The connections between environment, population and development have been fraught for decades, with some experts and activists calling for reducing global human population in order to reduce the extinction of species and to preserve natural resources such as potable water and arable land. Others, especially those in the reproductive justice camp – assert that a focus on population reduction blames the victim and is anti-woman.
Anthony Costello is a pediatrician, an expert on international child health and former director of Maternal, Newborn, Child and Adolescent Health at the World Health Organization. While Dr. Costello was co-director of the Institute for Global Health at University College in London, he was staggered by the projections on global warming and the potential effects on food security, clean water and changing patterns of diseases due to heatwaves and vector-borne diseases transmitted by infected mosquitoes, ticks, bugs, sandflies and blackflies.
Dr. Costello recently spoke at Yale University as part of a program on climate change and health. Between The Lines’ Melinda Tuhus spoke with him after his talk, and presents this excerpt from their interview.
DR. ANTHONY COSTELLO: I worked for many years in countries like Bangladesh and Nepal and India and Malawi, where child survival has been a huge issue, that many children die unnecessarily, newborns die at very high rates or they have done in the past. And many times people would say, why are you trying to save these children, because it increases the population?
BETWEEN THE LINES: I have to stop you right there. Did people really say that to you, and more than one person?
DR. ANTHONY COSTELLO: Yeah. Not so much now, but in the past, and in fact, I was asked to give a talk once to an ethical society where the topic of the talk was, Save the Children, question mark.
BETWEEN THE LINES: I can’t comprehend that. I mean, did you ask the people who asked you how they would feel if their child was sick or had diarrhea or was malnourished, should we let them die?
DR. ANTHONY COSTELLO: Yes, but I also made the opposite argument, which was not just the human rights one, but the scientific one. Actually, it was not just them, it was also very eminent people in health – you know, the population concerns group – would say, we are going to die because of too much population and it’s all terrible, and they weren’t realizing that the quickest way to get your population stable – the most important – is you’ve got to get your mortality rates down. So as long as your children are dying, you’re going to have more children, because that’s the human urge, to have more children. But once you know that they’re reasonably going to survive, they you are quite happy to have fewer children, and that’s a very important point we had to get across.
And all regions of the world are seeing their fertility rates fall, apart from Africa, although I think that’s going to follow now, because in the past ten years we’ve seen dramatic declines in death rates of under 5’s in Africa, despite all the problems and I think you’ll find that with a lag phase, that fertility rates will come down, and also with education increasing.
BETWEEN THE LINES: The whole issue of climate and development and population has been fraught, probably forever, right? But some of the people I work with almost don’t make any connection at all between pressures on climate from population and almost seem to lean to the side of women having more children, that it’s kind of too bad if people feel like they can’t have more children than they would like because they do have concerns about the climate. In fact, she said there’s a term for that; they’re called “baby doomers.” Have you ever heard that?
DR. ANTHONY COSTELLO: I haven’t heard that phrase, but it has come up in conversation, obviously. But I think the drive to have children should not be impaired. I think you should think about this in terms of populations. The reality is that in virtually every European country – Britain is a slight exception because of immigration – population is going down, because the reality is that now most people don’t want more than two children on average. Does that mean that if you choose to have four children, you’re committing a crime? Absolutely not, in my view. I think you need to look at this in terms of population perspective, rather than making people feel individually guilty.
And indeed we may run into some problems with declining populations. I mean, one of the biggest problems, for example, that Russia or Japan face is declining population, which means they are not going to be permanently not economically growing, because their population is declining. So, it introduces new challenges. I mean in China, where they’ve had the one-child policy, they’ve had the issues of the single child, and that’s raised a number of issues to the extent now that they’ve relinquished that policy.
BETWEEN THE LINES: Right, right.
DR. ANTHONY COSTELLO: The impact on feticide, you know, that people wanted boys rather than girls, and that’s leading to an issue that there aren’t enough girls to go around, so you’ve got lonely men. It was social engineering that has downsides as well as benefits. I mean, China has stabilized its population pretty much, and in fact, when you talk to Chinese demographers as I have done – their population right now is just under 1.4 billion, but by the end of this century some people say it will have fallen to substantially below a billion.
BETWEEN THE LINES: Wow, really?
DR. ANTHONY COSTELLO: … which I didn’t realize, because they will be below replacement level, and once you go down below replacement level you tend not to come up again. So population is quite complicated. But let’s see what happens. I mean we’re at seven point whatever billion we are at the moment, and I think it’s inevitable that we’ll head north of nine billion. I’m rather more optimistic than some people. I think there’s going to be a big hump, and we have to get over that hump. But your question is about climate. The more people you have, the more consumers you have and the more energy that’s used, and the more carbon-intensive energy that can be used. But my point is that you don’t go into poor countries and say, Well, it’s all about you having fewer children and do nothing about their poverty, their energy, their educational opportunities. So you need a much more balanced approach to energy development.
For more information, visit the World Health Organization’s program on Maternal, Newborn, Child and Adolescent Health.
