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SOUTH AFRICAN MEDICAL JOURNAL. 1995 May; 85(5):370-3.Thomas Robert Malthus in his 1798 publication sparked considerable debate and criticism when he pointed out that population, when unchecked, grows geometrically, while subsistence increases arithmetically. The author discusses Malthusianism, some of the history of family planning, and the evolution of ideas and institutions. The Special Program of Research, Development, and Research Training in Human Reproduction was established in 1972 by the World Health Organization to promote, coordinate, support, conduct, and evaluate research on human reproduction with particular reference to the needs of developing countries. This program is the main instrument of reproductive health research in the UN system. Since its inception, 339 scientists from 46 developing countries, 300 scientists from 17 developed countries, and 23 scientists from six countries in economic transition have participated in the program's advisory scientific committees. The program advises member state governments and supports research and development in the assessment, development, introduction, and transfer of technology, as well as epidemiological and social science research on reproductive health and essential national health research. Another important area of activity consists of strengthening the research capability of developing countries to enable them to address reproductive health problems of national relevance.
NEW YORK REVIEW OF BOOKS. 1994 Sep 22; 41(15):62-71.Both Robert Malthus and Condorcet offer an analysis of the population problem. Malthusian overpopulation notions suggest a link with the modern "override" approach of shifting aid from development to family planning with legal and economic restrictions to ease the pressure of a high birth rate. Condorcet's notions are more compatible with the modern "collaborative" approach of rational decision making by men and women with knowledge and a sense of personal security. The collaborative approach finds a solution to the population problem in joint government and citizen actions to produce economic and social conditions favorable to slower population growth. Gerard Piel has most recently written on this approach. Prominent calamity authors are Paul Ehrlich ("The Population Bomb") and Garrett Hardin's "Living Within Limits." There are many fears and concerns that drive the calamity scenario. There is fear of an increase in immigration pressure and of relatively well-off people being surrounded by a fast growing and increasingly poor population from developing countries. When fear predominates thinking, coercion becomes a more acceptable strategy. A population projection of 78.5% of Asians and Africans by 2050 would approximate the population distribution in the 1650s and 1750s. Social and economic development as a collaborative approach is found to lower fertility. Concentration on Africa's population growth rates obscures the influence of economic conditions, war, and political unrest. There is not a clear sense of direction from present food supply and distribution analysis that demand will not be met in the future. Economic conditions can deteriorate for some, while others are receiving the benefits of economic growth. Food prices have declined and are likely to continue to decline, and the regions of highest grain productivity are regions with large populations. Other factors besides population size explain the crowded slums in large urban areas. Birth rates appear to decline in countries that have more female education, lowered mortality, increased economic means and security, and greater public discussion about life styles. Despite the population problem being serious, the greater concern should be on the long-term effects of population on the environment and the adverse effects on quality of life, particularly for women.
POPULATION AND DEVELOPMENT REVIEW. 1995 Jun; 21(2):351-9.In 1793 Condorcet wrote to scientists about the important effect of wasteful consumption, the need to improve energy efficiency, and the usefulness of recycling. Malthusian notions of the natural laws of population continue to create scientific and literary controversy. Godwin's reply to Malthus in 1820 suggests a sustainable population limit of 9000 million. The 1993 World Population Science Summit held in New Delhi set a potential limit of 10 billion in 2050. Condorcet and Godwin believed man to be capable of reasoning about future population growth and responsible for constructing scientific tables of mortality. Summit papers by Nathan Keyfitz and Kerstin Lindahl-Kiessling support an overlooked Malthusian belief that futurists would plan for the balance between future growth and natural resources. The Summit papers are environmental Malthusianism, proposing that severe environmental damage will result if the consumption of poorer countries increases to the level of consumption in developed countries. The Summit papers also suggest that population increase is the key agent affecting local and regional environmental degradation. The number of migrants and refugees is expected to increase and to result in civil strife. Worldwide patterns are not described very well in the Summit papers. Natural scientific findings are disappointing. Individual fertility decisions have social consequences. Godwin and Hazlitt differ from Malthus in crediting political institutions as the cause of food shortages and overcrowding. Another Malthus critic, George Ensor, believed that fertility was controlled by intelligence and self-interest. Hazlitt, Godwin, and Ensor focused on the role of political institutions in affecting fertility decisions. The Summit papers neglect the role of political institutions but adhere to Condorcet's ideal of a universal union of sciences concerned with fertility, energy conservation, and responsibility to future populations.
Assessment and implementation of health care priorities in developing countries: incompatible paradigms and competing social systems.
Social Science and Medicine. 1984; 19(4):373-84.This paper addresses conceptual issues underlying the assessment and implementation of health care priorities in developing countries as practiced by foreign development agencies coping with a potentially destabilizing unmet social demand. As such, these agencies mediate the gap between existing health care structures patterned around the narrow needs of the ruling classes and the magnitude of public ill-health which mass movements strive to eradicate with implications for capitalism at large. It is in this context that foreign agencies are shown to intervene for the reassessment and implementation of health care priorities in developing countires with the objective of defending capitalism against the delegitimizing effects of its own development, specifically the persistence of mass disease. Constrained by this objective, the interpretations they offer of the miserable state of health prevailing in developing countries and how it could be improved remains ideological: it ranges between "stage theory" and modern consumption-production Malthusiansim. Developing countries are entering into a new pattern of public health which derives from their unique location in the development of capitalism, more specifically in the new international division of labor. Their present position affects not only the pattern and magnitude of disease formation but also the effective alleviation of mass disease without an alteration in the mode of production itself. In the context of underdevelopment, increased productivity is at the necessary cost of public health. Public health improvement is basically incompatible with production-consumption Malthusianism from which the leading "Basic Needs" orientation in the assessment and implementation of health care priorities derives. Marx said that "countries of developing capitalism suffer not only from its development but also from its underdevelopment." (author's modified)
[Society and procreation: the social factors that affect them] Societe et procreation: les facteurs sociaux qui l'influencent
Brussels, Belgium, Editions de l'Universite de Bruxelles, 1981. 291 p. (In series: Etudes sur la Famille)This volume contains a collection of papers by members of the Study Group for Family Roles, an organization of scholars which pursues studies on family roles from both historical and analytical perspectives. The theme of the present volume is the control imposed by the collectivity on individual fertility behavior through mores, laws, sterotypes, and other means, and which is apparent in widely varying historical situations. The 10 articles concern Malthusian problems in archaic societies; voluntary birth control in the Roman empire; aspects of birth limitation in traditional Jewish society; Islam and contraception; social pressure and material incentives in Chinese demographic policy; social aspects of procreation in the Soviet Union; social aspects of precreation in Rumania and Hungary; procreation and education; attitudes of family planning personnel toward contraception in Belgium; and the role of the UN in family planning.
Population Bulletin. 1975; 30(6):1-32.Catholic teachings on human sexuality, love, and marriage are traced from the days of the early church to the present in section dealing with the papal perspective, traditional teachings, the phenomenon of birth control, the love ethic, a post-World War 2 reorientation of moral thinking as revealed in Vatican Council 2, the Papal Birth Control Commi ssion, and the Papal Encyclical, Humanae vitae, and reactions to the encyclical. The teachings are not seen as absolutes but as expressions of values which have shifted with the cultural patterns of the ages. The one area of strict prohibition has been a ban on artificial birth control, most recently upheld in the 1968 Humanae vitae, much to the con sternation of many laymen and clerics. While to many the edict may have seemed to fly in the face of the future by denying the use of artificial means of contraception, what it has done, in fact, is to awaken Catholics to the need to take personal and immediate responsibility for their sexual and other moral acts. Individuals should follow the dictates of their well-formed consciences rather than blindly follow the ir bishops and pastors. Papal intransigence on the issue of contraceptives, however, has forced Catholic thinkers and theologians to face the issue and work out a more realistic Catholic attitude toward population policies and birth control.