Many births not necessarily bad

The language is changing, but the core assumption remains: babies create poverty. But is it true that people in Africa and other parts of the world with high rates of poverty will never have enough food, quality education and high incomes unless governments and NGOs guarantee them universal and free access to contraception?

I recently attended a conference on population and development in London sponsored by the UN Population Fund, which featured scholars, reproductive health professionals and officials from donor governments, foundations and non-governmental organisations. The overarching goal of ‘Countdown 2015’ was to determine how to provide free, universal sexual and reproductive health care. The resulting pronouncements lived up to the worst stereotypes of development-speak: they were pedantic, impenetrable and exuded a hopeless idealism born of paternalism and arrogance toward the poor. Participants argued that unless all women have access to free contraception of their choice, it would be impossible for hunger to be beaten, children to be educated, HIV/Aids and malaria to be combated and poor countries to deal with their debt problems. All this must be resolved by 2015.

The conference was a follow-up to a similar gathering in Cairo a decade ago, which gave birth to the ‘Cairo Consensus’. Before 1994, population control was all the rage in development circles. The birth rate in the Third World – high compared to that of the industrialized nations – was regarded by policymakers as a leading cause of poverty. Since Cairo, and prominently so in London, old population control ideas have now been re-branded as a human rights issue.

In this vein, the prevailing view at the conference was that rich nations are obliged to finance contraception and health care for the poor in the less industrialised countries. The recipients, according to the formula that gave rise to this demand, were relegated to a helpless victim-hood that was beyond their ability to relieve. Speaker after speaker proclaimed the right of the poor to contraceptive choice as a fundamental human right similar to that of free speech or association. Of course the glaring difference between them is that the latter rights are demanded by citizens from their governments, while the former is to be funded by faraway governments with no political accountability to the recipients. Can and should the poor enjoy rights based on Western charity?

I was embarrassed that my government could turn up at the conference begging bowl in hand. It is only the people most affected by poverty and disease in places such as Kenya, where I hail from, who have the ability to right their ship. Even in those instances when providing free health or contraceptives has been tried in poor countries, patients have often had to provide their own linen, syringes, razor blades and bandages. Working conditions for medical professionals have deteriorated markedly, worsening patient care. In Kenya, for instance, a free healthcare policy resulted in hospitals that became death traps and a staff exodus to greener pastures abroad.

There is simply not enough money for a central authority to extend the ‘right’ to free health care in any sub-Saharan country. But it is not only the paternalism evident at the conference that was so objectionable, it was also the poverty of the idea that a reduced birth rate would result in a more prosperous society. Many laypeople I have talked to imagine that Africa is overpopulated, and that this is one of the causes of its extreme poverty. I remember one telling me that if people had fewer children there would be enough schools, food and resources and images of starving people would diminish. I was surprised that this outlook was shared by many of the learned and supposedly informed health professionals at the conference.
Why do they ignore the growing body of statistical and anecdotal evidence that contradicts decades-old Malthusian opinions linking high national birth rates with poverty, war and disease? Policies arising from such perspectives have been the basis for inhumane programmes of coercion and the denial of personal liberty in one of the most valued choices a family can make: the number of children that it wishes to bear and raise.

About a dozen studies, including one by Nobel prize-winning economist Simon Kuznets, oppose the overpopulation consensus so evident at the conference. They demonstrate that high birth rates are not associated with slower economic expansion; on average, countries whose populations grew faster do not grow slower economically. Limiting the number of babies born will not make for more wealth or less misery, only the ingenuity and industry of the poor will make for long lasting solutions. But they will remain marginalised if their government is too busy begging for charity while its policies are guided by donors and NGOs.

It is fine for charitable organisations to support the provision of health and contraceptive services to the very poor who cannot afford them, but this should not be the norm applied to whole countries. The result would be the entrenchment of a crippling dependency, reflected in apathetic electorates used to politicians governing at the behest of foreign benefactors.
Countries would, as they often do, prostrate themselves for aid flows that are ever shrinking and that even at their highest have never come close to satisfying the needs of the world’s poor. Ultimately, the poor have only themselves to rely on and this is as it should be for they possess the talent and industry that will sweep away their poverty and misery. For them to realise their potential, they will need the opportunity to pressure their governments to enact policies that reflect their aspirations. This process will not be helped by the ‘guides’ I met at the London conference who have been given no democratic mandate and whose aid only serves to insulate politicians from their electorates.

Author: June Arunga is the youth affairs director of IREN (The Inter Region Economic Network, Kenya). This article may be republished without prior consent but with acknowledgement to the author. The views expressed in the article are the author’s and are not necessarily shared by the members of the Free Market Foundation.

FMF Feature Article\12 October 2004