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Many environmental trends are grim, and paths exists toward a more sustainable world—if we can address human numbers. But are these solutions realistic? Karen Hardee and William Ryerson discuss.

About The Population Factor:
A series of key conversations examining the connection between our planet’s growing population & related issues. Expect to be educated on a range of topics including climate change, wildlife preservation, immigration policy & consumption patterns.

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Transcript
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00:32Hello, and welcome to The Population Factor.
00:35I'm your host, Phil Kofaro.
00:37Today on The Population Factor, we discuss solutions.
00:41Although many environmental trends are grim,
00:44there are clear paths forward toward a more sustainable world,
00:47if we're willing to address human numbers.
00:50When I bring up population and the environment,
00:53one of the most frequent responses I hear is,
00:55I get it, more people mean more pollution.
00:59More people means fewer, less habitat for other species.
01:04But what can we do about it?
01:06People often don't know.
01:08Well, that's our topic for today, solutions.
01:11Here to help us sort things out are Bill Ryerson,
01:15President of the Population Media Center,
01:17and Karen Hardy, Principal of Hardy Associates Consulting.
01:22The Population Media Center creates and broadcasts radio
01:25and television dramas that promote family planning,
01:28environmental stewardship, and gender equality.
01:32Their many shows have reached tens of millions of people
01:35on five continents, and they include the Emmy-nominated
01:38East Lost High, which ran for four seasons on Hulu.
01:43Karen Hardy provides expert consulting on issues
01:46related to sustainable development,
01:48reproductive health and planning, and women's rights.
01:52Dr. Hardy was a reviewer for the IPCC's
01:55Fifth Assessment Report Chapter on Impacts, Adaptation,
01:59and Vulnerability, and she recently contributed
02:02to the development of a national gender strategy
02:04for the Ministry of Public Health in Afghanistan.
02:08Bill and Karen, welcome to The Population Factor.
02:11Thanks so much, Bill.
02:12Thank you. Thank you. Great to be here.
02:14It's great to have you.
02:16So here we are, a world in ecological decline,
02:20with the global population increasing between 80
02:23and 85 million people a year.
02:26What can be done about that? What are the solutions?
02:28Karen, what actions would you say you'd like to prioritize?
02:34Thank you. I think, you know, multi-sectoral solutions
02:38are what we need right now, and that is linking
02:41people's well-being with other sort of environmental,
02:46you know, strengthening the environment.
02:48There's programming that has been undertaken for, gosh,
02:5220, 30 years now called Population Health and Environment,
02:57and this is programming that it links,
03:00it goes to conservation areas like, you know,
03:04the coastal areas of Madagascar or the mountainous areas
03:08of Tanzania, many other countries,
03:10and integrates health services into their conservation efforts
03:15and their efforts to strengthen sort of their environment.
03:19And these have shown success.
03:21So that's just one type of programming.
03:26But post-Cairo, post the 1994 Cairo Conference
03:32on Population and Development, one of the things we heard
03:36was don't link family planning with environmental outcomes.
03:44The kind of programs you're talking about,
03:46sounds like they would seek to do that.
03:49Yes, thank you. Thank you for mentioning that.
03:52Cairo, I think what Cairo brought us was to say,
03:56don't talk about population in the sense of population control,
04:01but really look at it in terms of people's well-being and women,
04:05particularly women's well-being,
04:07and promoting women's reproductive rights.
04:11And that is, so that is to say,
04:13don't look at the sort of big numbers and have targets for countries
04:17to reach with their sort of family planning goals
04:21in order to reduce population.
04:24But if you meet women's reproductive needs,
04:27it will have the effect of reducing population in the longer term
04:33because there will be many fewer unintended pregnancies
04:38and women will have the number of children that they want.
04:41And that number of children has tended to go down since Cairo.
04:46So there's been a lot of work since 1994, since ICPD,
04:51to really strengthen rights-based family planning programming
04:55rather than demographic, you know, targeted programming.
05:00There's still, you know, there's still those still crop up sometimes,
05:03but that's been really the general trend.
05:08Bill, your thoughts on the solutions that we need.
05:12Well, I think Karen's absolutely right.
05:14I was at the 1994 conference in Cairo
05:17and was involved in helping to organize the largest NGO forum
05:22at a UN conference in UN history at that event.
05:26And I also attended the 1974 conference,
05:29the first population conference the UN held.
05:32And there was a dramatic shift from the Bucharest conference in 74
05:37to the Cairo conference in 94 in recognizing that coercion
05:43and policy attempts to regulate family size were a huge mistake.
05:50Certainly this happened with coercion in China and India.
05:55India and China both instituted coercive policies in the 1970s
06:00and they really backfired and they were really unnecessary.
06:04And I think what has scared a lot of environmentalists away
06:08from addressing population is many environmentalists
06:12think along policy lines.
06:15And when it comes to population, they shudder at the idea of some policy,
06:19but in fact, totally human rights-based approaches to elevating the status
06:25of women and girls, including daughter education
06:29and stopping child marriage and stopping other forms of violence
06:32against women, as well as modeling small family norms
06:38through entertainment media can be hugely influential
06:42in changing behavior without ever telling anybody what to do,
06:47just showing them different options and the consequences of those choices
06:52and allowing them to decide what's in their best interest.
06:57And when just one additional piece here,
07:00when one looks at the demographic and health survey data
07:05as to why people say they're not using contraception,
07:09the number one reason is wanting more children,
07:13but among the roughly 225 million women who don't want another pregnancy
07:19at the moment or in the next couple of years and are not using a contraceptive,
07:24the top reasons are male opposition, fear of health effects,
07:28religious opposition, basically fatalism,
07:32the belief that God determines how many children one's going to have
07:35and there's nothing they can do about it.
07:37And those are far more prominent in most countries than things
07:42like lack of access to services.
07:44So overcoming those cultural and informational barriers is key.
07:49So this gets to a question that I had.
07:53If you think about population growth, as long as average fertility
08:01for women is over 2.1 or 2.2 children per woman,
08:06the population is going to continue to grow.
08:09So my question is just this.
08:12Is the main driver of continued population growth unmet need
08:17or is it the continued desire for large families?
08:21Bill, what's your take on that?
08:23It varies by region of the world,
08:26but unmet need, just to give the definition,
08:30is not using a modern method of contraception
08:33and not wanting to be pregnant in the next two years.
08:36It's not unmet demand.
08:38So certainly close to half of those who are not using contraceptives
08:45are described as having an unmet need,
08:50but a slightly larger portion are people who are intentionally
08:54not using family planning methods in order to have more children.
08:58In many countries, let's take Africa,
09:02desired fertility and actual fertility are very close.
09:08That is, in East and most of Central Africa,
09:11desired fertility may be in the neighborhood of four or five,
09:16and actual fertility may be a tenth of a child higher than that.
09:21So people are coming close, but they're not perfect contraceptors.
09:25In West Africa, desired fertility is well above actual fertility.
09:31So in Africa's most populous country, Nigeria,
09:34fertility rates about 5.7 children born to the average woman during her lifetime.
09:40And when women are asked how many children they think is ideal,
09:44they say seven and men say nine.
09:48So this tradition of large families,
09:51and particularly in West Africa,
09:53is a major factor in growth in that region of the world.
09:59And addressing desired family size really includes changing norms
10:05with regard to what people think is normal.
10:08In Niger, fertility rate is 7.6.
10:12Women want 10 and men want 13.
10:15So they're not coming close to having as many children as they think is ideal
10:20because of poverty and poor health and other issues,
10:25but helping them achieve sustainability includes addressing desired family size.
10:32So, Karen, in 2017, you published a paper with John Bongartz,
10:38titled The Role of National Family Planning Programs
10:42in Meeting the Demand for Contraception in Sub-Saharan Africa.
10:45How important is it still then to increase access to contraception?
10:51You know, family planning programs have been very important in, as you say,
10:57expanding access to contraception and getting contraception used.
11:03There's been a big debate in the literature,
11:06oh, well, it's just development, just promote development,
11:09and population will take care of itself.
11:11And I think John Bongartz particularly over the years,
11:15and it was really an honor to work with him,
11:18has really shown that you need both.
11:20You absolutely need development, but you need family planning at the same time.
11:25You know, some people have said, well, and then development,
11:29or just educate girls, just educate girls,
11:31and then fertility will take care of itself.
11:34And, you know, some of that is true, because if girls stay in school longer,
11:38then they get married later, and then they tend to have fewer children.
11:43So, you know, that is very important.
11:45But we've also shown work that John and I did, that you need both.
11:50You need education and fertility.
11:52You know, I've sat with heads of state, and I say to them,
11:57when they say, oh, we're just going to educate our girls,
11:59and it's all going to be fine, I say, you know something?
12:02No matter how educated you are, if you don't want to get pregnant,
12:05you need a contraception, and that you get from a family planning program.
12:09Of course, they're taking it back, but it's true.
12:11You need both.
12:13So we need, what I'm hearing then is rights and norms are both important here,
12:20securing reproductive rights for women and couples,
12:24but also perhaps changing norms about family size.
12:28Bill mentioned reproductive fatalism.
12:31Both of you have talked many, many times.
12:34Changing norms about women's subservience is important.
12:39Empowering women to actually have a voice in how many children they have.
12:43So all of these things, then, are important.
12:49Karen, you brought up a view which is pushed, I think, primarily by Wolfgang Lutz
12:56and others in his demography group in Vienna.
13:00This view that educating girls is really the key to lowering fertility.
13:07And I think Lutz pushes it so far as to basically say, as long as we do that,
13:13everything else really will take care of itself.
13:16I just want to, since that view is so influential out there,
13:21I'd like to get clear on what your view is of that.
13:25Well, it's interesting because I also collaborated with a colleague, Dr.
13:30Lei-Wen Zhang, who worked with Wolfgang,
13:33so very familiar with Wolfgang's population pyramid,
13:37population projections that include education.
13:41And we used data from India to show that, again, that fertility is lower
13:48if you do the projections based on, if you looked at it just with education
13:53or just with family planning and combining both.
13:56So, again, I think we've even used Wolfgang's own methodology to show that both are really important.
14:04Bill, your take on this, because your work with PMC is all about educating people.
14:12So you're bringing in the education component there.
14:16Your take on the argument that educating, keeping girls in school longer is all that's needed here.
14:25I think Karen is right that it's a huge factor.
14:30When you look at fertility rate by length of education, primary, secondary or beyond,
14:41fertility rate declines steadily the more years of schooling a woman has, but it's not sufficient.
14:49One needs access to modern methods of contraception.
14:53So both are required.
14:57And certainly creating demand for contraceptive services requires overcoming misinformation about safety and effectiveness
15:06and overcoming various forms of opposition, male opposition, mother-in-law opposition,
15:13religious leader opposition and personal opposition.
15:18People sometimes are opposed because of misinformation about their rights.
15:25And this is particularly true in places where girls are put into marriages at age 10, 11, 12, 13,
15:34and they're basically brought up by their husbands and they have no idea that they have rights of their own.
15:41And so helping people understand their rights is very important along with education
15:49and helping them understand the safety and effectiveness of clinical methods of contraception.
15:57So I had Florence Blondel on the show a week or two ago.
16:03And she's from Uganda.
16:06She was giving me some statistics on the percentage of girls who are married as child brides, let's just say 18 or younger.
16:17And very high percentages in many countries throughout Africa.
16:22So I think that is certainly a part of this that's hugely important,
16:28both in terms of a woman actually having agency to choose how many children she's going to have,
16:36and also simply in terms of the sooner in your life you start having children, the more children you are likely to have.
16:45Yes. And there are aspects of girls' education that many policymakers never think about.
16:53For example, Jane Goodall's Institute is working to protect chimpanzees in Uganda.
17:01And they realized so many girls, when they reach puberty and begin menstruating,
17:08they are missing a week of school every month.
17:12And after some period of time, they just drop out and get married and start having babies.
17:18And so what they did as a contribution to help slowing the population growth and improving girls' education
17:26is providing sanitary materials for these girls so they could stay in school when they were having their periods.
17:34And that type of adaptation that's needed for girls' education is something many people never think about.
17:41But it's critically important, along with modeling girls' education to their parents as an alternative,
17:51a much more positive alternative to selling the daughter into marriage.
17:56Many people think, well, the girl is a liability and I'll just pay off this huge expense by selling her into marriage at 12 or 13.
18:07And they don't think about what's that going to mean in terms of her welfare, let alone my grandchildren's welfare.
18:14So modeling, changing those norms is critically important.
18:19And then the cost of education, including school fees, uniforms, books and other educational materials,
18:29is something that many people haven't given thought to.
18:31It's a huge barrier to go from being in favor of educating one's children to actually educating them.
18:38And that's something where governments need to do a much better job of putting funding in to make education really accessible.
18:48And there's been a lot of, most of the focus has been on primary education.
18:53So there's an additional need for attention to keeping girls in school even beyond primary school.
19:00Right. So we're getting into the whole issue of a rights-based approach to these kind of questions,
19:09and especially the rights of girls and young women.
19:14Karen, do you want to sort of explain to viewers, what's the basic idea behind rights-based family planning?
19:22Sure. So this is not new. This goes back to 1968.
19:29There was the Universal Declaration of Human Rights.
19:35And in 1968, there was a human rights conference in Tehran, in Iran,
19:40where the right of individuals and couples to decide freely and responsibly the number and spacing of their children.
19:49Actually, it was couples at that point, the right of couples.
19:52So this right has been enshrined in global human rights for over 50 years.
20:03And family planning programming, a lot of it has tried to be based on that.
20:08Although it's quite interesting, and maybe we'll pick up on this.
20:11The word responsibility is in that initial declaration.
20:18And that word has ended up being a bit problematic in the human rights committee or community, I should say.
20:27But what it says is that, and so that declaration has then, that was in the 1974 bill you mentioned, Bucharest.
20:36It was in the 1974 program of action, 1984, 1994.
20:42So that basic human right of individuals and then couples to decide freely and responsibly the number and spacing of their children,
20:52with the information and services to do so, and without discrimination and with equality.
20:59So that's sort of the umbrella rights.
21:03And then, but then, you know, there have been lots of conventions since then,
21:07including the right to the highest attainable standard of health,
21:10that then flows into the right for family planning and reproductive health information and services.
21:18So that's basically it.
21:21But there's the rights literacy is an issue right now.
21:24I mean, you know, people sort of say, yes, everybody should have access to family planning services,
21:29but they don't quite understand what that means,
21:32and that it has legal and sort of global human rights teeth,
21:37that communities should be holding governments responsible for providing these types of services.
21:46So it's you have the right, but then how do you infuse programming with rights principles?
21:53So, for example, privacy and confidentiality is, you know, one of the human rights principles.
21:58How do we make sure that services are private, are confidential?
22:02How do we make sure that they're of high quality?
22:06How do we make sure that everybody has access that, you know,
22:09in the words of the sustainable development goals that nobody is left behind, you know, that there's full equity?
22:15So that's sort of in a nutshell what rights-based family planning is.
22:21It's not something different.
22:23It's not, you know, some like we throw away everything we've been doing and start all over again by any means.
22:28It's just making sure that you're using a rights lens as you implement programs.
22:35And as you say, the way this has been discussed historically is in terms of the right of women and couples to freely and responsibly choose the size of their families.
22:50That language, too, was reiterated in Cairo in 1994.
22:55My sense is, as you hinted, the responsibility aspect of it, people have become less and less comfortable talking about that.
23:06And as an ethical philosopher, I see that as sort of a corollary of our inability in the modern West,
23:15and specifically in America, to talk about rights and responsibilities as sort of two sides of the same thing.
23:22We're comfortable talking about our rights and standing on our rights, demanding our rights for ourselves and others.
23:28We sometimes forget that if you don't have the flip side of that acting responsibly, then that could undermine what we're trying to achieve here, flourishing and good lives for everyone.
23:44Can I just give an example of this? Because I've been watching, and Bill, I know you have also, and Phil, family planning in Rwanda.
23:52And of course, Rwanda went through just the horrific genocide.
23:56But President Paul Kagame, but even before that, even before in the 80s and the 70s, that was one of the most densely populated countries in Africa.
24:08And President Paul Kagame said, we need to do something about this, because there are just a lot of people in Rwanda, and it's so densely populated.
24:20So he very strongly supported family planning, both the right, but the responsibility.
24:29So he said, have children, have the number you want, but make sure you're able to support them.
24:36We're going to help. We want to be the Singapore of Africa.
24:40So it wasn't as though, he said, you women of Rwanda, stop having so many children.
24:46This is bad. This is bad for the population.
24:48He said, we're all in this together.
24:50I'm going to implement policies that are good for the country, family planning at least.
24:57I know there's controversy about his rule, but family planning.
25:03You need to think about how many kids you can support.
25:06So that's the one example that I've seen where a leader has really taken that rights and responsibilities aspect of it.
25:16A need for responsibility and really educating people about responsible parenthood is illustrated by the US foster care system, which we've become very familiar with.
25:29Our daughter joined our family at age 12.
25:32And the children who are in dangerous homes have often been born to parents who really should have been given good counseling to avoid parenthood, given their circumstances.
25:48And they just fell into it and they weren't planning anything.
25:53And you see this in many countries around the world.
25:56Certainly, I know of many circumstances where men will have one girlfriend or spouse after another over a period of time, leaving children behind and not caring for any of them.
26:11And this issue is very touchy issue, obviously, but clearly modeling responsible parenthood is important to avoid having children who are not being cared for and loved.
26:29That makes a lot of sense.
26:31Let me talk about another kind of controversial and somewhat difficult issue.
26:37This is the whole question of governments setting targets for family planning programs.
26:42So post-Cairo targets for family planning programs were singled out as a bad idea, as potentially leading to coercion.
26:52And so the consensus going forward seems to have been that that's a bad idea.
26:58And so, Karen, in one publication, you helped to write right-sized family planning, a toolkit.
27:04There's this quote, rights-based family planning is driven by the needs and rights of people in the program that is meant to serve rather than the program structure system staff or numeric goals.
27:16And I think that that sort of represents the general consensus.
27:20But are family planning targets really so bad in a world where the failure to end population growth could lead to disaster?
27:30What's your take on that?
27:32You know, I think it's as Bill said earlier, that, you know, the China's program, India's program, Bangladesh, when they were, you know, you know, promoting vasectomies, they just backfire.
27:44They just are not a good idea.
27:48So targets and targets are, you know, it's they're a tough thing because, you know, you need some numbers for planning purposes.
27:59You know, you need to know how many contraceptives you need to order.
28:02You need to know, you know, sort of basically how many health staff you need.
28:07So it seems that those kinds of sort of numbers for planning purposes have to be OK.
28:14But actually giving giving providers saying, you know, you have to see this many women a month.
28:19You have to insert this many IUDs.
28:23You know, those kinds of targets are a problem.
28:26And this, of course, came up with in 2012 when we the world celebrated the London Summit on Family Planning, where world leaders got together with Melinda Gates and, you know, heads of state to sort of reinvigorate family planning.
28:43And they sort of announced a global a global goal of reaching 120 million additional users.
28:51And of course, people were, you know, a lot of people, civil society were up in arms saying, you're just reintroducing the targets, you know, that we got rid of in Cairo.
29:02And and what they said was, you know, we want something ambitious.
29:06We want to be ambitious so that we have something to strive for.
29:10But but that that that that sort of pushback was actually really, really important and useful because it really made the partnership, which is now called FP 2020.
29:25It really made that partnership reinforce the rights and that programming to achieve this goal absolutely had to be right, has to be rights based.
29:37You know, it can't be just, you know, that that that those kind of of targets for providers are simply not OK.
29:45So let me let me push back on that a little bit. I mean, that seems to me like a reductio ad absurdum of pushing rights rather than responsibility.
29:55In other words, you know, the Gates Foundation says we're going to give you tens of billions of dollars to try to to try to meet half of the unmet need and family planning around the world.
30:07And people say, no, that's a bad idea when providing that contraception is, in fact, part of securing rights for people to do that.
30:19I mean, again, it's just an example. Well, an example of failing to understand that with rights go responsibility, but but maybe also an example of failing to understand that we don't have forever to deal with population issues.
30:37You know, my take on this is if I'm a mid-level bureaucrat working for the government and I'm told that my evaluation and salary raises dependent on how many women I sterilize, I'm much more likely to violate their right to make a an informed decision than I am if that's not a factor in my evaluation.
31:02So I think, yes, at a global level, we need to set ambitious goals. And we certainly have a very serious crisis with regard to loss of biodiversity, which in the U.N.
31:19environment report program report that came out last year pointed to the fact that expanding human farming and expanding human habitation are the major causes of the loss of biodiversity that is now threatening the extinction of one million species.
31:36And it's this web of life that makes the planet habitable. So the stakes are high. But if we if we do this right on it in a rights based approach and we put our effort and money into such things as educating girls and elevating the status of women, along with reproductive health information and services, we can achieve the goal much more quickly
32:03and without backlash than we will if we have government officials telling people that they need to have a sterilization operation.
32:13OK, so we don't want mid-level government officials having quotas for how many sterilizations they have. Would it be fair to say we want them to have quotas for how many new people they sign up for for contraception?
32:28I think you have the same risk.
32:30Yeah, but nobody wants to be lectured to and told what to do. They want to make these decisions themselves.
32:39We believe in our experience with using entertainment, serialized dramas for modeling behavior, that in fact, modeling behavior by having stories about fictional characters who evolve through their own thinking and realize different consequences of their different behaviors is a far more effective and human rights based approach to changing norms than having government officials saying,
33:08you need to use a contraceptive or you need to do anything that can backfire. And we saw this happen in India when Indira Gandhi instituted coercion with regard to sterilization and she lost the next election and rightly so.
33:24So it makes much more sense to use modeling and education, persuasive education, perhaps, but not coercion in any form, including targets.
33:36And I think the environmental community has sort of shied away from working on population issues because of such things as targets. But approaching the environmental community with, no, this is rights based, it's meeting people's needs, it's taking a client orientation rather than a program orientation, makes people much more comfortable and makes policymakers more comfortable with the discussion.
34:04And it gets away from this idea that somehow we're blaming African women for environmental degradation and climate change, which of course, you know, nobody is doing, but it sounds that way when you talk about, you know, we need to pressingly do something about population and meet targets and those kinds of things.
34:23In fact, I've heard people say that, you know, we have coercion for stopping at red lights and we have coercion for not committing murder. And we're now talking about the habitability of the planet, why not use coercion? And the answer is, beyond the human rights violation, it doesn't work.
34:40Most coercion, in fact, has been in the opposite direction, preventing people from planning their families by banning access to contraception or access to girls education. And if you think about the community of governments of the world coming together to coerce people, the most likely outcome is they're going to coerce them in the wrong direction.
35:04I certainly, looking at the U.S. government, would not want and not be comfortable with the U.S. government deciding to coerce people to do anything related to reproduction. It would just backfire.
35:20But what's important to add there is, if you look at unintended pregnancy in the U.S., it's still almost half of pregnancies that are unintended. So, Bill, I think it really reinforces what you're talking about, that it's lack of access to reproductive health services that's a much bigger problem than sort of coercion in the other direction.
35:46So you are both making an excellent case for your arguments against coercion. And I don't really want to be in a position of arguing for coercion, at least in the black and white way in which this is discussed. You know, I don't want to start standing up for forced abortions or coerced sterilizations or anything like that.
36:10But we started with this issue of targets, and I am going to push back one more time on that. And I'll simply start by giving you some figures from the 2019 UN population projections.
36:22Democratic Republic of Congo, 2020 population, 90 million. Projected 2100 population for the Congo. In the median variant, 362 million. That's over a 300% increase.
36:38Nigeria, 2020 population, 206 million. Projected 2100 population, 733 million. That's a greater than 250% increase. Now, I'm not arguing about in favor of coercion, but I'm asking here, what really is the compassionate policy?
37:01Is it compassionate for governments not to set targets, for instance, for smaller family sizes, when Congo and Nigeria might not be able to feed people in the coming decades? Karen?
37:17So, no, that's a very good point. I think, you know, I think, you know, you talk about Nigeria, for example, and Nigeria is a huge country with, you know, in southern Nigeria, the statistics, you know, family size is much different than northern Nigeria.
37:33So, I don't think that there are any blanket solutions, like the government of Nigeria saying, okay, all of a sudden, you know, people can only have two children for one thing. And I lived in China, you know, at the beginning of China's one child policy.
37:46So, I've sort of looked at that, you know, what happened in that country over 30 years and, you know, talk about a human rights violation, honestly, and they've so messed up their age structure now that they're going to be, you know, sort of facing the consequences of that disastrous policy for many, many decades.
38:06But China today could not enforce the one child policy that it was able to do in 1979 and 1980. And so, no country, you know, there are some states in India that right now that are trying to legislate a two child policy, but they're just, they're, I don't think there's any country in the world that could actually enforce one for one thing.
38:32But what it means is you need to look at the root causes. You know, why is it in northern Nigeria that family size desires are so much higher than in the south? Well, it's, you know, the different religions, different, you know, tribal groups.
38:46So, you really need to, I think what Bill's been saying, and I'm a big fan of the programming that, you know, that Bill does, it's, I think it's really, really important.
38:56You know, look at social norms. How are we going to address social norms? How are we going to get to men? You know, how are we going to get to the root causes of why there are differences in the desired family size?
39:11And I have to say, I also did some research in Ethiopia several years ago, where we asked about, this was looking at population and climate change, and we sort of asked about, asked the population questions at the end, because we, you know, we wanted to get people's views on climate change first.
39:28And people said at that time, you know, we would love to have more children. We love children. We would love to have four or five children. But we can't now. We know we can't now because we know that there's deforestation.
39:43You know, there's environmental issues, and that a lot of that is caused because people need more room in the country. So, I think that that's probably happening in, you know, West and Central Africa also, that yes, there's a, you know, high desired family size, but, you know, people are realizing, but we can't have that anymore.
40:06So, I think that's a little bit where the sort of responsibility side is coming in.
40:11Bill, with your demographic projections of those two countries, Congo and Nigeria, you reminded me of Lord Carradine's poem about demographers, which goes like this.
40:23It is really no use in the end to be a demographer's friend, for she's given her heart to a graph and a chart, and at night she sleeps with a trend.
40:33And my reason for mentioning this is demographic projections are as good as the assumptions that are behind them.
40:42And certainly, those projections are concerning, the median projections, not to mention the high projections.
40:49And I think it's perfectly okay to have a population policy at a country level to say we want to achieve the low projection.
40:58We want to ensure that we have as good a chance of achieving sustainability, including environmental sustainability, by doing everything we can in a rights-based context to help achieve that, including ensuring all girls are given primary and secondary education, including access to information, including sexuality education, along with
41:28modeling regarding health choices and consequences, plus access to contraceptive services and other reproductive health services.
41:38I've been to now 93 countries, and I've never been to a country where they're trying everything they can in a rights-based approach. And until we are doing what we can,
41:49we shouldn't even be thinking about using targets or coercion of any type, because those are most likely going to backfire. There is a whole lot more we could be doing. I'm very much aware that
42:02the work we're doing, and Karen, thank you for the compliment, is a drop in the bucket. When you're in a country like Nigeria and you're broadcasting in the House of Speaking North,
42:15we did a show there that was 208 episodes long. It pulled in 71% of the population as weekly listeners to what was a twice a week broadcast. And we had characters modeling smaller family norms and stopping child marriage and use of family planning.
42:34And at 11 clinics that did questionnaires to new family planning adopters, 67% of them cited the program as the reason they had come. So, you know, it's possible through that kind of intervention to have a huge impact. And that was at a cost,
42:55counting the cost of all 208 episodes, including primetime air purchase across four states, of $0.30 per family planning adopter. So it was something that was simple and easy and in a rights-based context, and not nearly enough of that is going on. Until we're doing far more of that type of thing, we shouldn't be looking at measures that can backfire.
43:20Well, I think we'll all agree that we want the kind of rights-based approach to family planning that you've both described. And I think we all agree that it's important to work to model small family norms.
43:36I want to shift a little in the time we have left and talk a little bit about the developed world. We've been talking primarily about trends and issues in the developing world. But of course, many of our populations in the developed world are still growing. Many developed nations probably have larger populations that they can sustainably support.
43:54Now, the good news in the developed world is that in most of the developed world, we have fertility rates substantially below replacement rate. And in some developed nations, we actually have declining populations. But there's been a really a visceral reaction against declining populations in the developed world. As you know, it's almost always described as a problem instead of a success.
44:24Bill, should you be developing a telenovela for central bankers to get them to accept declining populations?
44:31You are so seriously correct. I spoke at the World Economic Symposium in Germany, and I stood up in response to a panel discussion about climate change, which didn't mention population.
44:49And I pointed out the importance of population as a factor in climate change, which this panel had never mentioned. And then I said, you know, the government of Germany, this room was filled with economists, most of them German, said the government of Germany is paying parents $16,000 per German baby born.
45:12If we have a climate crisis, a water crisis, a food crisis, an energy crisis, and a population crisis, which this panel had just agreed to, yes, they should have mentioned it. Why are we doing that? Is it because we like German babies better than other babies?
45:30I have a whole group of writers in Nigeria doing a program there who would be happy to move to Germany if you need more people. But in fact, the issue here is economists are persuaded that the economy can expand forever, even though we're in a finite universe.
45:49And they think if it stops expanding, the economy will collapse. This is driven in part by people who are land speculators or in the housing market, and they measure the world by housing starts. But in fact, the economy can't grow forever. We need to achieve a sustainable economy.
46:08And we can't try to stimulate it by having more babies in countries where, in fact, the dependency of the elderly on the working population will be worsened by adding babies to the mix because they're also dependent.
46:24What we need to do is learn how to live sustainably in the declining population scenario. And a country that's a great example of that is Japan.
46:34Certainly, it is possible and to be celebrated when countries go into declining population because ultimately, if we are to be able to live on renewable resources alone, and by definition, non-renewables are being depleted as they're used up, we're going to have to achieve a much lower population, ultimately, in order for people to lead a decent quality of life.
47:02At 10 billion, it will be very difficult for most people to survive on renewable resources alone. So we need to work out an economic model that is not dependent on ever-growing population because no matter what you may think, if you've never had a course in ecology, the fact is the population cannot grow forever.
47:26So we've got just a few minutes left here. I'd like to ask both of you what you think about some other proposed solutions to population growth or overpopulation. And I'm just looking for a quick comment. So I'll start with you, Karen. Restrict child marriage, raise the legal marriage age to 18. For or against?
47:53I think I'm for that. I'm for that. And a lot of countries are trying to do that. I think that is a good idea.
48:01And that's something we could do in the United States as well. There's still many states where a 14-year-old girl can still be legally married.
48:09Absolutely. Bill, disincentivize third and further children non-coercively by limiting government support to the first two children. For or against?
48:20I am not in favor of that. But I think instead, the way I would do it if I had the power to do this would be to take the government out of stimulating marriage and or childbearing at any level. In other words, I think the government should be neutral with regard to financial incentives, even for two children.
48:48So giving people a tax exemption for two children versus four children, I think the government should stay out of that. Giving people different income tax rates, whether they're single or married, I think the government has no business in doing that.
49:04So I think the best way is to remove the government from trying to incentivize that kind of behavior financially.
49:13Karen, make sterilization free for both men and women.
49:18Well, I am a huge proponent of male sterilization. I wish it were much, much, much more prevalent around the world. There's a problem with incentivizing one method over another. Part of the human rights is full, free, and informed choice.
49:43So I would say make them, well, all contraceptives free would be fine, but not just one method. But increasing access to sterilization, not India needs to do the opposite, but many other countries need much more access to both female, but particularly male sterilization.
50:07Bill, change the current foreign aid distribution, giving more support for health and education while cutting international military aid.
50:17Yes, totally in favor of that, because military aid obviously is important in situations where there is terrorism or turbulence going on.
50:31But in fact, military aid is the last resort after all the efforts to help achieve a population that's educated and employed fail. So we need to put much more effort into the preventive measures before we do measures that are just picking up the pieces after the fact.
50:53Karen, finally, connect family planning funding to international climate change funding.
51:00Oh my goodness, absolutely. Absolutely. That's so important to include family planning as one of the sort of adaptation measures and even mitigation also that is eligible for climate change funding. Absolutely.
51:16And I just thought of one more potential idea here. Encourage nations to figure out what national populations are actually sustainable and then put in place policies to decrease their populations until they reach that figure. Bill, what do you think?
51:33I think this is a great idea. The Sustainable World Initiative, which existed a few years ago at the Population Institute, actually developed strategies for helping any country on the planet determine what their sustainable population was given assumptions about quality of life.
51:55So you could look at the population of Nigeria and say, at a Western European lifestyle, what is the sustainable population using only renewable resources? And when you know that figure, then you can make a decision as a government that's somewhat informed about how are we going to get there if that's what our goal is.
52:19And so doing that kind of analysis is a very good idea.
52:25Well, obviously, there's a lot more we could talk about.
52:30Can I give one shout out, Phil, and that is I think that something that's been so destructive is what we all call the global gag rule and this ping ponging of taking away funding for international organizations that do anything related to abortion. It is so disruptive.
52:52We've been talking about Nigeria. I think you could probably just look at U.S. assistance to Nigeria and see how disruptive not being able to work with the International Planned Parenthood Federation, Marie Stokes, and even local groups within countries to provide family planning.
53:11And now under the Trump administration, it was HIV. So much disruption is really, really, really an issue. So looking forward to the next administration and that rule, that global gag rule being lifted.
53:25It would be wonderful if we could get back to where we were in 1970 in this country, where it was much more of a bipartisan support for international family planning.
53:37At this stage, I don't know what we can do about that problem except vote for Democrats for president because it's almost just a bone that Republican presidents are going to throw to their supporters, you know, whatever their personal views about this.
53:51So, yeah, you're right. It's a huge issue, Karen. Well, again, wonderful discussion. I'd like to pat myself on the back for having not one but two people on this show who obviously know so much more than I do about the ins and outs of these issues.
54:11I think it speaks very well to my own, you know, self-assurance that I was willing to have you both on this show. But beyond that, I'd really like to thank you for being here. Karen, Bill, thanks so much for coming.
54:24Phil, thank you so much. It was a very enjoyable discussion.
54:28Yes, I agree. Thank you. Thank you so much, Phil.
54:31Can we have you on the show again?
54:34Delighted.
54:36Absolutely.

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