This is the first of the lectures geared to the seminar programme and we move from theory into the more congenial area of the historical record, at least in part. As we shall see more clearly in the seminar discussion, the ‘population threat’ was one of the first features of developing economy experience that registered with mass opinion in the developed countries. It is not difficult to see why the developed countries should have so clearly identified population growth as the key problem for world leaders. Four-fifths of the world’s total population live in countries of the Third World. At the end of the 20th century, 95 per cent of the 90 million children born in the world each year have been in Third World countries. These high proportions have come about through persistently high rates of population growth, which themselves have been the result of declining death rates and continuing high birth rates. These concerns began to be addressed in the late 1960s and early 1970s, and it is not difficult to see why.
Population growth in history
In the year 1 AD our best estimates suggest that world population stood at approximately 250 million. In the year 1800, when the period of modern British population growth had been in progress for the best part of 80 years, world population stood below 1,000 million. In short, world population had quadrupled in 1800 years. At the start of the 21st century, the best estimates are that total world population stand at just over 6,000 million. In short, world population had multiplied sixfold in the previous 200 years. To make matters worse, the momentum towards continuing fast, or even accelerating, population increase seemed irresistible. The age profile of total world population had changed dramatically. The continuing high birth rates clearly meant that the proportion of children in the population had increased. It was anticipated that each young girl would begin to produce her own family at a relatively young age, and each of her female grandchildren would in turn produce her own family from a relatively young age. Moreover, there was a tendency for women to begin their child-rearing at increasingly early ages and therefore to produce more children during their lifetimes. This seemed to be what Malthus had predicted but 20th century demographers had a more subtle conceptual apparatus. We need to distinguish between
the crude birth rate (the number of births per thousand population)
and the total fertility rate (the number of children who would be born per woman if she were to live to the end of her child rearing years
and the net reproduction rate (the number of girls born per woman).
doubling time (the period in which it took for national or world population to double).
The problem in crude terms in the twentieth century was essentially that crude birth rates were higher in the developing countries than they had been in the developed countries when they were at a similar phase of development. Britain’s crude birth rate during its phase of fast population growth was around 35 births per thousand population. In many of the poorest countries in the 1960s, rates were around 50 births per thousand population. At the same time, the total fertility rate was high and rising, in part as a result of medical improvements, producing very high net reproduction rates and a tumbling doubling time. It should just about be evident from Figure 1 below to see why these concerns erupted in the late 1960s.
Figure 1: World Population Past and Projected, AD 1-2150
Two things should just about be clear from this graph (taken via Thirlwall, Growth and Development, p. 145, from the World Development Report, 1984). The first is that to the observers in the late 1960s the trend of world population appeared to be almost vertical (the main graph). The second, evident in the left-hand inset, is that before 1973 there seemed to be not the slightest evidence of any fall in the birth rate in the developing countries, even though death rates had begun to fall, probably from the 1950s. This really began to set the alarm bells ringing because demographers believed that they had clearly understood the dynamics of population growth and its interaction with economic development in something called the demographic transition.
The demographic transition described the changing patterns in birth and death rates. At the onset of economic expansion, both birth rates and death rates would be reasonably high. For example, in Continental Western Europe in the early-19th century, birth rates stood at roughly 35 per thousand and death rates at roughly 30 per thousand. You will appreciate that this gives a growing population, albeit at a slow pace. As economic expansion and development took hold, death rates began to fall, while the birth rate remained high, giving rapid population growth. In then third phase, birth rates began to fall to match death rates, with both resting at roughly one-third of the levels at which they began. The essence is in Figure 2.
Figure 2: The Demographic Transition in Western Europe
Source: Todaro and Smith: Economic Development, p. 273
Demographers expected Third World birth rates to fall just as death rates had, but were very troubled when the fall in the death rate appeared so steep and the birth rate refused to budge. Although demographers were concerned, they were not alarmed, but the emerging environmentalist lobby undoubtedly was and used neo-Malthusian arguments to justify their position.
The ‘Population Bomb’
The relation of humans to their environment, or ecology, is very much a twentieth century development and one which gathered force in the middle years of the century. After 1950, the international economy went experienced boom conditions of unprecedented duration. The pursuit of growth tended to outrun the interest in preserving the environment, and the fast growth was accompanied by growing radical interest in environmental conditions, stimulated by such horrors as acid rain and some of the more obvious signs of environmental degradation. The problem that the growing environmental lobby really cut its teeth on the emergence of the population problem. The main architects of this position adopted a position reminiscent of Malthus, and argued that almost all of the world’s economic and social problems were the result of population growth. They tended to argue that world food catastrophe and ultimately pressures that the world’s ecosystem could not sustain. The Public Broadcasting System in the USA has made a documentary on Paul Ehrlich, the pivot in this approach, and you can access a summary of the main points at: http://www.pbs.org/kqed/population_bomb/index.html
This site gives a brief summary of Ehrlich’s position (but is no substitute at all for reading at least one of the books). The essence of the position of the population bomb theorists is that the world’s supply of renewable resources will be depleted by the pace of population growth and cause prices of these materials to rise to such an extent that growth will be throttled by expensive raw material prices. Note that The Population Bomb was written at a time when world food and raw material (primary product) supplies were beginning their rise that would culminate in the price rises of 1973 enforced by the OPEC countries, in part to ensure slower depletion of their resources. The main case against the population bomb hypothesis is that the experience of the late 1960s and early 1970s was very atypical, and the most spectacular illustration is the bet over material prices in the 1980s made by Julian Simon with Ehrlich. Details on: http://www.stanford.edu/group/CCB/Pubs/Ecofablesdocs/thebet.htm
This remains a highly charged area of debate. Ecological concerns have led to the creation of important and influential environmental pressure groups, such as Friend of the Earth, formed interestingly enough in 1971 in the wake of the interest aroused by Ehrlich’s book. Their web-site (http://www.foei.org/index.php) has an interesting brief history, which gives an excellent impression of the vast international concern about the issues raised. Yet, Todaro heads his discussion of the Ehrlich view on population and world development as: The Extremist Argument: Population and the Global Crisis (Economic Development, pp. 288-9).
It is also worth pointing out that population growth is slowing in all countries. Evidence began to accumulate from the 1980s that population growth in Latin America was beginning to decelerate and in the 1990s even Sub-Saharan Africa showed evidence of slower population growth. The poorest countries have real difficulty in finding the resources for population censuses, and so the evidence is less than conclusive, but the general expectation is for the demographic problem, narrowly defined, to become rather less pressing as the twenty-first century progresses than was anticipated forty, or even thirty, years ago.
Figure 3: Population by Age and Sex in Developed and Developing Countries, 1980
Source: : via Todaro and Smith, Economic Development, p. 270 from Population Reference Bureau, 1998 World Population Reference Sheet.
One of the key issues is the extent to which governments should go to curb population growth. At one level, it is easy to see what has motivated environmentalists like Ehrlich. They had a good idea of the shape of the age pyramids of developing and developed countries (illustrated above in Figure 3), recognised that both the total fertility rate and the net reproduction rate were high, and that doubling time was decreasing in Third World countries. The age pyramid of the developing countries clearly has an in-built momentum for rapid growth. At least some of those in the population bomb approach tend to see severe and coercive measures to control family size, such as compulsory sterilisation in the most populous countries, as acceptable and necessary. This has frequently put the environmentalist and feminist approaches at odds with one another, a point to which we shall return.
Less Cataclysmic Approaches to Population Growth
The great criticism of approaches based on Malthusian ideas is the inadequate attention paid to technical progress. We saw this in an earlier lecture in connection with technical change in agriculture, and there is no question at all that the pace of agricultural change has quickened in response to the increasing demand for food. The topics of land reform and green revolution are for the next lecture, but although malnutrition is endemic in developing countries, Malthusian catastrophes have been rare and generally highly localised. Even approaches based on the idea of the demographic transition have been criticised as less than appropriate for developing countries. The implication of the demographic transition is that there is a very general relationship between levels of income per person and population growth, which may hold for Western Europe, but do not appear to apply elsewhere (of which, more later). This has prompted development economists (in particular, but working with anthropologists) to start from the decision of the individual family to produce more children. In this approach, children are treated as if they were a special kind of consumer good. The first stage of the analysis is to propose that
the higher household income, the more children the household will want. This first step makes it clear that it is surviving children that the household will consider. This is not an approach that rests on the assumption that families are constrained by the absence of contraception to go on producing children during the period of the female partner’s fertility.
But, the higher the price of children the fewer will the household demand.
On the other hand, the household is also free to switch consumption patterns between different goods and so the higher the price of all other goods relative to children, the more children the household will want.
There is also the question of the strength of tastes. The greater the strength of tastes for goods rather than for children, the fewer children will be demanded.
This may appear to be an excessively hard-boiled approach to a question that on the face of it defies such simple economic reasoning, but the approach can easily accommodate family preference for male children and the practice of female infanticide, as has long been common in China. Family preferences for males are much higher than for females. It can also explain better than rival approaches why birth rates in even the poorest countries in Sub-Saharan Africa are falling while those in Iraq have shot upwards in the period of the anti-Saddam embargo. The approach has also lent itself to the development of a much broader approach to the management of population growth and has resulted in much better integration of the various strands of development policy.
One of the key consequences of this rather bald approach to population dynamics is to place enormous value on steps to provide women with better educational opportunities in developing countries. For some years, the World Development Report has published for each country figures of adult literacy for males and females. The traditional pattern in developing countries was higher levels of male than female literacy, and often much higher. The new economic theory of fertility suggests, however, that if women are educated sufficiently to increase their employment prospects outside the home, the cost of raising children rises enormously since it implies the sacrifice of the mother’s earnings during pregnancy and infant rearing. The universal experience has been that increasing the educational status of women, especially when combined with efforts to increase employment opportunities for women outside the home results in falling birth rates. The Todaro-Smith website contains a good example of policies in Pakistan for the education of young girls and the decisive impact on the birth rate and family size. See http://wps.aw.com/aw_todarosmit_econdevelp_8/0,4921,284684-,00.html
The other policies that have had quick and direct impacts on birth rates in developing countries have been concerned with health and social security. So improved public health, especially when geared to reducing infant mortality and improving the nutritional status of mothers and children, almost always reduces the birth rate. Equally, if the developing country can afford some form of social security for old age and/or sickness, families would not need as many children to provide income in the event of an interruption of the earning power of the main breadwinner.
If the developing country can afford to provide these basic social services in health and education more generally available to the poorest and combine this with increased employment opportunities for women, the benefits are twofold. First, there are the direct benefits in improved human capital, but more importantly, they form the essential bedrock upon which family planning programmes must be built. The essential conclusion from the above is that family planning policies will only work when they are supported by and are consistent with a broadly-based development programme. Some members of the ‘population bomb’ school, however, went beyond this and called for more draconian efforts at reducing birth rates, and so we ought to look at the nature and effectiveness of the various types of family planning policy.
Family Planning Policies
Family planning is a very broad term and can cover a whole range of measures and even of philosophical approaches. The feminist writing on development has been very useful in distinguishing two broad types. On the one hand, they can be focused on the needs of the ‘clients’ to the extent that they seek to achieve better health and better control by women over reproduction. On the other, they might be imposed ‘from above’ to meet specific crises and have the goal of reducing birth rates as quickly as possible. The former sees family planning as part of a development strategy, the latter sees population control as the essential first step in a development programme. The essence of the argument above is that the former stands some chance of success, but the argument also rests on the very well-publicised problems of the policies from above. India under Indira Ghandi is the paradigm case of the failure of compulsory family planning.
India was one of the first developing countries to introduce family planning policies in part from an early awareness of the threat to its development from rapid population growth. But India has traditionally been a country where development has come from above and has left the needs of peasant families somewhat under-explored, at least until comparatively recently. As a result, Indian family planning policies had comparatively little success. The main approach was to offer incentives, either in the form of cash or food, as a reward for sterilisation. The policy was thus aimed at the poorest, and the policy did not attain sufficient popular acceptance to work, in part because it stigmatised those who were on the receiving end and treated them like second class citizens. Take-up, if that is not an inappropriate word, was disappointing and India’s birth rate remained stubbornly high. This led to new efforts, but each organised in a similar fashion from above and directed at the poorest with little attempt to link in with other programmes at the household level.
In the mid-1970s, the government conducted a major vasectomy programme in which thousands of men were pressured at work or again given cash incentives, a transistor radio or even tickets to championship football matches if they agreed to have a ‘voluntary’ vasectomy. Public employees’ salaries were made contingent on the number of acceptors they brought to the vasectomy camps, and fines were levied (and even imprisonment imposed) on families that did not agree to sterilisation after three children. Food rations and other government services were withheld from the unsterilised. Civil liberties were suspended and in some cases state governments resorted to brute force, with police raids to round up ‘eligible’ men for sterilisation. In at least one case, all the young men of one village were sterilised. The poor were the obvious victims of this policy, since the wealthy could buy themselves out, either by bribes or by paying poor men to take their places. In the last six months of 1976, 6.5 million people were sterilised, four times the rate of any previous period.
But the policy was incredibly unsuccessful. The government of Indira Ghandi that had introduced this programme in 1975 was defeated in 1977, and when it finally returned to government in 1980-84, it had to promise not to reintroduce compulsory and coercive birth control policies. The best judge is that the measures of 1975-6 set back population policy in India by many years, but the notion of policy from above persists in India. Family planning policy continues to target the poorest, continues to concentrate on sterilisation in the belief that the poorest cannot understand other forms of contraception and continues to rest on the assumption that their fertility of these groups needs to be controlled at all costs. The Chinese case has some similarities, and we will look at this in more detail in the seminar.
The structure of these policies and their evident lack of success aroused the intense opposition of feminists, particularly in the developed countries but also in the Third World. The feminist perspective starts from the proposition that it should be the right of all women in all countries to decide if and when to have a child and to have access to safe, voluntary birth control and abortion. The agenda, not surprisingly is highly controversial in developed as well as developing countries, but there were attempts to make it acceptable to a wide range of opinion. The success of these efforts was seen at the third International Conference on Population and Development, held in Cairo in 1994. The first two conferences had been concerned above all with the provision of family planning services but the Cairo Programme of Action emphasised rather more strongly that it was essential to raise the social and economic status of women, especially in the area of reproductive choice. Although feminist commentators see some problems with the agenda agreed at Cairo, they do regard it as a major step forward in recognising women’s rights in this area. The Programme states:
The empowerment and autonomy of women and the improvement of their political, social, economic and health status … [are] essential for the achievement of sustainable development and … for the long-term success of population programmes. Experience shows that population and development programmes are most effective when steps have simultaneously been taken to improve the status of women.
Family Planning and Western Companies
The involvement of companies from the developed world in family planning policy in the developing countries is a very big, if little-told story, but we have space for only a small part. I want to concentrate on the involvement of western, largely US, companies in the sale of the contraceptive pill. The first pills were approved for marketing in the USA in 1960 after clinical trials in Puerto Rico, chosen because of its enormously pressing population problem. Within two years, the company that produced the pill, Searle, had received notification of over a hundred cases of thrombosis and embolism associated with use of the pill. However, these first signs of seriously damaging side-effects (eleven deaths had been reported by 1962) were rather glossed over, some would say because of the potential of the contraceptive pill in the developing world. Thereafter, evidence of side-effects continued to accumulate and could not be prevented from escaping into the public domain and pressure was eventually brought on the drug companies to modify the contents of the pills and to develop different types to meet the range of health statuses of those taking them.
Since the 1980s, sales of the pill have been greater in developing than in developed countries. The known success of the pill in preventing pregnancy has had an even more stultifying impact on investigating and publicising adverse effects of the pill in the developing than the developed countries. In the developing countries, the Western pharmaceutical companies that marketed the contraceptive pill were inclined to argue that the side effects recorded in the West were more the result of a Western lifestyle than of inherent risks of the pill itself. But they have done very little to investigate the safety of their product in the developing countries. In these rather murky operations, the companies have been aided and abetted by the western dominated population agencies, whose primary concern is not profit but to reduce birth rates. The screening and follow-up care and information flow for women in the developing countries operate to far less demanding standards in the developing countries. The pill is but one example, see Hartmann, Reproductive Rights and Wrongs, chapters 11-13 for further details and a good discussion of other birth control methods.
Our thinking about the ‘population problem’ has undergone great changes since the later 1960s, when popular attention first focused on the scale and pace of population growth in developing countries. The analysis of the problem remains highly controversial, with very deep divisions between those who follow and those who oppose Malthusian approaches. One of the more remarkable features of the past two decades is growing evidence of deceleration in population growth in all countries. The Malthusian attitude finds reflection in pressure from both governments in developing countries and the Western-based population pressure groups to make immediate reductions in birth rate the central goal of policy. Where this has produced policies of compulsory sterilisation or the indiscriminate supply of contraceptive pills, there are grounds for disquiet and considerable evidence of limited success. Those who argue for a broadly-based development policy and the empowerment of women as the central foundations for family planning have the weight of evidence on their side, but the cost of such measures is heavy. This is one of the areas in which the important role of women in development has belatedly been recognised.