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close this bookWIT's World Ecology Report - Vol. 06, No. 2 - Critical Issues in Health and the Environment (WIT, 1994, 16 pages)
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Population, Health and Environment

A special focus report on stabilizing population at 10 billion

Population is at the forefront of world issues as governments, NGO's, medical and health professionals, and private citizens prepare for the United Nations International Conference on Population and Development (ICPD) to be held in Cairo, Egypt, September 5-13, 1994. The title of the Conference indicates the link between population growth and economic and social development. As a result of Agenda 21, development by definition now means environmentally sustainable development.

Last year the World Ecology Report published a Special Focus feature titled "Population Growth: A World in Balance" [World Ecology Report, May/June, vol. 5, no. 3., 1993]. WIT interviewed the Secretary General of the ICPD, Dr. Nafis Sadik. Trained as a physician, Dr. Sadik is the Executive Director of the United Nations Population Fund (UNFPA). In that report Dr. Sadik expressed optimism that because the nations of the world seemed poised to seriously address population issues, perhaps "we will in fact take the critical additional measures needed during the 1990's in order to cut in half the current population growth rate in developing countries-from 2 percent to only 1 percent-by the year 2020, and by so doing, put the world on a realistic path to reach a stabilized population level of around 10 billion people by some time in the middle of the next century." In an earlier issue, WIT reported that the UNFPA did not regard decreased future populations as "a goal in itself, but as a means to a far more important end: improving the lives of present and future generations." [WIT Report, Aug./Sept., 1990].


Women are more than baskets of eggs./Credit: Richard Mock

Here again, we focus on the critical and complex issues related to population and our Point of View column contains a new concept of growth and development that emphasizes the importance of individual responsibility which is often disregarded. We would also like to make a note of clarification on another topic that often insinuates itself into discussions of population, that is consumption. Any discussion of population patterns and their effects on the environment should include an examination of consumption patterns. To a limited extent we will include that here, but we do not intend to discuss consumption patterns in order to point fingers at a "profligate" North. Nor do we intend to present data on the patterns of population growth of some Southern nations for the purpose of criticizing policy. To reiterate, our orientation to population issues comes from recognition of our common bonds and responsibilities.

PROJECTIONS

According to UN projections for median global population growth world population is expected to reach 8.9 billion by 2030, leveling off in 2150 at about 11.5 billion. The UN estimates that global population reached 5.3 billion in 1990, and is increasing annually by an average rate of 1.7% or by more than 90 million people per year. Population distribution as of 1990 by region indicates varying rates in population growth. East and SE Asia contained over half of the world's population by 1990-1.2 billion in China and 880 million in India. However, within these regions current growth rates are expected to alter the 1990 picture. The population of Africa is expected to triple to 1.5 billion by 2025 even though the growth rate is projected to drop from 3.1% in 1990 to 2.2% in 2025. The developing world on the whole is anticipated to experience a decline in growth rate from 2.0% in 1990 to 1.0 by 2025. Western Europe is expected to have a declining population after 2000. China, with its stringent population policy of one child per family is expected to reach zero population growth by 2000. The U.S. population, projected to include an average of 880,000 immigrants annually, is expected to increase from 249 million in 1990 to 334 million in 2025 and to reach a zero growth rate after 2050.

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CURRENT PROFILE OF REGIONS

South America more than doubled its population between 1960 and 1990. In this period the average annual growth rate was 2.4% largely due to increases in birth rates with little influence from immigration. Mortality rates declined as birth rates jumped to produce a ratio of about 25 births/1000 and 8 deaths/1000. Birth rates have started to decline but still do not approach the death rate so that the population of the continent continues to grow though at a somewhat slower rate. With the exceptions of Argentina, Uruguay and Chile about half the continent's population is about 15 years of age and therefore of child bearing capacity for at least two decades.

Population statistics vary widely from nation to nation in Africa, yet a sketch can be drawn of the continent's people. The population on the whole is young and rural with current trends suggesting that the population is growing more urban with longer life expectancy. Decreases in the death rate have occurred at a slower pace than decreases in birth rates so that the ratio of birth to death rates is on average about 46 births/1000 compared to 17 deaths/1000. This balance produces an average annual population growth rate of 2.9%.

The Europeans have maintained an average annual population growth rate of about 3% during the 1980s. The former USSR showed a population growth rate of approximately 8% and the US and Canada approximately 1%. The populations of these regions tend to live primarily in urban centers.

Population Growth 1950-90, With Projections to 2030, for the Most Populous Countries1





Increase

Country

1950

1990

2030

1950-90

1990-2030


(million)

Slowly Growing Countries


United States

152

250

345

98

95


Russia

114

148

161

34

13


Japan

84

124

123

40

-1


United Kingdom

50

58

60

8

2


Germany

68

80

81

12

1


Italy

47

58

56

11

-2


France

42

57

62

15

5

Rapidly Growing Countries


Philippines

21

64

111

43

47


Nigeria

32

87

278

55

191


Ethiopia and Eritrea

21

51

157

30

106


Iran

16

57

183

41

126


Pakistan

40

118

260

78

142


Bangladesh

46

114

243

68

129


Egypt

21

54

111

33

57


Mexico

28

85

150

57

65


Turkey

21

57

104

36

47


Indonesia

83

189

307

106

118


India

369

853

1,443

484

590


Brazil

53

153

252

100

99


China

563

1,134

1,624

571

490


1 Census Bureau data are used because they are updated more often than the U.N. medium-range projections; the two series are usually similar, but differences do exist.

SOURCE: U.S. Bureau of the Census, in Francis Urban and Flay Nightingale, World Population by Country and Region, 1950-90 and Projections to 2050 (Washington, D.C.: U.S. Department of Agriculture, Economic Research Service, 1993).


China was the first nation to achieve a population of more than 1 billion people, according to 1982 Chinese census. In 1989 the birth rates averaged about 16/1000 while death rates averaged 7/1000. These ratios showed a marked decline in both birth and death rates compared to 1953 statistics when births averaged about 45/1000 and deaths averaged about 22.5/1000.

India is the world's second most populous country with a population that increased 160,000,000 in a ten year period from 1981 to 1991, according to census figures. This is a total expansion of 23% in a decade.

POPULATION TRENDS IN HISTORICAL PERSPECTIVE

Current and projected population trends stand out when placed against their historical background. Before the 20th century, estimates of total global population are based on fragmentary data which suggest that over the long term, population growth rates averaged .002% per year. By 1970 population growth rates had reached an all time high of an average of 2%. Actual growth fluctuates because of climate, war, food supply, disease-the same conditions that currently affect population growth. Between about 1650 to 1950 it is estimated that all regions of the world experienced a fivefold increase in population from 500 million in 1650 to 2.5 billion in 1950.

Between 1950 and 1990, however, global population expanded at unprecedented rates. During this forty year period world population doubled from 2.5 billion to 5.3 billion. This can be understood as an annual increase of 70 million or a total increase of 2.8 billion. Growth was slowest in the developed world and most rapid in the developing countries. This expansion of global population resulted from advances in new and generally inexpensive technologies which included the development of high yield seeds that produced higher yield crops, and the use of pesticides. Overall food production outstripped population growth. Grain production tripled as population doubled in this period. Beef and lamb production increased 2.6 times over population that doubled. Fish catch increased 4 1/2 times and global economic growth expanded 4.9 fold.

AMMAN DECLARATION

The Declaration was adopted at the end of the Regional Population Conference for the Arab World jointly organized by ESCWA, the League of Arab States and UNFPA. The Declaration is the foundation for the region's position at the International Conference on Population and Development to be held in Cairo, Egypt in September 1994.

"In spite of the varying priorities of population policies from one Arab State to another, there is a need to formulate a clearly defined Arab population strategy to ensure optimal utilization and distribution of human resources." So say the Arab governments that adopted the Second Amman Declaration on Population and Development in the Arab World.

The Declaration, adopted in April 1993, follows the one adopted in 1984 at the Arab world's first population conference. It calls for "Pan-Arab" development policies, plans for the rational use of land and water, and cooperation on regional and international migration.

Although family planning programmers have had some impact, the Arab region's population is growing at an average of about 2.7 percent per year, the second fastest rate in the world after sub-Saharan Africa, according to United Nations officials.

"Initial estimates show that the woman's average fertility rate in the ESCWA UN Economic and Social Commission for Western Asia region, which exceeded seven children in the 1960's, is starting to drop and is expected to go below three children by the year 202 5," ESCWA Executive Secretary Sabab Bakakji told journalists. Nevertheless, UN projections show the region's population reaching 449 million by 2020, compared to 222 million in 1990. The increase in human numbers is set against the backdrop of slower economic growth, rising unemployment, and a widening gap between rich and poor.

"Population policies should be formulated within the framework of a comprehensive strategy for sustainable development," the Declaration states. It acknowledges "a need for more thorough understanding of the interrelationship between population, resources, environment, and development," however, and calls for further research and the establishment of regional environmental information networks.

The Declaration urges special attention "be paid to policies aimed at improving the equality of life in rural areas," so as to "curb rural-urban migration." It calls for more reliable data on "population movements, on factors associated therewith, and on population needs, through population census, socio-demographic surveys on migration," and area-based studies.

The Declaration urges improving the status of women in view of its "crucial importance" and "effects on demographic behaviour, age at marriage, fertility, and infant, child, and maternal mortality rates," adding: "The reproductive role of women should in no way be used as a reason for limiting women's right to work, education, and participation in public life."

In countries where fertility levels are high, "efforts should be made to set appropriate fertility and family planning targets," and "health and nutrition education activities related to MCH [maternal and child health] and family planning should be strengthened."

SOURCE: Populi, Vol. 20, #5, 1993

Technologies improved the safety of water supplies and sanitation facilities. Childhood immunization and medical therapies, including the very effective oral rehydration therapy brought down mortality rates. In many countries of the developing world where these new technologies were applied, the combination of rapidly lowered mortality rates among people with traditionally high fertility rates produced annual population growth rates of more than 3.1%. This doubles the population size in about 23 years.

DEMOGRAPHIC STUDIES: PAST AND PRESENT

The writings of Thomas Robert Malthus (1766-1834), the often misquoted British economist, encouraged the first systematic demographic studies. His theory of population presented in his famous "An Essay on the Principle of Population" (1798) was his main contribution to economics and influenced, subsequent economists. According to Malthus, population tends to increase faster than the supply of all goods, [not only food], available for its needs. The effect of this tendency is to depress living standards continuously to a bare subsistence level. Whenever a relative gain occurs in production, a higher rate of population increase is stimulated. On the other hand, if population grows faster than production, the growth is checked by famine, disease, and war. Amartya Sen has argued that famine which leads to starvation tends to result from problems of distribution, including those caused by war, rather than supply of food. International experts meeting at the International Food Policy Institute (IFPRI) in Washington, D.C., from February 14-16, 1994, presented results from studies which together indicate that the growth in the world food supply is likely to keep pace with population demands. Following from Malthus and Sen then, it would seem that even if there is enough food available for the world's increasing numbers, war and disease would act as checks on the benefits of that food.

The twentieth century has witnessed unprecedented warfare around the world, by any measure.

One of the important causes of World War II was the need to find land and resources for the growing populations of Germany and Japan and these nations made claims to that end. It has been argued that rapidly expanding populations of the developing world have created waves of migrants who create conflicts for the populations and governments of their new country. These conflicts occasionally erupt into warfare. A complex maze exists leading from rapid population expansion to war. The coexistence of both of these conditions in the developing world suggests that competition for resources in a degrading environment contributes to warfare.

Population Size and Availability of Renewable Resources, Circa 1990, With Projections for 2010


Circa 1990

2010

Total Change

Per Capita Change


(million)

(percent)

Population

5,290

7,030

+33

-

Fish Catch (tons)1

85

102

+20

-10

Irrigated Land (hectares)

237

277

+17

-12

Cropland (hectares)

1,444

1,516

+5

-21

Rangeland and Pasture (hectares)

3,402

3,540

+4

-22

Forests (hectares)2

3,413

3,165

-7

-30


1 Wild catch from fresh and marine waters; excludes aquaculture.
2 Includes plantations; excludes woodlands and shrublands.

SOURCES: Population figures from U.S. Bureau of the Census, Department of Commerce, International Data Base, unpublished printout, November 2, 1993; 1990 irrigated land, cropland, and rangeland from U.N. Food and Agriculture Organization (FAO), Production Yearbook 1991 (Rome: 1992); fish catch from M. Perotti, chief, Statistics Branch, Fisheries Department, FAO, Rome, private communication, November 3, 1993; forests from FAO, Forest Resources Assessment 1990 (Rome: 1992 and 1993) and other sources documented in endnote 30.

VIRAL DISEASE AND CANCER

At the end of the century we arc seeing the emergence of new diseases to humans and the resurgence of diseases once thought eradicated. Some communicable diseases are making a comeback such as tuberculosis and measles. Water borne diseases spread by consumption of contaminated water, including the recent outbreaks of cholera, are appearing more frequently. Of great concern is the global increase of infectious diseases caused by viruses including some cancers, HIV, hepatitis, influenza. Virus, which is Latin for poison, is defined as an organic entity consisting of genetic material surrounded by a protective coat. Viruses are lifeless forms on their own and can only replicate within actively metabolizing cells. When viruses replicate within living cells, they harm their hosts in the process. The existence of viruses was first identified in 1892 with the discovery of the tobacco mosaic virus. Shortly afterwards, viruses were found growing in bacteria.

A fully satisfactory cure for viral infection eludes medical research largely because those agents that kill the virus also damage the cell. Prevention of viral disease through vaccination is the only successful means available to combat viral disease. According to WHO, the global eradication of smallpox was achieved by 1979 as a result of an intensive vaccination program launched in 1967. Some viruses are spread by person to person contact as in the case of the common cold as well as HIV, the fecal-oral route as is the case with diarrhea disease, and by insects as is the case with yellow fever, malaria and Lyme disease.

The worldwide increases of various cancers is continuing. Recent research indicates increases in the incidence and mortality rate of cancers with no known links to smoking as well as increases in overall cancer. A 1990 study of international trends based on data submitted by nations reporting to The World Health Organization (WHO) found that between 1968 and 1987 "death rates from cancer of the central nervous system, breast cancer, kidney cancer , multiple myeloma, non-Hodgkin's lymphoma and skin cancer had increased in people over age 54 in six different countries. A strong hypothesis exists suggesting that the rising cancers arc caused by environmental factors, but specifically what these factors are and their connection to population pressures is not certain. Links have been made between carcinogenic toxins like dioxin and DDT and increased incidence of cancers among those exposed to these chemicals. Connections have been established linking greater radiation from the sun resulting from ozone depletion and increases in skin cancers. Scientists have concluded that sun exposure increases the risk of skin cancer, suggesting that other factors contribute to the cause of this illness.

HEALTH PERSPECTIVE

The Human Development Report provides an index of socioeconomic progress rating the nations of the world in three areas: longevity as measured by life expectancy; knowledge as measured by adult literacy; and standard of living as measured by purchasing power and based on real Gross Domestic Products adjusted for the local cost of living. This index can be used to view populations in relation to the balance of health, wealth and wisdom. The 1994 Report cites Canada as the nation with the highest "human development" rank, with life expectancy at 77.2 years on average, real GDP per capita at $19,320, and 12.2 mean years of schooling. Switzerland ranks second, Japan, third, the USA 8th. China ranks 94 and India stands at 135. Since 1960, Malaysia and Botswana have made the most progress in terms of the measurements of the Human Development Report. The nations of Northern and Western Europe rank in the highest 15 nations on the index. These are also the nations whose populations are barely growing. Africa, on the other hand contrasts with the Europeans especially in the rapid rate of population growth, with population growing fastest in Kenya and Niger at an annual rate of 3.5%. In 1992, Nigeria, contained a population of 88.500,000, the largest of any African nation. More than any region of the world, sub-Sahara Africa has the highest rate of AIDS cases, highest infant mortality rate and poverty rate. Very recent statistics show that of the 14 million known cases of AIDS in the world, about 9 million of those infected live in Africa. The impact of AIDS on African population growth is so profound that population projections are being revised downward. The WHO press has reported that ignorance and poverty contribute greatly to the spread of this disease. The expansion of health care clinics and the availability of medical personnel that promised so much hope two decades ago declined during the 1980s. In the nineties, newly resistant strains of malaria have been reported, meningitis is up, and for the past two years Zaire has reported the spread of bubonic plague. Uncontrolled population growth, poverty and epidemic disease go hand in hand and need to be tackled together. The hope in Africa is that the turn towards democracy which is also spreading among the nations of sub-Sahara Africa will support those policies that will ultimately solve Africa's great problems. The WHO believes that implementation of policies that will provide fundamental health care will "require a firm commitment by political leaders at the highest level" and a shift in priorities from hospitals in cities to the rural poorest. WHO recommends this shift in priorities for all of the least developed nations.

Net Imports of Forest Products, Selected Asian Countries, 1961-91

Country

1961

1971

1981

1991


(thousand cubic meters)1

Japan

8,800

45,000

50,000

70,100

South Korea

500

2,900

4,700

12,700

Taiwan

0

1,200

6,700

8,800

China

200

200

3,100

6,800

Hong Kong

900

1,300

2,000

2,500

Singapore

200

1,600

1,400

1,100


1 All forest products are expressed in equivalent units of wood fiber content.
SOURCE: Worldwatch Institute.

POLITICAL IMPLICATIONS

The draft document for the ICPD addresses the connection between population and environmental degradation. In part III section C the document states, "Agenda 21 leaves to the International Conference on Population and Development further consideration of the interrelationships between population and the environment. Meeting the basic human needs of growing populations is dependent on a healthy environment. Pressure on the environment may [italics ours] result from rapid population growth..." WIT is less tentative about the impacts of population growth on the environment. Evidence indicates dramatic impacts to the environment from rapidly expanding populations.

Total Fertility Rate (TFR) 1990-1995

The TFR comes as close as possible to answering the question of how many children are women having. It is the average number of children that would be born alive to a woman during her lifetime (ages 15 to 49)

Africa

6.0

Asia

3.3

Latin America

3.2

Oceania

2.4

USSR (former)

2.3

North America

1.8

Europe

1.7

World

3.3


SOURCE: UNFPA

Often the migration of rural populations to the cities occurs because of depiction of agricultural resources which create economic decline in the rural areas. As urban populations expand too quickly for adequate planning, health hazards occur. Increased emissions of carbon, sulfur and nitrogen oxides contaminate the air and cause bronchial illness. Overcrowded housing contributes to respiratory illness, diarrhea and dehydration due to inadequate availability of sanitation facilities and clean water. Overcrowding also provides the opportunity for the swift spread of any epidemic. Poor sanitation, moreover, contaminates land and waterways as raw sewage is dumped untreated. This practice alone causes a variety of acute and chronic illnesses to the most vulnerable people, children and the elderly.

The city of Sao Paulo, Brazil, is a case in point of rapid, sprawling population growth that occurred mainly among the poor in the periphery of the city. Now almost 60% of the city's residents live in housing deemed precarious. Relative to the rest of the city, infant mortality rates in the periphery run at about 97/1000, Pneumonia and diarrhea also occur at much higher rates than in the more affluent, less crowded parts of the city. The slums of Sao Paulo are located mainly along steep hillsides. The rapid growth of these slums has led to heavy soil erosion, severe landslides and flooding. The impact of rapid urban population growth on the environment in Sao Paulo is clear. This Brazilian city with its historic center is representative of the impact to the urban environment of uncontrolled, unplanned population growth.

What is less well understood is the connection between the destruction of ecosystems and the spread of disease. The potential for cure that is lost when an ecosystem is damaged is only estimated. The litany of destruction to balanced biodiversity is too well known to repeat, but broadly the causes are deforestation, soil depletion, aquifer contamination, desertification and contamination of protected wetlands and flood plains from over development.

Henry W. Kendall, who shared the Nobel Prize in Physics, 1990 and is professor of physics at Massachusetts Institute of Technology has stated the following: "The destruction of our environment cannot be stemmed unless the growth of the world's population is stemmed. This growth is putting demands on resources and pressures on the environment that will overwhelm any efforts to achieve a sustainable future. Population growth rates, while declining, are still too large to allow adequate protection for our environment."

The relationship among environmental degradation, poverty levels and population growth has become so clear that the suggestion has emerged for donors "to link assistance" to sustainable development programs "to population-control programs..." Though this suggestion does not take into account the developed and developing nation's demand for raw material, uncontrolled population growth does not confront the developed nations. Professor Kendall continues, "developing countries must realize that environmental damage is one of the gravest threats they face and that their attempts to blunt this damage will be overwhelmed as long as population growth remains unchecked."

HUMAN RIGHTS AND RESPONSIBILITIES

Dr. Sadik addressed the linkages among these problems in her opening remarks at PrepCom III at the UN in April, 1994. Perhaps the most important underlying themes which she highlighted in her remarks were those of integrating population issues into all aspects of development; the central role of the individual, which is a main theme of Agenda 21; and the acknowledgment of individual rights, needs and responsibilities. The ICPD document supports the rights of individuals to freely decide on the number and spacing of children and suggests many supports to enable individuals to make choices to lower population levels, and in the case of nations who have already achieved zero population growth or are close to reaching that goal, to maintain those levels.

The dilemma, here, is one of human rights and human responsibilities. It has been argued that responsibilities come into the picture only after the basic human needs are met and then after basic human rights are achieved. We question this concept and wonder about the lost idea that human responsibility resides in the individual much the same way as human rights do, transcending national boundaries and particular conditions. We wonder what the balance is between an individual acting on one's right to have as many children as s/he decides, and fulfilling responsibilities to other individuals, including the children whose individual rights might be compromised when other individuals exercise their rights to bear 4 or 6 or 8 children. Is there a moral equivalence between individual rights and individual responsibility when it comes to the choice of having any number of children and the individual responsibility to lower world population?

In conclusion Jacques-Yves Cousteau has very well crystallized how we arrived at our present dilemma: "Almost all our social evils, famines, shocking differences between rich and poor communities, desertification, decrease in biodiversity, increase in the number of hereditary taints, and even the warming up of our planet, originate in the population explosion. And that population explosion is due to the fact that our new set of antinatural values-generosity, solidarity, pride in our medical victories-had been enthusiastically applied long before we developed their logical counterpart, birth control."

SOURCES:

· Environmental and Economic Dilemmas of Developing Countries: Africa in the 21st Century, ed. Valentine Udoh James, West fort, Ct, Praeger, 1994.

· Human Development Report, UNDP, United Nations Publications

· ICPD 94 Newsletter, No. 13, March 1994

· Microsoft Encarta, 1994

· New York Times, June 19, 20, 21, 1994

· Populi, Vol. 19, #5, 1992

· Sen, Amartya, Poverty & Famiines, Oxford University Press, 1981

· Sen, Amartya & Nussbaum, Martha, eds, Quality of Life (Wider Studies in Development Economics) Oxford University Press, 1993

· State of the World, 1994: Worldwatch Institute Report, NY: W.W. Norton, 1994

· World Health WHO, Vol. 6, #3, 1993

"We who are adults must ask ourselves what is the use of anything we do if it does not help children? Let us commit ourselves. We owe this to every child."

- Mother Teresa for UNICEF