Keeping it Real: Lower Child Mortality Equals Higher Population Growth

I admire the fact that Bill and Melinda Gates are spending part of their fortune as the richest people on earth to help the poor. They began especially by helping to lower child mortality and then two years ago came to the realization that this needed to be accompanied by efforts to also bring down the birth rate. Nonethelss, this year's annual Gates letter seems to back down a bit from that position, arguing that it is a "myth" that reducing child mortality leads to overpopulation. In the letter, Melinda Gates even goes so far as to quote Hans Rosling, a professor at the Karolinska Institute in Sweden and one of her "favorite data geeks,"who said, “The amount of children in the world today is probably the most there will be! We are entering into the age of the Peak Child!” Now, I like Hans Rosling, too, but as smart as he is, he isn't a demographer and I don't think that he knows more than the United Nations demographers who project that the world's population of people aged 0-14 (children by any definition) is likely to peak in 2055. The crux of Melinda Gates's argument is that somehow fertility magically declines when child mortality declines. Not so fast, my friends.

I like the fact that USAID objected to this comment in the Gates letter and posted a link on their website to a response by James Shelton, a science advisor at USAID. 

Like it or not, we face an inconvenient truth. Reducing child mortality does increase population growth, which will likely substantially impair the quality of life for those very people we wish to help. Does that mean we should curtail our child survival efforts? Not at all. We have an ethical imperative to reduce mortality, and it affirms our humanity. But in my view, it also reinforces the imperative to make a full menu of quality voluntary contraceptive services widely available, and as expeditiously as possible. Unmet need for family planning remains high in developing countries. And recent experience in Ethiopia and elsewhere demonstrates that quality family planning programming can be highly successful in advance of major socioeconomic development.

As Potts [Malcolm Potts of UC Berkeley] points out and as reinforced in the Gates annual letter, the great appeal of family planning is that it has so many benefits. Those include substantial health benefits for women and children, enhanced women's empowerment, economic benefits for the family, the demographic dividend, reduced pressure on the environment, and the right to determine one's own life destiny. Not just convenient, but a compelling opportunity.

Well put--let's keep it real, folks.