Download Hearing Two - APPG on Population, Development and Reproductive

ALL-PARTY PARLIAMENTARY GROUP ON POPULATION
MINUTES OF PROCEEDINGS
at a
PARLIAMENTARY HEARING
held at
The Palace of Westminster
on
Monday 15 May 2006
Population, Development and Reproductive Health Inquiry
Before:
Richard Ottaway MP, in the Chair
Viscount Craigavon
Baroness Tonge
Sandra Gidley MP
Ms Catherine Budgett-Meakin
Ms Patricia Hindmarsh
Ms Jennifer Woodside
(From the Shorthand Notes of:
W B GURNEY & SONS LLP,
Hope House,
45 Great Peter Street,
London SW1P 3LT)
Witnesses: MR ROBERT ENGELMAN, Vice President for Research, Population
Action International, and MR JOHN ROWLEY, Planet 21, examined.
CHAIRMAN: Ladies and gentlemen, this is our second hearing. Thank you
all for coming. It is a great pleasure to welcome John Rowley from Planet 21 and
Robert Engelman from PAI, both well-known in the field. I would be grateful if you
could open up with a statement of about five minutes, or something like that, and then
we will throw it open for questions. The room is booked for two hours but we do not
necessarily run for the entire length. We have already identified quite a few key
questions we want to ask you. I propose doing it in alphabetical order, so would you
like to start, Robert.
MR ENGELMAN: Thank you very much. Mr. Chairman and Members of
the Committee, thank you for inviting my organisation, Population Action
International of Washington DC, to participate in these hearings. I am honoured to
represent PAI as its Vice President for Research, and I am particularly grateful to
speak as an American researcher here in the United Kingdom. I compliment this
body for its consideration of this linkage, which may be more important today in
some ways than ever before, despite being less often considered.
Several panels of international scientists have characterised today’s
human impact on the environment as unprecedented in scope and risk. The Royal
Society of London and the US National Academy of Sciences jointly stated in 1992:
“If current predictions of population growth prove accurate and patterns of human
activity on the planet remain unchanged, science and technology may not be able to
prevent either irreversible degradation of the environment or continued poverty for
much of the world”.
The scientists added, and this is really the point that I want to stress
today: “Unlike many other steps that could be taken to reduce the rate of
environmental changes, reductions in rates of population growth can be accomplished
through voluntary measures. Surveys in the developing world repeatedly reveal large
amounts of unwanted childbearing. By providing people with the means to control
their own fertility, family planning programmes have major possibilities to reduce
rates of population growth and hence to arrest environmental degradation. Also,
unlike many other potential interventions that are typically specific to a particular
problem, a reduction in the rate of population growth would affect many dimensions
of environmental change. Its importance is easily underestimated if attention is
focused on one problem at a time”.
The conference that produced this statement led two years later to a Science
Summit on World Population in New Delhi. This was the same year that the
International Conference on Population and Development took place in Cairo, 1994.
No fewer than 58 of these societies, essentially the world’s national scientific
societies, endorsed a statement that asserted: “Humanity’s ability to deal successfully
with its social, economic and environmental problems will require the achievement of
zero population growth within the lifetimes of our children”.
If we want to know what scientists have said about the linkage between
population growth, environmental sustainability, and human health and prosperity,
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these statements remain the closest scientists have come to an international consensus
today. I want to briefly review some of these connections, taking a broad view of
environmental sustainability that includes soil, fresh water, living things and the
climate that sustains human life and wellbeing. I want to stress, too, that when it
comes to environmental sustainability, as other things, human population is a unified
whole. The world is thoroughly globalised and closely connected. Human
environmental impacts can be remote in time and place, as well as local and
immediate. Neither my analysis nor my policy recommendations are fundamentally
different for lower income populations – whether we call them developing countries
or majority populations – than for wealthy ones. We are all in this together, and the
same principles and values, I believe, apply to us all.
More than two-fifths of all the land on earth is now serving human
ends – either food production or settlement or commercial and industrial purposes.
Today’s farmland is almost all we are likely ever to have to produce food for
humanity, yet an area of agricultural land the size of China and India is already
significant degraded. Most of this is in Africa and Asia, where food insufficiency is
already acute.
Today there is a frightening additional prospect: a long-term upward
shift in the cost of petroleum and natural gas could significantly raise the price of food
worldwide, regardless of how exporting nations resolve the tough question of
subsidies. If we succeed in substituting biomass fuels for petrol, as some, including
the President of the United States, have suggested we do, we will be putting energy
production for vehicles in direct competition with food production for human beings,
further coupling food prices to those of energy. Already the world is failing the
population of the malnourished, 852 million people in the 2000-02 period, and rising
by almost five million a year. Optimism about ever-cheaper food has always been
based on the assumption of cheap energy. That optimism is less justified today more
than ever.
More than half of the world’s accessible renewable fresh water is now
withdrawn by humanity. In parts of Africa most surface water is diverted for farming
and raising livestock. This is probably a good part of the reason why Lake Chad is
disappearing today. Growing scarcities of fresh water are contributing to the bloody
conflicts that have been occurring this year in northern Kenya and the Horn of Africa.
Last Wednesday, the Guardian featured a news story suggesting that
some 20,000 people from Somalia and Ethiopia have attempted to emigrate, not to
Europe, not to North America, but to Yemen across the Gulf of Aden. Several
hundred have died in the attempt. All three of these countries rank quite low in their
cultivated land and renewable fresh water per capita, and these values are shrinking
rapidly as their populations continue to grow at 2.4 per cent a year in Ethiopia and
more than three per cent a year in Somalia and in Yemen. This recently uncovered
stream of international migrants has nothing to do with the lure of the developed
world or strong economies. This movement of people is driven by desperation. Each
year, the amount of cropland and fresh water available for the needs of the average
population is declining by two to three per cent.
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Within two decades, as many as 700 million people may live in
countries with only a twelfth of a hectare of cultivated land per capita. This has been
established by a number of soil scientists and agronomists as something of an absolute
minimum for food self-sufficiency when you are not using what we often call in the
United States Iowa-like techniques of food production, which I am sure is true of
Great Britain as well. If you are not having high inputs of fertiliser and energy use,
this is what you need as a minimum to keep you fed a vegetarian diet.
More than four times that many, that is more than four times 700
million people, may live in countries without enough renewable fresh water per capita
to assure food self-sufficiency. The tendency today is to blame the problems of food
insecurity and water scarcity on the weaknesses of institutions, and that is
understandable. Governments are indeed notoriously prone to corruption and they are
often incompetent. But to treat these issues as purely institutional would be to blur
the important distinction between long-term systemic forcing mechanisms that cause
these sorts of problems and failures of response in institutions that are incapable of
coping. Population growth above certain thresholds tends to push human activities
past critical natural tipping points - I would stress, in combination with other factors,
always – in environments where farmland and fresh water are teetering on the brink of
insufficiency for existing, let alone growing, populations. Under good circumstances,
governments can effectively cope. Often, pressed by the spiralling demands that are
being placed upon them, they cannot.
Population growth – again, above certain thresholds – also frustrates
our efforts to maintain the biological and genetic richness of the earth, to save what
amounts to our only known companions in the universe, especially in forests, coastal
areas and the seas. In the Washington area, where I live, the Chesapeake Bay, which
was written about by Capt. John Smith, an English explorer of the time, as literally an
endemic natural paradise which is on the flyway where the birds migrate from Canada
into the tropics of the Americas, is developing a vast dead zone of low to non-existent
oxygen. Environmentalists and local governments are beginning to despair of
returning it to anything resembling health while the watershed gains 110,000 people
each year, all of whom need a place to live and like to drive cars. With this issue,
differences in the kind of government policy, technology, and even per capita wealth,
tend to create differences on the margins of plant and animal extinctions.
The loss of biodiversity is global and slow-acting, with genetic
impoverishment in one generation often condemning a species to extinction several
generations later. And this genetic impoverishment and species loss is occurring in
every country regardless of its current level of population growth as well as its level
of income and government, in response not just to the population growth that may or
may not be occurring in that country today but that which has occurred in the past and
that which is occurring in other countries that may trade with them and consume the
products of that country. The most direct causes are the shifting of land from natural
to human management. Mostly this is agriculture, but it is also housing and
commercial and industrial development. A key driver of species loss is the growing
segmentation of natural areas as roads divide them and patchworks of settlements
slowly break up and fill in previously natural areas. This parcelisation inevitably
increases the ratio of perimeter to the interior habitat. Predators tend to be favoured
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over prey, and whole ecosystems are thus disrupted. The introduction of alien species
compounds the threat.
An even larger threat to biodiversity than these may be human-induced
climate change. Both climate change and the rising cost of energy – both of these
much on our minds today – relate to the long-term growth in human demand for
energy. That demand is always a function of population coupled with levels of
personal consumption and prevailing technological and energy-source options. These
linkages are among the most difficult and sensitive for us to tease out today. Highconsuming, more slowly growing industrialised countries, especially my own, I might
say, have historically consumed the lion’s share of the world’s annual fossil fuel
production. Of course, our own population growth since the Industrial Revolution
began has been a dominant feature in the size of our total emissions of greenhouse
gases, which we should not forget. Now developing countries, as is their right and in
a sense their duty for development, are beginning to catch up to our consumption
levels, as the meteoric growth of automobile ownership in China and India illustrates.
The rapid population growth that occurred 40 years ago in these countries, when peak
oil and global warming were not on anyone’s minds, provide the base on which
today’s rapid increases in consumption in some of these developing countries is now
occurring.
That offers an important lesson. The population growth that occurs
from today forward will be strongly determinative of how much of a cushion we will
have for the rest of the century to continue enjoying the use of fossil fuels. We will
need that cushion. Somewhere between six and 14 billion people are likely to be
consuming energy in this century at per capita rates that may be, and should be in
some ways, much higher than today’s world average. Everyone in the world has the
right to drive the way Americans do. Indeed, many economists would say that this is
what economic development is about, freedom to have that right and the wealth to
have that right to drive a sports utility vehicle if you want to. It is extremely difficult
to imagine a plausible shift to non-carbon energy sources sufficient to meet these
needs soon enough to head off a doubling of atmospheric carbon dioxide levels. I
find it hopeful that according to the United Nations’ lowest projection of future
population, the number of human beings rises for another 25 years and then levels off
and then begins a gradual decline to the end of the century. That is somewhat parallel
to – hopefully parallel to – and thus, I believe, can help support the curve of annual
greenhouse gas emissions that we will need in order to stabilise those gases’
concentrations in the atmosphere in this century of roughly double their industrial
concentrations and not much more. In other words, for both greenhouse gas
emissions and population, at the lowest most positive scenario for both, you have a
curve that looks something like this going off into the future (indicating downward
trend), as opposed to with high population growth a curve that goes like this
(indicating upward trend) and medium emissions growth going like that (indicating
downward trend) choking everybody’s per capita ability to emit greenhouse gases.
Let me return briefly to Ethiopia as a closing illustration of the
complex but, I believe, close relation of human population dynamics to environmental
sustainability. Earlier this year, researchers at the University of Bristol and University
College London reported on a development project that provided needed tap water in
a group of remote communities in southern Ethiopia. Women who had once walked
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up to six hours in a day to obtain water could suddenly get it in 15 minutes – by any
measure successful water intervention, clean water, which is something we all want to
work on – but one side of this new access to safe water was that these women were
healthier, had more energy, and as a result apparently, so the researchers believed,
ended up having more children and their birth rates rose, which eventually contributed
to the local population growth in these areas, at least of kids – it is a fairly recent
project so it has not gone through the age structure yet – and, thus, ironically a more
rapid depletion of water supplies, all of which were coming from surface and some
underground water, the same basic water supply for these communities no matter
where women went to get it. As a result of that, there was poorer child health than the
communities had experienced in the past. The researchers also found, however, and
unfortunately they did not write this up in their paper but it was covered in the local
press at the time, that women in these communities were quite interested in obtaining
access to family planning services, although so far as I have been able to determine
access today is still pretty much lacking in that part of Ethiopia. The researchers
wrote: “Development intended to improve human welfare that does not include a
family planning component”, and I would add assuming one is desired by the local
population, although I think that is frequently or almost always the case, “can actually
undermine the long-term wellbeing of the target population”. I could not say it better.
We live in a world facing higher energy costs, human-induced climate
change, and real risks of increasing food insecurity, poverty and civil conflict. The
slowdown in population growth humanity is now experiencing – due to smaller desire
families, later desired pregnancies, and increased use of contraception – is the most
positive global trend we can point to today. But it is a fragile trend, with support for
international family planning and sexual and reproductive health and rights only a
fraction of what is needed. I and Population Action International urge the
Government of the United Kingdom to step further into your leadership in helping to
assure that all people who seek to plan their families in good health, with full rights to
direct their own sexuality and reproduction, can do so. Their wellbeing alone will be
sufficient reward for these efforts. But we also stand a chance of gaining a more
peaceful and less economically divided world, one that can support thriving human
and non-human populations for millennia to come.
Thank you very much, I look forward to your questions.
CHAIRMAN: Thank you very much indeed. There was plenty of food for
thought in that and I will be interested to see how the shorthand writer does your
graph.
MR ENGELMAN: Hand gestures!
CHAIRMAN: John, would you like to speak to us?
MR ROWLEY: Thankfully, Robert has covered a great deal of ground there
so I need not repeat that.
I very much appreciate the chance to put my pennyworth in today. I
thought I would start with a few thoughts as a journalist, and as someone who has
been around this issue for a long time, about the way governments approach these
great trend subjects of population, environment and development.
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It seems to me that governments are often fickle in the way they pick
and drop these issues. They are often influenced by ideology and prejudice and
fashion rather than by looking at hard scientific evidence, and to some extent by
pressure groups that muscle in on the scene. It is not altogether surprising because we
know, as journalists, that it is extremely difficult to get people interested in things
which are not here and now. The further away in time, the more distant they are, the
less interested people are. This is why even our own national new media feel
impelled to relate almost every story to the UK.
My own experience of this in terms of international discussions was at
Bucharest where I edited the conference newspaper. Then the environment was in the
air because of the 1972 Stockholm meeting. There was some discussion as to how far
population was driving this environmental problem but there was no real consensus
about it. America was on side as far as population and family planning were
concerned. China was still maintaining that each child has two hands and therefore it
need not worry about its growing population. A number of other developing countries
had hesitations. Of course, the development lobby was vociferously arguing that
‘development is the best contraceptive’. There was a mixed bag of views there that
did not really gel.
Then we came to Mexico City ten years later in 1984. There,
population and development were finally agreed to be two sides of the same coin. But
a rather less than popular US delegation that seemed to have changed their tune and
started arguing that market forces were the best way to address the population
problem and we did not need to worry too much.
Then we came on to Cairo in 1994 where there was a big breakthrough
when the women’s lobby, which had done a huge amount of preparation for the
occasion, made a very good and very strong case for reproductive health and for
investing in women and women’s development. The resulting Action Plan also saw
money on the table. Unfortunately, the donors failed to follow through on the funding
targets that they had promised to meet. The broader environmental and population
issues were rather left behind on the battlefield on that occasion. As a result, some of
the impetus had gone out of the drive to bring the Cairo Conference agenda into
being.
Here we are 12 years later in 2006 and we find that environment is
now centre stage. It has become increasingly obvious, as Robert was saying, that the
whole life support system of the planet is beginning to breakdown. The fact that
population has anything to do with this has almost been disregarded. Nor is there any
real concern that today’s 6.5 billion people will grow perhaps to nine billion by 2050,
making all these problems much more difficult to solve. The fact that Sub-Saharan
Africa, and Central and Southern Asia are on course to add two billion, to some of the
poorest countries in the world, is not mentioned.
These hearings are therefore a very hopeful sign that somehow we can
get some of these issues back on the agenda and the balance can be put right.
It seems to me we also have to take the public along in this. As long as
the public does not understand the crucial scale of the issue, then the politicians are
not going to do so either. I believe we need a much greater education and
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communication effort in this area. Perhaps it is time to bring some of the agencies
together, which are noticeably absent from these particular hearings. I have some
experience of this because since 1992 at Rio I have been running a magazine, and
now a website, on these issues and I take some comfort in that we get 100,000 visitors
each month to our People and Planet website and over a million pages of material are
downloaded each month. These are mostly students and school teachers. Something
like 80 per cent are students or teachers. There is an interest out there.
Unfortunately, I take less comfort in the fact that Planet 21 has very
little funding. All our wonderful funders who started out with great enthusiasm after
Rio have somehow fallen away. DFID has never come round to giving us money.
The Swedes have given generously but the British Government has not taken any
interest - the argument being that we do not tackle poverty on the ground. That is a
point but it seems to me there is a need for education as well.
That is rather a personal preamble. I would just like to make three
points on the Planet 21 submission.
First of all, I think the population issue has to be viewed in at least two
different ways. The impact of population growth on the MDG goals, in terms of the
environment, needs to be looked at globally first of all. It seems to me we are in the
middle of a consumption avalanche. India and China are going to have a massive
impact on the planet. The conservation agency WWF has shown that we are using 20
per cent more of our natural resources that come on stream every year and that if this
goes on we will need two planets by 2050. It is not a static situation. China is already
the second biggest emitter of CO2, according to the International Energy Agency, and
will probably overtake the US by 2020. China and India together already have a
greater ecological footprint than the US or Europe, according to the Worldwatch
Institute. These two countries are expected to add another 500 million people to the
2.5 billion that they already have in the next quarter century. This is going to have a
massive impact. I have seen a striking graph, which I cannot seem to track down,
showing the projected CO2 emissions of these two countries in relation to Europe and
North America and the overtaking curve is quite amazing. We do have a very big
climate problem that will affect all our MDG goals.
Secondly, we also have regional and local problems that relate to the
same issues. It is the poorest countries that are growing most quickly. According to
UN projections, Africa alone is due to add another billion by 2050 to its 700 million
people, making 1.7 billion people. That is allowing for the effect of AIDS in
countries like Botswana and Swaziland. When you look at the actual country
situation, the population of Ethiopia is projected to go up from 72 million to 173
million. Little Niger, abjectly poor, with a total fertility rate of eight and rising, is due
to increase its population from 12 million to 52 million. Pakistan, which is bedevilled
with salinization and all sorts of other environmental problems, is due to go add over
100 million to its population of 159 million. These are in countries with enormous
problems of water, firewood, cropland and city pressures, social needs, housing and
employment, and so on. As Lester Brown from the Earth Policy Institute has said, if
these countries are not helped to stabilise quickly we will see the death rates go up
and conflicts cut the numbers. Climate adds another dimension to the uncertainty. In
fact, we are already seeing that in Africa the death rates have started to rise and life
expectancy is coming down.
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I was very struck by Professor Anthony Young of East Anglia
University, who has been working in development activities for 40 years and knows
Africa very well. Contrary to some statements by FAO, he claims that countries like
Malawi, Ethiopia and elsewhere really have no spare land. Young says in his
experience a country like Malawi, due to increase its population from 11 million to 47
million in the next 45 years, has a farm size of well under half a hectare, the fertility
of the land is down, yields are also down, while malnutrition is a growing problem.
He says an essential answer to the problem of these countries is to get on with the
Cairo agenda. That is my second point.
My third point is that it is easy to be drawn into crisis view of one part
of the global problem at the expense of others and get the reality distorted. Population
was the great issue of the 1960s and early 1970s; now climate is obscuring
everything. It is really important, as Mark Lynas has said in his book High Tide, to
address the central question. That question is whether the vast mass of humanity now
exceeding 100 times the biomass of any large animal species that ever existed on
earth, consuming and polluting at an ever faster rate, can learn to share our fragile
biosphere with other species and with future human populations, because we are
taking the resources of generations of the future away from them at present. We have
to try and see these things in the round, in balance, and to educate people better as to
what is really going on.
CHAIRMAN: Thank you very much indeed. Thank you both. I am going to
throw it open for us to quiz you both. Having called you two in alphabetical order, I
am going to call the panel in alphabetical order. It comes to Catherine first to kick
things off.
MS BUDGETT-MEAKIN: When I gave my evidence last week I talked
about the difficulties of talking about population growth when we, in what I call the
minority world, are doing such a lot of consumption. I wonder how we might deal
with this dilemma of our over-consumption and the population growth conundrum in
the same breath.
MR ENGELMAN: Personally, I think it is important for us who work in the
population field, or at least who try to call attention to population growth itself as
opposed to just reproductive sexual and reproductive health and rights, to make clear
that we simultaneously are working on consumption. I do that in my own life by
chairing the board of a non-governmental organisation in the United States called the
Center for a New American Dream. It is a very patriotic localised name. The idea in
naming it the Center for a New American Dream is that as America has provided a
beacon of the old American dream, which was high consumption, everybody after
their own good, everybody keeping up with the Jones’s, as we say in the United
States, we could perhaps provide a new model for the rest of the world and there
might be more satisfying ways to be happy. Our motto is, “More fun, less stuff”,
including community and family, and our main point is to try to find a way to bring
down what I call the over-developed world’s over-consumption of resources and still
maintain a sustainable existence.
I think what needs to be made clear is you need to address both of
these issues simultaneously. They are not symmetrical and they are not at the expense
of each other, that if we deal with population we are not dealing with consumption
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and if we deal with consumption we are not dealing with population. To some extent,
they are two sides of the same coin and can be addressed together. I am not happy
when people say, “How can you as a person from a developed country work on
population when clearly it is your population that is causing the whole problem?”
Yes, my population grew at population growth rates – speaking of the United States –
similar to majority world populations today through most of the 19th Century, and that
is one of the reasons we are quite a large population with quite a large impact. On top
of having a large population, we consume a lot. Now I do believe that the developing
world has the right to consume in the same way we do and my effort is not to say,
“Don’t consume the way we do”, but “Let’s see if we can collectively find ways to
consume with less damage to the environment”. It is not consumption people want
but the satisfaction of natural human desires. Let us deal with both questions at the
same time.
MR ROWLEY: I think that is right. There is a problem clearly in this fact
that the old industrial nations have done so much of the damage to the earth, but what
we have to do is to work towards a new eco-economy for the whole world. If China
and India go down the same route as the United States and Europe then there is not
much hope for us, but how can we expect them to take a different route if we do not
start doing it ourselves? We have to try to create awareness, that we need a new way
of behaving, and that is beginning to happen, certainly in industry and in people’s
ordinary lives,.
At the same time it is also true that it is no longer right to separate out
the developing world from the developed in that old-fashioned way. The world is
changing extremely fast and we want countries in the developing world to develop.
We should be pleased with that, but it has been happening on an enormous scale.
China now produces as much steel as Europe, the United States and Japan put
together. It is the world’s biggest user of coal with growing imports of wood, soya
and raw materials of all sorts. At the other end of the equation, many poor regions of
the world are also damaging their environment, sometimes because poor people have
no option but to continue to do so. They are over-grazing, they are moving into
marginal land, creating urban squalor and pollution. Asia’s rivers are some of the
filthiest in the world laden with sewage and waste of every sort. China is turning its
northern lands into desert because it still has tens of thousands of goats. Slash and
burn farming, if practised too frequently, is not sustainable. The fertility of the
African land has fallen by something like 30 per cent since 1970 and some people
estimate that it could halve in another 40 years as a result of land degradation.
Population growth is linked to environmental destruction in many poor
countries from coastal pressures on lakes, seas and farming of marginal land,
destruction of watersheds, pollution of rivers and much else, and the governments
know it. That is why countries like Iran have done such a good job in trying to deal
with the problem. It is a very complex situation but to have influence in the world it
is quite right that the minority world shows by example what can be done. There is a
great opportunity for technical cooperation so that, for instance, China can try and use
its coal more sustainably and in a cleaner way. Whether that is going to be possible I
do not know, but China is planning to build 500 coal-fired power stations in the next
few years and that could be very polluting.
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MS BUDGETT-MEAKIN: This is slightly different but ever since I have
been involved with this I have been aware of the taboo of the word “population”, it
has been very, very difficult. I was at Johannesburg and nobody would mention it.
Fortunately you call yourselves Population Action International, it is there in your
title, but Population Concern here has changed its name. There are real problems
about this taboo. I just wondered what you both think we could do about that.
MR ENGELMAN: As our name suggests, we believe in stepping forward with
the name, we believe in stepping forward with the concept and we believe in not
stepping back. I think the way out is to go further in. Population, in spite of the
whims and fancies of issues, is an ongoing and consistent issue for humanity. I think
Margaret Mead in reference to her study – she was an American anthropologist who
laid a lot of ground in this area in the 1920s, 1930s and on after that – said that every
population has two problems and has to address those two problems: how not to grow
too large and how not to grow too small. One thing I do know is that population is
not such an unfriendly topic in countries that have very low fertility and are trying to
wrestle with the issues that are raised by their extremely low fertility because that is
something of a different question.
I think the way to embrace all of these questions as universal human
interest and concerns and establishing the way we want to approach these issues is
through the rights and development framework that was established in Cairo in 1994.
With enough public education I think we can get past this problem. It is frustratingly
hard. I have worked with environmentalists for 15 years, certainly since Cairo, on the
fact that this is a framework based on human rights and human development
particularly focused on the lives of women, and yet it has not been a story, in spite of
its simplicity and elegance, that has sold very well. All I can say is we need to keep
working on that and changing our name is not the way to go.
MR ROWLEY: I think in this country it is particularly difficult. Somehow
the United States has managed to keep its main population agencies going. The issue
seems to be more of an acceptable one to discuss in the States. Until some of the big
environmental development agencies in this country grasp the nettle and see a
connection it is going to be extremely difficult. I think Population Concern was
probably wrong to change its name and perhaps they regret it. I really do not have an
answer to the question.
CHAIRMAN: Thank you very much.
VISCOUNT CRAIGAVON: Can I say to Mr Engelman, thank you very
much for your very useful and fascinating overview of the whole subject. I hope you
do not mind if I ask you about a rather small part that you mentioned. I picked up in
reading your text the very interesting example you gave about women walking for
seven hours for water and then when you reduce it to a quarter of an hour you find
they have other attitudes to reproduction.
MR ENGELMAN: I am not sure it is an attitudinal change.
VISCOUNT CRAIGAVON: I did not want to draw too much from that
example and you did not say in the article that such a survey came from Ethiopia. I
do not want to draw too much from it but has that been duplicated anywhere else?
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MR ENGELMAN: No, not so far as I know. I was intrigued by it because I
follow research on this sort of issue on how development relates to fertility and the
interactions of provision of family planning and natural resources. It was a very
unusual study. I have not seen it replicated. The way science works is you will often
have a commentary on this sort of thing afterwards and I have not seen a response
from people who are saying it was faulty methodology or it was done wrong and there
are other things to consider.
MR ROWLEY: I think there are a number of examples where development
has gone ahead without effective consideration of family planning with negative
results. I was reading the other day about Machakos, which is a very interesting
example. It is the home of a farming community on the hillsides outside Nairobi
where is frequently held up as an example that a problem can be solved by good
agricultural extension work, rather than dealing with population. Machakos is an
extraordinary story starting when the Akamba people settled there in the 18th century.
Their numbers had increased to about 120,000, living on these rather poor hillsides at
the beginning of the 20th century. By 1930 this had grown to about a quarter of a
million. That growth led to erosion and deforestation and the colonial government
and various other actors began to get involved. By 1994, the population of Machakos
district had grown to 1.4 million and must be more now. What Mary Tiffin from the
Drylands Research Institute in Somerset showed was that with encouragement from
outside and great community spirit, the coverage of forest land had improved, the
people had used every sort of conservation method to collect water, they had terraced
much of the land and they were doing quite well despite this enormous increase in
population.
More recently, I came across a World Resource Institute report of 2001
which went back to Machakos and said that land settlements are now so small, having
been divided and sub-divided, that the water supply is so limited that the opportunities
for further conservation are now almost nil; meanwhile the population is still growing
at three per cent year. The situation is ameliorated by the fact that the men are
travelling to Nairobi to get work out of season and there has been a lot of outside help
brought into Machakos. But this story does show how, in the end, it is very important
not to forget about population and family planning. There are a number of other
examples.
VISCOUNT CRAIGAVON: Can I ask John Rowley another question. I
picked up in the last paragraph of your article where you were talking about these
very large figures, and you mentioned it in your oral presentation, the population of
Africa of 700 million might add another one billion.
MR ROWLEY: Yes.
VISCOUNT CRAIGAVON: You said that took into account HIV/AIDS. My
question is, is that based on other things being equal or is that allowing for any input?
MR ROWLEY: That is based on the fact that outside the areas where AIDS is
really limiting population growth for the time being, populations are still projected to
grow very, very strongly.
12
VISCOUNT CRAIGAVON: That is assuming no further input from us or
from the developed world.
MR ROWLEY: That is based on the UN Population Division’s projections
for how they see the trends going. Most of these countries have extremely young
populations so there is a great deal of momentum in that figure. To some extent it is
also affected by the fact in areas with high infant mortality rates some mothers want
to have more children to ensure the survival of some. Dr John Cleland is, I believe,
going to tell this group that by far the biggest reason for population growth is
unwanted pregnancy: that if women could have help with unwanted pregnancy those
populations could be ameliorated otherwise the death rates would probably rise, as is
already being seen in Sub Saharan Africa.
MR ENGELMAN: The main assumption in that medium projection that John
is referring to is simply a fertility decline in Africa to roughly 2.4 by 2050. They do
not think about how much governments will provide for family planning, they do not
think about whether agriculture is going to be improved, they just do a straight,
“Mortality will do this and fertility will go to 2.3 or 2.4”, that is the assumption. We
do not really know that but if that were to occur then that is what the population could
be.
CHAIRMAN: Of course it could be done quicker than that, it does not have to
be 2050 if there is the political will to do it.
MR ENGELMAN: One thing the UN does helplfully is it provides a low,
medium and high projection, and even a few beyond that, and they state their fertility
assumptions. At PAI we are trying to see if we cannot figure out a way to relate these
to the government assistance that would be required to provide the level of
reproductive health care that would enable several tens of millions of reproductive age
women in Nigeria, for example, to achieve a family size and related concept of
prevalance rates that would allow 2.5 children on average. That is a lot of money and
it would take a lot of effort.
SANDRA GIDLEY MP: I want to come back to the water issue again, if I
may, because I found that particularly interesting. We have talked a little bit about
the increased fertility rates and I am not quite sure whether that is more time or better
health. Could you expand on the issue of child mortality and morbidity and what
factors are coming into play there.
MR ENGELMAN: I wish I were more familiar with the research. I have not
talked to the researchers but since they are here in Britain it might be a good idea to
perhaps summon them or ask them if they can provide the information directly. My
understanding of their work is they did not demonstrate an explanation, what they
found was an actuarial result, essentially. They found that the birth rates went up in
these communities fairly dramatically after the tap water was provided. Their
assumption or their theory about that was there were a number of side benefits to the
provision of clean water without women having to walk so many hours that raised
their fertility. These were probably related to more confidence that their children
might live. I think one of the main ones they cited was better health and better
nutrition, that these women were eating better as a result. These were farm
communities. Everything was improved. This is so true if you work in water. When
13
you have clean water it is the fountain of good life. We all take it for granted in the
United Kingdom and the United States. Their health improved generally and as a
result of their health improving - and this is well documented in demographic
literature; nobody quite knows what the thresholds are and how starving you have to
be to have lower fertility - their fertility went up.
One message I take home from that is that there may be conditions in
Africa as agricultural land deteriorates where fertility comes down but not for good
reasons, for very bad reasons associated with poor health and poor nutritional status.
The end result – it is kind of a paradox – was the women’s health improved and that
gave rise apparently, and this is documented in a paper which I have with me and
would be happy to share with the Committee, to an increase in birth rates and yet
ultimately the children who were born had poor health indicators a few years later
than previous age cohorts had had before the introduction of the water. That was a
very paradoxical result. That was what they documented and noted and said, “Why is
this happening”. Their interpretation was that it was an expansion of this youngest
age cohort contributing to the depletion of water supplies ultimately resulting in poor
health outcomes. It is what John Rowley was saying about Machakos. You rise up
but then because of the problem of continuing growth and limitations of your natural
resources you fall back again. That seemed to be what happened in this community.
SANDRA GIDLEY MP: This is in Ethiopia and presumably the same sort of
pattern is replicated, although you said earlier you did not have any specific examples.
As population increases water scarcity will become more acute. Which parts of the
world will be most affected? Africa is obvious but are there other parts of the world?
MR ENGELMAN: Yes, western Asia particularly. There are pockets
elsewhere. Haiti is beginning to be of real concern with regard to fresh water. Peru
on the west slope of the Andes unless they build some sort of water pipeline from the
eastern slope, which is very well watered as a result of the rain forest there. Also, the
Koreas. The United Kingdom is fairly short of water on a per capita basis ironically
enough but it does not seem to be a major problem, although I cannot say not being
British. When you are a developed country this is one of the advantages you have,
you have a water infrastructure.
If you look at Africa and draw a line around the whole perimeter of
Africa, maybe West Africa least, Northern Africa, Eastern Africa down to the Horn of
Africa, Kenya, all the way to South Africa, it is getting extremely scarce.
MR ROWLEY: One of the problems with climate change is that those places
that are likely to be hit worst with reduced rainfall are expected to be those areas north
and south of the Tropics, so you may get desiccation in areas which already have low
rainfall. I was reading the other day about an IIASA study – by the International
Institute for Applied Systems Analysis. This is looking into the situation in Egypt
where the total fertility rate has stalled at 3.5 children. The demand for water is
increasing in all ten countries of the Nile Basin, so it seems quite certain that the
amount reaching Egypt is going to decline even though there are treaties to try and
stop other upstream countries taking more water from the river. The impact of
climate change could also be quite dramatic. It could result in up to an 80 per cent
14
reduction in the flow of the Nile according to one estimate or possibly in a slight
increase - it is very uncertain. But, drawing on UN and FAO data, IIASA shows that
the annual supply per person could drop from 2,000 cubic metres in 1960 to as little
as 250 cubic metres by 2020. There could be some major difficulties in some of these
countries.
SANDRA GIDLEY MP: Do either of you think this could lead to violent
conflict over water resources?
MR ROWLEY: I think it is definitely a problem, yes.
MR ENGELMAN: Looking at this in Population Action International we
came up with results that surprised me a little bit and I do not know whether they are
robust or can guide us in the future but, surprisingly, up until now water scarcity has
not been much of a contributor to conflict. Someone has written a paper saying that
in spite of all this talk about water wars, the last water war was in 4000 BC and
documented in Mesopotamia. The thinking about this seems to be that water,
blessedly, seems to be particularly open to engineering solutions and it is a problem
that often can be more readily solved than some other problems. Engineers from
different countries get together and say, “Right, we will build a pipeline from this
particular basin over there and supply you with a certain amount of water”.
That seems to be more amenable to solution than another natural
resource scarcity which is not taken as seriously but I think is much more serious,
which is farmland scarcity, which John alluded to. You cannot move farmland
around. In fact, some countries in Africa are getting so short of farmland, and I think
Rwanda was a very good case of this prior to its civil conflicts in the 1990s, and there
is not much you can do to provide more farmland per capita. Whether water will
continue in this nice situation where engineers can work out their differences and find
solutions is an open question given the scarcities. I had not heard of those and that
sounds quite extreme to me. As populations grow and there is no more water we do
not really know what climate change will do to watersheds. I think you are seeing
localised examples of conflict over water in Somalia and northern Kenya right now as
a result of the drought in combination with the general increase in water scarcity. I
think it is a question mark and we do not really know. There was a small battle
during the 1967 Israeli-Egyptian conflict with Syria that involved a dam, and that is
often mentioned but, generally speaking, to date water has not been a source of
conflict.
MR ROWLEY: Daniel Hillel wrote a very good book on water in the Middle
East – Rivers of Eden - and he took an optimistic view. He said that water is a
potential way of getting collaboration in the Middle East and that if governments
could be brought together to discuss and share water supply then maybe they would
get together on other areas.
MR ENGELMAN: If leaders could think about these things ahead of time,
and I think with water they are beginning to, the demography of water, early on, we
can see where we are going to reach a crisis point, that it is going to be in 15 or 20
years, so let us work now so when we reach that point we will have the mechanisms
in place to avoid serious scarcity and at the same time realise scarcity is not going to
end in 15 or 20 years and what happens then if populations continue to grow. In other
15
words, if you linked population policy with policies in relation to national resource
distribution and equity now and saw these things as integrated I think we would have
vastly better chances of success 15 or 20 years down the line.
CHAIRMAN: The problem is democracy which tends to get in the way of
such long-term thinking and the Middle East is a bit short of that.
MS HINDMARSH: Many questions have already been answered but I would
like to ask you both if you could expand a little on something which has been touched
on. You talked about the paradigm shifts over the years from Bucharest to Mexico to
Cairo and the reproductive health paradigm which has been the major guiding
principle since Cairo. We heard last week from various people, and I would say it is
the case, that funding for family planning programmes has decreased since Cairo. I
wonder what you feel can be done given that there does not seem to be any
contradiction between the recognition of population growth and its importance and
the detrimental impact of population growth and the fact that you are saying it should
all be addressed through the Reproductive Rights Framework and there is the unmet
need. What would you suggest in policy terms to bring these formerly separate
agendas together?
MR ROWLEY: You are absolutely right to say that everything that needs to
be done to slow down population growth is a contribution to development. It is a
contribution to social development and to environmental protection. This is a
win/win situation. Everything that you do, if you do the right things, including
people-centred, good quality family planning, involving the community and both
women and men, is a positive thing for social and economic development. It is a
package. If you leave out any concern with population and the environment, then you
lose some of the motivational force and the urgency of the issue. If only people
understood that what we are facing is a sort of oncoming shadow, a cloud of disaster
ahead of us if we are not careful, which brings not just changes to the climate but all
the impacts on the environment which we are facing, all the social consequences for
people, poverty and so on. Christian Aid today forecast that there will be 180,000
deaths in Africa because of climate change. They have extended their view of
development to take in this issue. Perhaps they might extend it a little further to
campaign – on behalf of the poor - to stabilise population a little faster.
Somehow we need to bring the thinkers on this issue in terms of the
reproductive issue, the environmental issue and demographic problem together, but
how we do it I just do not know because there is enormous resistance. It has been
tried in the past. Efforts have been made to involve the development agencies, but
they have often been rather reluctant to do so. It seems that there is a mindset, a
prejudice, an ideological barrier, and until you get a new administration in the United
States perhaps things will not change.
MS HINDMARSH: Are there any examples of the various groups coming
together? Are people very exercised by these issues and keeping them separate? Are
there any examples of them coming together, good examples?
MR ENGELMAN: Yes, there are. I think one of the problems is that uneasy
alliances that have existed between those who think population is an important aspect
of development and of environmental sustainability and the other side, which is
16
particularly focused on the rights and health of women, and that is their major interest,
have existed but they have broken. One of the disappointments after Cairo, which
was generally a very successful document, a very successful conference, and one of
its weaknesses was that this alliance was largely broken out of an unwillingness to
acknowledge the mutual interest that both sides had in the advancement of those
rights for woman and access to healthcare for woman particularly.
Up until the mid 1990s, until electoral politics changed things, in the
United States there was something of a successful alliance between grassroots
environmentalists from such groups as the Sierra Club, the National Audubon
Society, other groups that had large memberships in the United States would bring
those groups to Capitol Hill, to our congress, to lobby our House and Senate on behalf
of bills that were designed to increase international family planning assistance and
food programming of the United States for international development. I remember
one time there was a wonderful lunch celebrated at USAID headquarters in which a
director of the Population and Health Office welcomed various environmental leaders
to his office and thanked them personally for organising groups of their members to
lobby on Capitol Hill on behalf of international family planning assistance.
I think this kind of thing can be done but, unfortunately, there is a lot
of mutual animosity right now. Maybe the people who talked about population have
oversimplified things and that has made some people uncomfortable. Perhaps there is
a sense of, “Are you really interested in the lives of women or do you simply want to
control population?” and there is a suspicion about that, but I think the movement on
both sides has lost as a result of the friction which existed.
MR ROWLEY: I think some damage was done historically by people who,
again, saw population as the great problem and did not relate it to these other issues.
That is a problem because each agency has its own bailiwick and defends it and
pushes it really hard, so it is difficult to get them to come out of that corner.
However, the way in which the development agencies are now coming into the
environment because of climate change is rather interesting. Maybe this is going to
begin to break the logjam.
MR ENGELMAN: If I can give one other example. When President Bush
suggested he would propose a budget that would cut international family planning
spending by about 18 per cent in the United States several officials at USAID said,
“Well, but we are spending in so many other areas that are so important for the health
of women” and they pointed to proposed increases in malaria spending, for example.
I thought it was poignant because it was not getting at the multiple benefits of family
planning. Malaria, as we all would recognise, is a serious problem in the developing
world. I think this is the problem we have, we are forced to fight with each other for
little pieces of a pie which is not growing larger. It struck me as a really important
comment because it demonstrated that both sexual and reproductive health, the right
side, and the population and environment side argued that family planning and
reproductive health care has multiple benefits which extend beyond just simply a
woman’s capacity to plan her own pregnancies, but had failed to keep that argument
alive. It was nowhere mentioned that there were some other benefits that would
ripple out in other ways than simply improving the world by reducing malaria, which
is a noble cause.
17
BARONESS TONGE: We always go round in circles, do we not? All of the
things which have been done in the last 50 years in the name of development have
actually served to increase population in those countries it has been done to. If you
think of vaccines, children have stayed alive because of vaccines and treatment of
diseases. Incidentally, treatment of diseases, particularly the anti-retrovirals now, is
benefiting the big drug companies in the West as well as benefiting the people who
receive them in the developing countries. They are all serving to increase the
population, as you said many, many times. Some sort of birth control needs to go
alongside all of those major developments. Food, when I was in southern Sudan just
after the big famine in 1996-97, the women there that I met - and I was meeting
groups of women on their own - were complaining that the main thing that worried
them was they were not having periods anymore since they had been starving. We
know there is a link with anorexia in that area, so we fed them so their periods would
come back and they would have children. It seems painfully obvious to me that if you
do not have to walk seven hours a day in the early morning probably to fetch water
you are more likely to lie in your hut a bit longer with your husband and maybe have
sex, so you are going to have more babies. It just gives you more time to do those
things.
MR ROWLEY: I do not really agree with you about this question of
development increasing population or increasing the desire to have a larger family
because on the whole the healthier women are, the more their children are surviving
and the more likely they are to want and to seek out family planning.
BARONESS TONGE: Yes, but it has not got to that stage now, that is what I
am saying.
MR ROWLEY: That is why it is important to include it. There are some
interesting examples. Ann Kendall, who runs a project in Peru restoring the canals of
the Incas, tells me that there the lives of the people have really improved, they have
done terracing, they have got water now from the canals, but the women are saying,
“We do not want to share this land with too many other people, we do not want to
have too big families”, so they have learnt a lesson, unlike the case in Ethiopia. It is
possible that they have got access to other agencies that can provide them with family
planning. Without that availability, of course, it is very difficult.
BARONESS TONGE: What I wanted to go on to say was that you have all
said that doing these things without having good family planning provision as well
alongside development allows the population to increase.
MR ROWLEY: Or to have it available by some means.
BARONESS TONGE: Is family planning the quick fix? Is this the only thing
we have got? I am not suggesting we should not do all the other things we have been
doing, but I am saying there must be other things surely that we can do than just
family planning.
MR ROWLEY: As Cairo said, family planning by itself needs to be supported
by the education of girls and by the improvement of women’s health and status
18
generally.
BARONESS TONGE: Yes, but the problem at the moment is we are not
getting through on family planning, that is what I am saying, partly because a lot of
programmes have been curtailed recently on women’s reproductive health and family
planning. Even in this country, we have gone back years in family planning over the
last couple of decades. Is there anything else you feel we can do? We talk a lot about
the problems but we do not talk much about the solutions.
MR ENGELMAN: Do you mean outside of the population in the sexual health
and rights field or further in yield in population?
BARONESS TONGE: Either. Is it only giving women better reproductive
health, improving their maternal health, and giving them access to family planning?
Is that the only thing we can do to prevent population growth? That is what I am
saying.
MR ENGELMAN: No. I always feel awkward when I have lunch or a beer
with my friends in the agricultural development field. I say it bothers me about how
international family planning assistance is being cut. They point out to me that in
almost every single year over the last 20 or 30 years more money has been spent on
family planning than is being spent on agricultural extension assistance for the
developing world. That is an interesting point, and it is hard for me to say much when
that point is raised. I think there is so much more we could do for basic agricultural
development, teaching farmers how not to mine their soil and how to return crop
waste and animal waste back to the soil. Ways that were sustainable for generations of
African farmers are not sustainable, not because African farmers have lost their
wisdom but because of a variety of reasons, one of which is the increasing density in
farmers and the people they are feeding. There are also probably some globalisationrelated reasons too. We need to share what we know about how to farm marginal
land. There is a lot that we know and we are not doing nearly enough on that. That is
outside population, but I think as people see these more integrated approaches to
managing their natural resources - and please understand that I am not suggesting we
should not be providing tap water to women in Ethiopia, we absolutely should be
improving water supply all over the world, it is a killer of children - we need to do
these things together and see them as being part of one piece that in the long-run will
advance demographic transition. Demographic transition is the needed social
transformation in these areas, and demographic transition is not just about having
fewer children, it is also about longer lives. I think we need recognition by all of us
who work in this field that we are not just about having fewer children, we are about
human survival. Here is how we approach human survival: sustainable energy,
sustainable food production and health, not just reproductive health but complete
health. I think one of the most difficult questions is, “Okay, great, you are saying
everything is important, but how are you going to parcel out your scarce resources?”
And that is a good question.
MR ROWLEY: I saw a very good project outside Mombasa where the Family
Planning Association was just doing family planning, but it was working with the
local extension operation and with the Ministry of Health. What happened was they
had a little centre in each of the villages where the women would go and get some
19
advice about farming, about how to grow better vegetables, what manure to use, how
to plant their maize better and so on, they would go next door and get a short talk on
vaccination and immunisation and how to look after their children, and then they had
another person come along and talk about family planning and breastfeeding and so
on. They got a complete mix of messages and information. This was a very popular
and very successful project. The film we were making was about two mothers, one
who only had two children and one who had 13. Mrs Kingi, the mother who had 13
children, was so grateful that she did not have to have any more children because she
said, “I could not cope with any more children”. Her health was giving way and she
had no money to send her children to school with uniform and books. There was also
a centre nearby where women who had problems with low birth weight children could
go and spend some time and be taught how best to make sure the nutrition of the child
was built up. This was excellent, inter-agency co-operation, which is really
worthwhile doing. It does not mean to say that one agency has got to do everything.
MR ENGELMAN: One other thing I would add is that a lot of lip service is
paid to this. Maybe it is more than lip service but at least in my own country touting
the importance of focusing on women in development, micro-allowance for women
and things of this kind has to be much, much more than lip service and has to be
united with sexual reproductive health and rights. It is not the only thing that relates
to population but, again, these things just fit together, that women who have economic
opportunities, women who are participating in their governments, in civil society,
have much more to live for and have every reason to want to plan their families. It is
critical that when we do that we also make sure we have access to good sexual and
reproductive healthcare, because without that the intention to have fewer children may
not match with the result. When you put all these things together, they are all that
need to be done in this sphere.
BARONESS TONGE: Yes, but still we are not doing it. I have seen wonderful
projects all over the place. We were in Senegal recently and the organisation
TOSTAN do brilliant projects. They do just the sort of thing you are saying, really
integrated work with people, but it is so patchy and there is so little will on the part of
the governments in developing countries to actually do integrated services. The really
good ones are all being pushed by voluntary organisations, maybe from here or within
their own countries.
MR ROWLEY: There are people who speak of negative tipping points. The
pressure on resources, for example, reaches a point when systems collapse. There are
some examples of tipping point the other way, where one intervention can lead to a
virtuous circle of change. The classic one is Apo Island in the Philippines where the
people were over-fishing, using blast fishing and cyanide fishing, and the fish had all
but disappeared. A researcher persuaded them to set aside about one-tenth of the bay
of this island as a marine reserve. Lo and behold, within a year or two the fish were
back. The people then realised that if they went on fishing as they had done before, or
if they allowed too many other people to come and benefit from this, there would be
trouble. Because they had been involved in this project they got together to do other
things. The women got together to process and market the fish and a committee was
established to stop tourism coming in and spoiling the bay. According to some reports
I have seen, this success in Apo Island has spread to about 400 other parts of the
Philippines where they have taken that same route of setting aside some of the area of
20
the sea for a small marine reserve and have wonderful results. That can be replicated
globally and we must have marine reserves to save our fish. There are some
possibilities from these positive tipping points. They were also receptive to family
planning because they realised their numbers had to be limited.
MS WOODSIDE: My question leads on from Baroness Tonge’s question
regarding the patchwork work that is going on in the bio-energy we see in a lot of
developing countries. Mr Engelman, you mentioned in your testimony just now that
you would like to urge governments and the UK Government to do more in terms of
providing funds for reproductive health programmes. My question is how do we also
persuade governments in those developing countries to give the funds and allow the
funds. I was in Nigeria last week and I was amazed, talking to a lot of people
working in this area and also people working in the government, that the Ministry of
Health has released 60 per cent of its funds this year for health and only seven per
cent has been used. In terms of maternal health - they cannot talk about sexual
reproductive health and NGOs cannot even talk about reproductive health - they often
cage it in the terms of maternal mortality, which is fine, and they are hoping to work
with the government. Part of how they are thinking now is perhaps they should be
looking at it from the ripple effect, that improving women’s health will therefore
ensure that more of their children live because obviously when a mother dies the risk
of her children dying is much higher, et cetera. I am wondering if either of you have
any thoughts about encouraging other governments in developing countries and how
we tailor those messages to different parts of the world?
MR ENGELMAN: My first thought is to look at our history and know our
history. There were a lot of successes in this area 30 or 40 years ago when initially
non-governmental organisations, and a fair amount of philanthropy, the Ford and
Rockefeller Foundations, got very engaged in this kind of patchwork approach and
used the successes in places like Thailand to show these to governments and to work
directly with governments, mostly developing countries, and say, “Look to see what
works, let’s try to do it and see if we can learn from it”. It is worth remembering that
some of the very earliest population programmes - and if you look at them now they
do not look too good, but nonetheless they were a start - 1951 in India, 1954 in Egypt,
were years before the United States ever got involved, and I would venture the same
would be true of Europe. It was mostly the work of non-governmental organisations
with some US-based foundations, and I guess based elsewhere as well, documenting
the successes of these areas. There was a time when there really was a partnership and John would have more direct experience of this than I because I am more recent
to the field - Bucharest, and by the time of Mexico City there really was a real
partnership being built between private philanthropists, the developed country
governments and developing country governments, in recognising the needs and
working on be it called “maternal and child health” or be it called “sexual and
reproductive health” and it was succeeding. I have to say, probably one of the
biggest initial thunderclouds on the horizon came up again, as it sometimes does,
from the United States Government at the time of the Reagan administration at
Mexico City. It began this systematic retreat from governmental help in this regard
and began a policy which specifically tried to strangle non-governmental
organisations that were working in this field. One of the most successful aspects of
this partnership was you had entrepreneurial non-governmental organisations that
could get government money, small government grants to begin documenting and
21
piloting what they called “patchwork programmes”, the success of certain ways to
operate. The typical pattern was developing country governments would see them
and say, “That makes sense”. Community-based distribution was involved with that.
Community-based distribution was initially a small idea that governments saw and
said, “This is successful, this works, a distribution of contraceptives in small rural
communities. Let’s see if we can fund this and then help ministries get involved”.
Now, from a US perspective, we are in an awful situation in that the
most dangerous place to be working in this field is with a non-governmental
organisation if you get assistance from the US Government. You not only have to
worry about the global gag rule, the Mexico City policy, but also the possibility that
you might be supporting prostitutes, God forbid, and there are now increasing
restrictions on that. You have to be looking over your shoulder all the time. I would
turn to celebrating the work of this panel in trying to bring these lessons to the
Government of the United Kingdom to have hearings like this. I might point out that
there has not been a hearing on this topic along these lines in the United States, as far
as I have been able to determine, since the late 1960s or early 1970s. It is specifically
addressing population growth and its impact on development. I think you are taking
the right path and we have to hope that we may be able to do so again soon in the
United States.
MR ROWLEY: In the follow-up to Cairo it was the developing countries that
put in a much bigger proportion of what was promised to implement the Action Plan
than did the donors. The developing countries almost met their obligations, whereas
the donor countries fell far, far short. As Steve Sinding said last week, one of the
problems here is because the United States, mainly, has limited funds for this area of
work. Ministries in receiving countries are picking up the message, “This is not the
issue where there is money. They could ask for something else, ask for HIV funds,
ask for whatever, but do not ask for family planning money because that is going to
be hard work to get”. It is a sort of vicious circle. The developing countries pick up
the messages from the donor countries and take notice, and it is a shame.
MS WOODSIDE: Both of you mentioned - Mr Rowley, you certainly did in
your document and, also, Mr Engelman, you did in your testimony just now - about
migration issues and how it affects sexual reproductive health. Do you have any
thoughts on how we can, as the world is moving around more and more than ever
before, ensure that people know about sexual reproductive health and we can provide
the resources to people?
MR ROWLEY: Sorry, can you repeat the question?
MS WOODSIDE: It is in terms of migration and in terms of people either
living in refugee camps or migrating to different countries and not having citizenship.
MR ROWLEY: Is it how we get services to them?
MR ENGELMAN: It is the importance of it. Again, it would be worth
looking at the Programme of Action. The Programme of Action of the International
Conference on Population Development is the most complete and, in fact, I would
say, only international accord we have of any type - it is not a treaty, unfortunately,
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but it is an international accord - that actually has a chapter on international migration
and refers to an ordered way for governments to proceed in regard to international
migration. I wish we would pay more attention to it, I think it offers a lot of wisdom.
It fell a little bit short of making the point that I think it could have made and it was
strengthened a little bit in the Cairo Plus 5 activities in 1999 in making clear that all
migrants and all refugees should have the exact same rights in sexual and
reproductive healthcare as anyone else in any society and that might require some
special initiatives on behalf of those people who are not well served. That is sensitive
because if you have special initiatives, or you make special efforts to make sure that
family planning and sexual and reproductive healthcare is available to immigrants in a
country, it can look as though you have got certain demographic intention there.
I think that has been one problem in the United States. There is pretty
good awareness in the United States, for example, that many immigrant populations in
the United States do not have the same access as even African-American as well as
other American populations to reproductive health care. A cardinal indicator of this is
that Hispanic women get far fewer Pap smears than other populations in the United
States. That is a very obvious sign that something is amiss. It does not necessarily
relate directly to whether you are using family planning or not but you are not getting
Pap smears. It is not being corrected in part, I think, because there is sensitivity about
the question of whether we should have special family planning and reproductive
health outreach efforts to immigrant communities in the incredibly volatile
atmosphere in the United States right now about immigration. It has never been more
volatile in my memory. At the moment, it is really difficult to talk about these issues
but I think we should. We should say, “Let’s separate out xenophobia and people who
want to build walls and let’s just talk about the real needs that every migrant should
have and the rights that every migrant should have” and that is the most appropriate
way to approach that.
MR ROWLEY: This issue did come up at the 1980 Women’s Conference in
Copenhagen, where I was also involved in the conference newspaper. A proposal was
agreed about the rights of refugees to have access to family planning services. I do
not think anybody took a great deal of notice of it but it did broach the subject and
began to make the point. The women’s movement did, at that stage, become aware
of that issue. I am not sure that is what you are referring to.
MS WOODSIDE: I think both of you have answered my questions. That is
fine, thank you.
MS BUDGETT-MEAKIN: Picking up your point about the fact that we are
putting our heads above the parapet through doing these hearings, is there a way that
the report which will come out of this could be used in the States to try and bring this
issue back into the American environment?
MR ENGELMAN: Short answer: Population Action International will see
what it can do. I think it is a brilliant idea and I would like to try and be involved in
helping with that.
MS HINDMARSH: Finally, what is your single, most important, message to
the UK Government, UK parliamentarians here, European parliamentarians and the
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European Union, given the background that we have referred to of the situation in the
US?
MR ENGELMAN: It is a tremendous opportunity for the British Government
and for the European Community right now, because of the vacuum of leadership
coming from the United States, to step forward and continue. I think to a large degree
it has, and thank God it has. I have got to stress how demoralising and discouraging it
is for Americans right now who work in this area. We do not like to feel that we are
operating at cross purposes on development but on this issue we are. I think we are
looking really to Europe, the United Kingdom and, to a certain extent perhaps, to
Japan, New Zealand, Australia and Canada as well, all of the other OECD countries,
as well as the developing countries, to show some leadership. London itself seems to
be a place where this conversation is occurring at the moment, and I would encourage
you to keep at it. As John and I have both said, and I think you have all said as well,
do not abandon population itself and the importance of population dynamics as part of
this overall discussion, not overwhelming the discussion of women’s wellbeing and
development generally but simply being an integral part of this discussion. By
making that point I think that is a wonderful image, you are sticking your head above
the parapet but without courage none of this work can be done.
SANDRA GIDLEY MP: You started off by saying that we should all be able
to drive like the Americans.
MR ENGELMAN: Be able to, not necessarily do it!
SANDRA GIDLEY MP: I am not quite sure that is the answer because we are
talking about population growth and saying that is one of the only solutions, but
surely as living standards rise throughout the world there are other issues to be tackled
as well, not just population?
MR ENGELMAN: The point I am trying to make there is - I do not know
about Europe or the United Kingdom or if petrol is a lot more expensive than it is in
the United States - there seems to be almost an attitude of irritation you see in the
press in the United States sometimes about our gasoline prices rising to an horrendous
$3 per gallon, which I think is about half of what you pay here maybe at best, as
though we had some sort of right, “How could the Chinese and Indians presume to be
starting to drive automobiles, they are not supposed to do that”. The point simply is,
“Sure they are, of course they are supposed to do that if we do”. This is my point
about my other organisation, the Center for a New American Dream. We cannot look
down our noses at people in developing countries wanting to use natural resources to
the same intensive levels per capita that we do. You are absolutely right, the solution
is not simply reducing their populations, not at all, not by a long shot, the solution is
to find ways and find mechanisms to fund ways and simulate research in ways that all
of us all over the world can use resources less intensively and yet still be healthy and
happy.
MR ROWLEY: It was quite interesting that the Christian Aid campaign
launched today, warning about the rising death rates in Africa, was talking about the
importance of using renewable energy in Africa and helping them set up solar-power,
wind farms and all the rest of it. If we are going to break the barriers down, it is very
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good.
CHAIRMAN: On page one of your evidence you quoted a Mr Jäger in saying
that: “The earth is not operating in a non-analogue state”, can you tell us what that
means?
MR ENGELMAN: I thought I should have been more careful with that. It is
simply saying there is no precedent. This is science-speak. I like the sentence but I
probably should not have used it. A non-analogue state is, you cannot take guidance
from history to figure out what is going to happen next; it is science-speak for that
basis.
CHAIRMAN: It is unpredictable?
MR ENGELMAN: Yes.
CHAIRMAN: Not operating in a straight line?
MR ENGELMAN: That is right. If scientists were constantly buildings
models, this is the way. I am not a scientist myself, I just watch them and, to a certain
extent, pretended to be one for years. Scientists love to build models and say, “If you
put in this input and that input this happens and you can see this will happen next”.
Demography is largely built on models of reproductive behaviour. I think what he
was saying was in reality we cannot begin to construct a model that will show us what
is likely to happen next in the planet because it is too big, it is too complicated and
nothing like this has ever happened before.
CHAIRMAN: John, in your evidence you say that urban populations are at
least in a better position to achieve sanitation and access to credit schemes et cetera. I
presume you mean that in a turnaround context, the city that was in a mess and is
improving. Have you got any examples of this?
MR ROWLEY: There is a big project in Karachi called the Orangi Project.
This is a very famous project where the local people have got involved in improving
their sanitation and drainage system and their water supply, among other things. They
have done a fantastic job, as I saw myself. They asked the women, “Would you like
trees?” and they said, “Yes, we want trees”, “What sort of trees?” and the men all
wanted to put up great big trees that they could cut down and have wood but the
women said “I want fruit trees”, so they have now got fruit trees. I had a look at the
Million Houses Programme in Sri Lanka as well some years ago and you could see
how in urban areas it is possible to get people motivated to improve their houses, put
another storey on if they are allowed to do that and improve their water supply and so
on. Very often it is somehow easier in the urban areas but, on the other hand, if you
talk to David Satterthwaite of IIED’s urban programme, he will say there are greater
problems and greater poverty in the poor slums of the world than there are in some of
the rural areas, but there is a big argument around that.
VISCOUNT CRAIGAVON: John, at the end of your evidence you were
talking about the consumption avalanche and you reminded us to watch out for China
and India. Is that partly due to numbers increasing or is it simply an expectation?
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MR ROWLEY: As Robert said, it is because the numbers base is already so
enormous and it is past population growth which is now having that influence and
impacting on the global environment because of its sheer size and scale. Then, of
course, there is the fact that India, in particular, is still growing and is going to
overtake China in numbers. India is projected to grow to 1.8 billion before it begins
to stabilise. We are talking about huge numbers of extra consumers.
MR ENGELMAN: Another way to put this is there are time differences
between population and its environmental impacts. Frequently it may be when a very
poor population is growing quite rapidly that somebody tries to make the argument
that is environmentally significant and they will be chastened because in reality those
people are not really consuming. For years we have used the example that one
American is equivalent to 30 Indians in terms of fossil fuel consumption and that is
true. Nonetheless, what I think John is pointing to in the example of consumption in
India and China is that is true now but, again, as you have these numbers these are
people who, as I say, have the right and the expectation of developing, so at some
point down the line those people, their children and grandchildren, will, in fact, we
hope, become major consumers.
BARONESS TONGE: Two very brief questions. Firstly, if you had all the
women in the world in one room and you could speak to them, how would you
persuade them to use contraception? Secondly, if you ruled the world, what
population policy would you be after, honestly?
MR ENGELMAN: I think I would just be a listener if I had all the women in
the world in the room. I think that would be a better part of wisdom, really it would
be, because I do not think I would need to convince anybody of anything, I would just
be very interested in what they had to tell me about what I might be able to do to pitch
in. I do not think there is any great mystery about population policy, it is almost a
little boring. It has been done for 30 or 40 years with incredible success. Let us
remember, because we have not mentioned it yet, that the average woman in the
world has half the number of children today than the average woman in the world did
back when I was a teenager. That is a success story. The way we did it was the way
we are continuing to work on it. It was providing family planning services to
everybody who wanted to use them, it was making sure that girls got to school in the
same number as boys did and made it through secondary school at least, pretty well
into secondary school, and it was making sure - and this is probably where we have
the furthest to go, but we have a long way to go on all three of them still - that women
had the same opportunities that men did in economics and politics and so on.
MR ROWLEY: I do not think the biggest constraints are women themselves. I
think women, given half a chance, want to control their fertility and want the best for
their children and their families. One real constraint is we have this problem of
population momentum and there is nothing much can be done about it other than slow
it down a little. We do have consistently high infant and child mortality in some
places, which means that, again, people want to have more children to ensure they
have enough to look after themselves in old age and so on. As I think John Cleland
has pointed out, in terms of what you can do to slow population growth, only about 18
per cent is this problem of people who still want larger families, the other 80 per cent,
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are people who want to control their fertility and want to limit their family size; it is
an unmet need. That is the first big thing, to meet the unmet need. The big
constraints on that is political will; then there is the lack of international support,
especially by the United States; the influence of patriarchy in countries where the men
are dominating and the women do not get much of a say; and the influence of the
Catholic Church. These are all big problems. When you take countries where there
has been success, like Iran, Thailand, Kerala and Bali, you see that they have done
wonderful things, and it has been done quite quickly in quite poor societies. It is not
such a difficult thing to do and the pay-off is enormous, not only for women and
children but for the population growth and the environment, it is a real win-win
situation.
MS WOODSIDE: I was going to ask another question but now Baroness
Tonge has prompted me to ask this. If you had all the men of the world in this room
what would you say?
MR ENGELMAN: Then I could feel at least I could speak to them. I hope
this is not inappropriate for me to say, but I think I would say, “Sex is a lot more
satisfying when women are equal to you”.
CHAIRMAN: On that note, we will end there. Can I thank you both very
much indeed, it has been quite an absorbing session. We really focused on the
environmental aspect today, which was our plan, but your views on other subjects
have been very much appreciated. Thank you.
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