogent. But in a number of Third World countries there is no escaping the fact that, while such innovations are being developed, children and adults will die of malnutrition and starvation. Meanwhile, advances in the control of diseases have increased general health and life expectancy, and therefore population sizes. In many Third World countries the vagaries of climate, soil, political and cultural variations, as well as the availability of agricultural know-how and resources, remain largely unpredictable. It is hardly surprising that there is much controversy surrounding the best way to help such poor, developing countries to overcome dire crises of food shortages, as well as high mortality and morbidity levels, both immediately and in the longer term.
Just such a controversy was sparked off in the correspondence columns of The Times recently by a letter signed by a number of well known personalities from the academic and media worlds. Each of them had supported and worked for Oxfam for many years but had come to the conclusion that Oxfam had in recent years devoted too small a proportion of its resources to the funding of contraceptive programmes and thus to helping to keep population levels down. This was despite a decision of more than 25 years ago that a proportion of its income was to be so used. That policy ‘‘has been progressively watered down by Oxfam in the apparent belief that birth control is too controversial.’’ Oxfam had interpreted its medical advisory panel’s call for more family planning as well as other aid to imply ‘‘family planning instead’’, wrote Dr John Guillebaud, one of the original signatories, in a further letter. The huge numbers of induced and frequently botched abortions demonstrate, it was also argued, that large numbers of couples want fewer, healthier children. If Oxfam is no longer minded to help such people achieve that aim, which would inter alia help to reduce population growth, then the writers would reluctantly transfer their support to other charities which spent less on publishing literature which appears to ignore the dangers of rapid population increase.
The Director of Oxfam answered that ‘‘a significant part’’ of the 11 per cent of annual income spent on health care and education programmes deals with family planning. Many unsuccessful programmes had been instigated which ignored cultural issues. At present, the policy is ‘‘to study the family planning needs and perceptions of poor people’’ and to provide information generally. Obviously this approach does not satisfy those whose concern lies with the imminent problem of over population. But other writers insist that birth control programmes are feared and resented by poor countries as long as it is hinted that the acceptance of population targets is a condition for the provision of other essential forms of aid given by the industrialised world. Moreover, the Director (UK) of the Committee on Population & the Economy argues that it is not at all clear that such targets are acceptable to governments and people of such countries. While family planning is widely accepted, cultural attitudes on marriage, women, sex and family will determine actual family size.
Abortion is seen as a greater evil by other correspondents, but the Director of Family & Youth Concern believes that the provision of contraception leads to an increase in abortions, presumably because, once family limitation has become accepted, people resort to it if there is insufficient or inefficient availability or use of contraception. But Malcolm Potts gives examples from Soviet Russia and the Netherlands. In the former, with very inadequate family planning provisions, there are 112 registered abortions per 1000 women aged 15-44. In the latter, where ‘‘contraception is enthusiastically promoted ... the rate is 5.3 - incontrovertible evidence that good family planning prevents abortions’’.
Another writer argued that infertility is a much greater problem than over-population in Ethiopia where there is much fertile but underpopulated land, largely because of transportation and communication difficulties due to lack of people. But while it may be correct in theory to argue that development will lower both birth and mortality rates, will they both come down in time to avert disaster? The ‘‘demographic transition’’ in western industrialising countries took well over a century, so the answer may well be ‘‘no’’.
Dr Bavelaar, the Director of the World Population Foundation wrote from its Amsterdam headquarters that recent surveys confirm that if women had only their desired number of children, the birthrate would fall by 27 percent in Africa, 33 percent in Asia and by 35 percent in Latin America; and that ‘‘lack of knowledge of and access to family planning services are by far the most important factors determining family size’’.
All such conflicting opinions seem to stem from commitments to entrenched beliefs and moral attitudes in the richer countries. Should we stop preaching to African or Latin American parents that they must have fewer children, and ‘‘allow’’ malnutrition, even starvation, to take its toll? One faction appears convinced that we should not meddle with God’s Will or other people’s culture. Others feel as strongly that if we now have the knowledge and ability to provide for a healthier, more prosperous existence for the living, then we have a moral duty to use and promulgate them.
Elizabeth Still