Millions of Poor Women Are Still Waiting to Reap the Benefits of Cairo

SUSTAINABILITY FORUM on the Population Factor

Barbara Crossette, September 19, 2011

The debate about whether the world needs fewer people to sustain itself too often leads nowhere. It is essentially an argument over numbers: how many of us there are, how much we consume, how many species or woodlands are disappearing.

More useful might be an analysis of why populations are actually shrinking or stabilizing in many countries, while growing rapidly in others. Women, the men in their lives, and the inequalities that hamper their reproductive choices should be at the center of the story.

The idea that population "control" can be imposed on people was decisively rejected in September 1994, when 179 nations met in Cairo at the historic International Conference on Population and Development. Lately even China has begun to rethink its already crumbling one-child policy, as officials see their Asian neighbors reduce fertility rates—the number of children each woman has in her lifetime—to China's low levels, without coercion.

The Cairo conference put reproductive choice in the hands of women. That was fine, but unrealistic where it mattered most. In the richer industrial countries women and their partners had long made choices about family size. These personal choices had serendipitous national effects, not least on economic development and the environment.

In developing countries, millions of poor women are still waiting to reap the gains of Cairo. Reproductive health specialists believe that at least 215 million women in developing countries want, but do not have, the health care and contraceptive choices their richer sisters have long enjoyed. Almost all of the children born in this century will be born in poor nations, yet international aid for family planning has gone down precipitously, in part because donors deem it culturally intrusive or morally unacceptable. Dr. Gamal Serour, director of the International Islamic Center for Population Studies and Research at Al Azhar University in Cairo, told me recently that this amounts to a denial of human rights.

Culture may play a part in barriers to choice, but successful family planning programs in numerous Catholic and Muslim countries prove that religion is not necessarily a bar. Studies in Bangladesh by T. Paul Schultz, an economist at the Yale University Economic Growth Center, show this, and demonstrate the economic benefits of choice. But where there is no political will to honor Cairo pledges, millions of unwanted births take place and hundreds of thousands of women die of preventable, pregnancy-related causes and unsafe abortions.

Women in rural villages and city slums in Brazil, East Timor, Egypt, Ethiopia, Ghana, and India have told me that given the chance, they would have two, three, or perhaps four children; many have already had five or six. (The fertility rate at which population growth begins to stabilize is 2.1 children.) Many of these women are farmers who see land deteriorating, water and food getting scarcer, and forests disappearing.

By all means, bring down consumption, waste, and the squandering of energy resources in rich societies, and do so in time for the global poor to get more of their share. But more than empty pledges to women living in poverty are needed, so that they too can take part in saving the Earth.

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