Population growth – forever an issue?

Toespraak | 12-11-2009

Ladies and gentlemen,

First of all, thank you for inviting me. I am happy to be able to address you today. I feel honoured to close a series of such eminent speakers.

We are here today to discuss the important subject of the population question. An issue which in my mind doesn’t get the attention that is required. I therefore welcome this lecture series organized by the Society for International Development. In my view, the population and development question cannot be discussed well without looking at history and historical developments.

One name which is inseparably linked to population growth, is that of Thomas Robert Malthus. He still is “the elephant in the room”. Even though Malthus published his famous “Essay on the Principle of Population” more than two centuries ago, his ideas are still influential, though more for some people than for others. Malthus argued that "population, when unchecked, increases in a geometrical ratio. Subsistence increases only in an arithmetical ratio”. A line remembered by moth of us. Opposing the views of writers like William Godwin, who foresaw a rosy future for humanity, Malthus essentially argued that food production could not keep pace with population growth. Policy measures like late marriages, but also famines and other disasters which, in Malthus’ view, were sent by God, would, provide for the limits, the "checks" on population growth.

Malthus was a man of his time, and parts of his treatise (including the passages on human nature) reflected his religious views. He essentially wrote the first economic theory of the poor. But his views on the poor, and his arguments against bringing wealth within their reach, remain controversial.

Next, let us make an enormous jump to 1972. Technology - in agriculture, but also birth control - had developed in ways that Malthus could not have foreseen. The Club of Rome, a think tank of scientists from various disciplines, published “The Limits to Growth”. A landmark publication that was – to our great peril – neglected. The Club of Rome did not neglect the risks of population growth, but put the issues out of isolation in n the context of industrial and food production, and the necessary efficient use of natural resources and environmental pollution. They concluded that economic growth could not continue indefinitely because of the limited availability of natural resources, oil in particular. Their message, which made a big impression at least in The Netherlands, was one of urgency and – for some – ‘imminent doom’.

So here we are in November 2009. We are all a lot older, I might add. But are we wiser as well? As we are on the eve of the UNFCCC conference next month in Copenhagen, global warming and global environmental change including climate change are the hot topics of the day. Belatedly, I might add. It has been said many times, and rightly, that the Copenhagen Summit is the litmus test for our climate policies. This planet is inhabited today by some 6.8 billion people . The world's richest half billion people - some 7 percent of the world’s population - emit about 50 percent of the world's carbon dioxide . "Meanwhile, the poorest 50 percent are responsible for just 7 percent of emissions. "World population in 2050 range from 7.9 to 9.1 to 10.4 billion people, depending on different scenarios. Together with Western patterns of consumption, this is a major reason why it will become increasingly difficult to achieve sustainable development for all. In order to maintain our current levels of consumption, by 2050 we will need not one globe but two - an oft-cited image, but no less alarming for that, and one which vividly illustrates how we are treating the world. The time between now and 2050 is critical, after that consequences of lower fertility might make life easier.

But what does this mean for economic growth now? What does this mean for development? What are the consequences for the poor? The debate around climate, population, development and consumption touches on many issues, including ethics and equity. Simple population control is not the solution nor feasible. The question is how we balance the right to develop against the right to live in a healthy and safe environment? And what about the rights of future generations? And what is important for politicians: how do we make these intergenerational and intreplanitary relationships politically relevant in the consumer society we are, which relates a media-democracy to shorttermism in markets and politics.

As one publication puts it succinctly: Consumption versus Population: which is the climate bomb? In this work, at scientists conclude that "climate change is far more sensitive to consumption patterns than to demographic considerations, since demographic dynamics are subject to greater inertial forces than consumption and production patterns.... Tackling consumption not only has sounder ethical foundations, but also greater scope for rapid action". And the poor- Don’t they risk losing out on all fronts? A new middle class in the world is adding to global effective demand for food and meat. If this demand is not met. Prices will further increase jeopardising the life chains of the poorest.

Belated agricultural investment is now increased and related to expanding work for the poorest. But also here an equity and distribution question should be at the core: scarcity and growth are in essence social phenomena. That is I think the crucial link we are missing so far in the population and environment debate: the Sustainability Movement will have to change technology to changing consumption and production patterns. We can build also on positive population developments: the move to replacement level fertility is one of the most dramatic social changes in Russia and Japan, but also Brazil, Indonesia, China and now also South Asia. But even in Bangladesh the rate dropped from 6 to 3 children when the country slowly went from poor to middle income level.

With only a few weeks to go to Copenhagen, population growth and its impact on the environment are receiving in that context a great deal of attention. Last week, fertility rates made the cover of The Economist. It almost seems as if Malthus is back. In my opinion, those of us with a more balanced approach need to take a stand. In that context, population growth well deserves the attention it is getting.

I am glad to announce here that I intend to add the issue of demographic development to the mandate of my Ambassador for Sustainable Development. The Ambassador will look specifically at demographic issues in relation to Climate and the Environment. Given the width of demography as an issue, and given that SRHR already features strongly in my policy, I believe it is best to let the Ambassador focus on these -already extensive and complicated- areas.

I would like to underline that, when discussing population growth, it is essential we keep in mind that the developing countries are not to blame for the consequences of consumption here. Therefore, they should not pay the price. It is counter productive. The debate should be respectful and based on facts. At the same time, we should not and cannot close our eyes to what will happen if we continue on our current course. Anyone who has seen the film ‘The Age of Stupid’, a frightening picture of the world in 2055, will understand what I mean.

Furthermore, climate change does not only magnify the effects of existing global inequalities, but – perhaps even more importantly - it increases the chances of violent conflicts and wars. Everything from anthropogenic climate change, the irreversible exploitation of natural resources and disruption of room for living to population growth is in essence a social problem – as all problems are social. In my opinion, this is the only way to integrate the issue of population growth in development policy.

The timing of this lecture series could not have been better. I believe the lectures have enriched our understanding of a wide range of demographic developments. From production and consumption patterns of a growing world population, the discussion on the changing power relationship between “greying” and “youth bulge” countries continue to be mirrored in the accompanying spirits of “pessimism” and “optimism” that Dominic Moïsi has recently described so well in his “Geopolitics of Emotions”. From these large, more contextual issues, I think it is important - as a Development Minister - to focus on the social context of population and development policy in more partical terms. How does this context relate to the reality of population policy and planning.

Let’s become practical.

Your lecture series started with Tim Dyson who argued that "the provision of safe, effective and affordable contraception is the main way of minimising the destabilization caused by demographic transition. “Contraception provides people with choice”, he said. “And all the evidence is that, given the possibility of making the choice, then eventually women and men always decide to take it." I couldn’t agree more.

I also would like to recall Wendy Harcourt’s, point that the adoption of the MDGs in 2000 meant a paradigm shift from human rights to a more narrowly defined right to choose, and then to an even narrower focus on maternal mortality, approached even more narrowly as purely a health issue.

The series provided us with other fascinating insights, for instance into the dilemmas that Chinese policy makers are facing.The lectures have presented enlightening, enriching, disconcerting views on demography that needed to be aired. I am happy that you have been with SID, WPF and ISS, and with co-funder UNFPA, to make this lecture series a platform for such pioneering thinking.

I listened with great interest to Dr Sinding's fascinating analysis of trends in the international debate on demography. He is an authority in his field, and we have been privileged to have him share his knowledge with us tonight.

In his lecture, Dr Sinding has illustrated how the demographic debate over time has moved from demographic policy to a rights based approach. He also makes a case for offering women free choice in planning their families, in the conviction that this will lead to a more balanced demographic growth which the world will be better able to handle. He combines a sense of urgency with the concept of rights. These are in fact the fundamentals of Dutch policy SRHR, sexual and reproductive health and rights. I am glad that the figures he cites confirm the basis of our policy.

So as far as I am concerned, Dr Sinding is preaching to the converted. I completely share his sense of urgency. And I am not alone. The sense of urgency is growing day by day - notably here in the Netherlands, where the Advisory Council on International Affairs recently published a report on Demographic changes and Development cooperation. This report focuses on another aspect of demographic development: the balance between different age groups in a society. It highlights the importance of the phase called "demographic transition", when countries move from high birth and death rates, to low birth and death rates. A country’s exact position in this phase affects both its population growth and its age distribution. Countries with a relatively high proportion of young people of economically productive age have a chance of what’s called a 'demographic dividend'.

In order to fully benefit from this temporary phenomenon, economic growth but also good governance are important conditions.

Ghana, Malawi, Mozambique and Namibia, countries with growth of the working population as well as with reasonably good institutions, have the potential for demographic dividend.

However, if these conditions are not in place, a so-called 'youth bulge' can slow the pace of reaching democracy and increase the risk of domestic instability, especially under conditions of economic stagnation . A lack of jobs, and possibly a wider disconnect between young people and the society around them, may provide fertile ground for extremism and the politics of intolerance. Again we have to ask ourselves: where does this leave the poor? And where does it leave women? In my speech in Jerusalem earlier this year, during my visit to the Middle East, I noted that the Arab Human Development Report clearly shows how openness, labour intensive growth and women’s rights are a prerequisite for the area to grow and survive in an increasingly complex economy. Turning the youth bulge into true demographic dividend requires investment in health, in education, in vocational training, in stimulating the private sector and creating jobs.

But it requires more. It requires a broadening of vision. It requires concrete steps towards regional integration, on the African continent for example, but also in the Mediterranean. It requires taking not only growth but also equity as firm starting points. In countries already in a demographic danger zone, struggling with stability issues, investing in the social sectors and in job creation is extra vital. It is vital that this group of young people actively take part in our economic and social structures. While the economies of many developing countries may be growing, the rate of job creation does not keep pace with absorbing young people who leave school and enter the job market. The development of an entrepreneurial spirit among young people, and the development of micro and small enterprises by young people, have become critical in many developing countries. One of the areas where we can stimulate their inclusion is programmes aimed at the development of skills and knowledge, for example in entrepreneurship. The YDN (Youth Development Network), supported by my ministry, is such an organisation that runs skills training, youth entrepreneurship and community development programmes to this effect in many South African countries.

Another example is support to young farmers. In the context of Farmers Fighting Poverty, within a program to support farmer’s organisations in developing countries, one part focuses on young farmers specifically. The exchange between young farmers from developing countries and young farmers in the Netherlands is aimed at issues such as fair trade, climate change and other areas relevant to modern agricultural development. The youth bulge is a phenomenon we face in almost all our post conflict aid interventions, be it SSR, be it DDR. This is a reality we have to tackle together.

Another issue which we have to take into consideration is ageing. This may solve some problems, but cause many others. In my country an emotional debate is now raging about the sustainability of the state old age pensions provided to Dutch retirees. Our demographics have forced us to plan ahead to keep them affordable, by raising the pension age from 65 to 67. Touching this bastion of Dutch social security has proven painful and difficult.

Ageing is also a problem in some middle income countries, with consequences for many areas, from transfer of knowledge, pensions to social security systems.

Meanwhile in some African countries devastated by AIDS, the elderly are the carers of last resort for children who have lost their parents to the pandemic. AIDS has burnt a hole in the age group of parents and professionals, leaving the very young and the very old exposed and vulnerable. Again the poor, and especially women and girls, are hardest hit.

Let me add one more factor to the many other sides of the demographic picture: population policy. As Dr Sinding noted the call for population policy subsided in the West once population growth started slowing down. In fact, some in the West have been arguing for policies to raise fertility rates - among some groups, that is. Meanwhile, at the other end of the world, in China, the one child policy was introduced, a drastic response to demographic developments at the opposite end of the policy spectrum from the rights-based approach I support. Professor Peng demonstrated in his October lecture that the biggest drop in China's fertility curve was caused by introducing Chinese couples to family planning methods, not by the one child policy . This seems to suggest that the 'rights based approach' and economic necessity are not as much in conflicts as the might at first seem.

In the Netherlands these days, unlike in the past, population policy is no longer a hotly debated issue. I believe that the relative lack of a population debate now results from our specific Dutch approach to sexual and reproductive health and rights or SRHR. Our own experience has helped us see that access to reproductive health, information, services and commodities works better than quantitative population policy. We have been called the champion of the rights-based approach, and I am proud of that title.

In the Netherlands, we have had a lot of debate on this issue. Many people fought a long battle to reach the situation where we are today. Like Aletta Jacobs, more than 100 years ago. She was the first woman to qualify in our country as a doctor. She held free consultations for the poor in Amsterdam, gave family planning courses, and popularised the diaphragm as a means of contraception. And make no mistake about it, 100 years ago in the Netherlands this was a very sensitive issue, as it remained till the end of the sixties of the last century. In the 1970’s, battles were fought about abortion, quite literally around the Bloemenhove clinic for abortions. It is not so strange that emotions ran high, when you consider that family planning and reproductive health are very sensitive issues. This is of course also the case in a religious context.

But we witnessed real progress. It is safe to say that for the last several decades, access to contraceptives has been virtually universal in the Netherlands. This applies to safe and legal abortion as well. We have often been attacked for the wide availability of abortion. However, there is evidence that although abortion is legally available in the Netherlands, it is not used as a family planning tool. Our abortion rate is very low compared to other countries: a third to a half the level in the US or other Western European countries.
Why? Because we have broad access to sexual and reproductive health, information, services and commodities. The contraceptive pill for instance is part of the obligatory health insurance package.

We know what does not work: a ban on abortion. Recently, the Guttmacher Institute published a report confirming that banning abortion does not reduce the number of abortions, but does affect the conditions under which women have abortions.

Dutch policy may make some people uncomfortable. Sexual and reproductive health and rights touch on subjects that are considered sensitive, private or even taboo in many countries and cultures. After all, they relate to very personal decisions on family planning, relationships and sexuality. These are not “cold”, “technocratic” issues. They should be discussed with respect and sense of different views, not so much between, but within cultures that are constantly on the move.

I am prepared to defend our policy at any time. I am convinced that these sensitive issues have to be raised. So I am particularly grateful for the arguments that Dr. Sinding has just made since they support our case.

Let me underline that access to sexual and reproductive health and rights is not merely a peculiarity we like to promote abroad. It is crucial if we want to achieve the Millennium Development Goals.

MDG5 is the mother of all MDGs – an investment in it promotes the attainment of all the other MDGs too. In extensive areas of the world maternal mortality is a tragedy that affects almost everyone. Although motherhood is valued highly in all cultures, women and mothers are not always protected as they should be. Nonetheless, MDG5 does not seem to have a natural constituency, and over and over again we have to make the case for sexual and reproductive health and rights, and for measures to effectively bring maternal mortality down. Why is that? We all have a mother, and all of us were babies born to those mothers. Why can we not simply come together and make MDG 5 the reality it should have been a long time ago?

What makes it even more pressing to focus on SRHR and MDG5 is the fact that so little progress has been made over the last 20 years. Nor has the pace picked up since 2000, when the MDGs were adopted. MDG5 is seriously lagging behind. This was my personal biggest shock when I began work as development minister. Each year 536,000 women die from pregnancy-related complications, nearly all of them in developing countries. More than half a million preventable deaths. That’s more than the entire population of The Hague.

In the Netherlands, we fully recognize this. Long ago, we put the rights based approach at the centre of our policy on SRHR. On the basis of this same experience, we enthusiastically adopted the Cairo programme of action, which has human rights at its core. Dutch SRHR policy in developing countries focuses on investing in women and girls and in family planning, and on providing education, information and access to care, including safe abortion. And we argue for recognising the key role of young people. About half of the world’s population is under 25, and that proportion is growing. Everything depends on their choices and their opportunities. They are, quite literally, our future. Young women and men must be able to choose, and they must be able to have children safely. They must be able to decide if they want children, how many children they have, and when. Young people need to determine what the agenda will be in practice. That is why young people, men as well as women, are playing an active part in this debate. But above all, it is vital that young people have access to sexual and reproductive health information, education, services and commodities. This is a universal right, with no exceptions.

Research has shown that more than 200 million women worldwide would have chosen not to get pregnant, or to get pregnant later in life, had contraceptives been available. 200 million women say they want to use contraceptives, but have no access to them. This means that, had these women had access to contraceptives, the birth rate would have dropped significantly. This is fact some people still haven’t realised.

We need to respond to this unmet need for contraception, which affects so many women the world over. It is in the interests not only of the women themselves, but of their children, their partners and society as a whole.

This makes clear why it is so important to invest in women and girls and in their education. Research has shown that educated women choose to have fewer children, later in life. Children from small families are more likely to go to school and receive health care and good nutrition. Small families are also often better able to rise out of poverty. And the mothers are more likely to have a paid job, which benefits the family’s income.

The issue we are dealing with is very complex. We are all working hard, struggling to find answers. Although a lot of research is done, there are still gaps in our knowledge, for instance about behaviour change. Within my ministry, the Policy and Operations Evaluation Department (IOB) recently concluded [in their recent Synthesis of Impact Evaluations in Sexual and Reproductive Health and Rights] that there is a need to invest in further research (as there are gaps in existing evidence), as well as to thoroughly document experiences.

Clearly we do have some success stories, notably in Bangladesh. "Bangladesh's success in fertility decline is interesting for a number of reasons. Much debated is the question whether decline in fertility is attributable to reduced poverty and increased women's empowerment, or to family programming in the country. In an analysis of interventions to improve maternal and child health and nutrition outcomes in Bangladesh, it is argued that although socioeconomic changes have played their part in the changes, a substantial part is plausibly explained by the presence of a successful family planning programme".

Similar results exist for Pakistan. Generally in Asia, doorstep delivery of family planning seems to have been an important factor in success.

The Dutch government thinks it is important to boost investments in family planning. These have fallen dramatically in recent decades, a decline thrown into sharp contrast by increased investment in combating diseases. Dr Sinding also refers to this disconcerting phenomenon. This tide has to be turned. We are trying to help, for instance by investing 5 million Euros in female condom programmes and distribution. And in 2008 I increased our contribution to the Global Programme on Reproductive Health Commodity Security from 5 million to 30 million Euros over four years. I call on other donors to follow our example. The urgency is clear.

Let me emphasise here that the Netherlands is not a ‘rights extremist’. Although promoting individual rights is – in my opinion - a legitimate and very important aim in itself, we also see a broad social agenda behind respect for the rights of the individual. It is crucial that states and societies come to realise, from a perspective of enlightened self-interest that they stand to gain from respect for individuals’ sexual and reproductive health and rights. After all, if overpopulation increases, all countries will suffer.

In times of economic crisis, rising food and fuel prices, and negative projections of the effects of climate change, thinking about national population trends becomes more pressing. This is a global problem. Especially in countries where the population is booming, whereas economic growth has not caught up – as is the case in many developing countries – it is going to be difficult, if not impossible, to provide enough food, water, schools, houses and jobs for a rapidly growing, young population.

Take Yemen. If there is one country where the close link between rapid population growth, poverty reduction and the impact on sustainable environment and water supply is painfully clear, it is Yemen. The country is facing very rapid population growth of between 3 and 4% a year. It is estimated that the current population of 21 million will have reached 71 million by 2050. Yemen is a country with a strong tribal culture and structure and a relatively underdeveloped economy. The rate of unemployment is 34%, rising to around 50% for the younger generation. It goes without saying that this can be destabilising, certainly if the population continues to grow at the current rate. This may in turn result in security risks, in both Yemen and the region. This is one example of a specific situation in which sexual and reproductive health issues may turn out to have far-reaching cross-border consequences. The Yemeni government is aware of this, and we are working with them to tackle this many-sided problem. When I visited Yemen a year ago, I signed an agreement with the Yemeni authorities on reducing maternal and infant mortality.

I am aware of the negative forces that have been actively trying to undermine the Cairo programme of action, in Latin America, in Central Europe, in the US, in some Western European countries as well. Those who lobby against the rights of women, of girls, of young people. Those who lobby against the right to inform yourself, to protect yourself, to choose. Forces like these effectively obstruct the much needed progress on MDG5 and other internationally agreed development targets. The bottom line is that such a lobby cost lives.

Three weeks ago, the Netherlands and UNFPA organised a High Level Meeting on Maternal Health/MDG5 in Addis Ababa. Many of the issues that we are discussing here today, were on the table there as well. The meeting adopted the “Addis Call to Urgent Action”, an appeal to presidents and ministers; parliamentarians; development partners and donors; civil society, young people and the private sector.

We concluded that maternal deaths and disability are the world’s worst health inequity and one of the greatest moral, human rights and development challenges.
MDG5, to improve maternal health, can only be achieved if concerted action is taken in the five years remaining before 2015. This right is bound up with the responsibility of men and boys to help reduce gender inequalities and combat gender-based violence. I cannot overemphasise the importance of MDG 3! Investing in the health and rights of women and girls is smart economics for families, communities and nations, especially in the financial crisis. It requires key measures to:

1. Prioritize family planning, one of the most cost-effective development investments. If we ensure access to modern contraception, we can prevent up to 40% of maternal deaths.
2. Make adolescents a priority. If we invest in adolescent health, education and livelihoods, we will accelerate progress.
3. Strengthen health systems with sexual and reproductive health as a priority. If a health system can deliver for women, it is a strong health system that benefits all.

I have committed myself fully to this ‘Addis Call to Urgent Action’. I repeat today what I said in Addis: despite the substantial cutbacks to the development budget, I have decided to maintain my support to sexual and reproductive health and rights at the same level. And I call on others to do the same. The fact that the many countries present in Addis, including India, Brazil, Tanzania, Afghanistan, Yemen and Ethiopia, agreed to this Call to Action is very encouraging. The next day I presented the outcome of the High Level Meeting and the “Addis Call to Urgent Action” to a meeting of Parliamentarians form all over the world; they endorsed the call. With and through them we can follow-up on the actions taken; to monitor the translation of words into deeds.

Ladies and gentlemen,

Let me return to the question “Population growth - is it still an issue?” I believe it is. Yet I oppose a return to Malthusian approaches. I am glad that in the Netherlands, we don’t speak anymore about population politics, which I associate with top down imposition of policies geared towards quantitative population goals. But population policies based on the Cairo consensus need to be on the agenda. As is a broader population policy putting the issue in social context as the only relevant one.

I call on everybody to work towards population policies that are founded on human rights and look at population from a rights based point of view. We have done so since before Cairo, and I remain committed to upholding this approach.

Now, more than ever, the universal right to access to sexual and reproductive health information, education, services and supplies has to be guaranteed. We have to respond to the unmet need of so many women for contraception.

It is the moral, human rights and development challenge we stand for and it is our common concern to act.

Thank you.