Boston Globe Editorial, September 1, 2004
Beyond birth control
TEN YEARS AGO this month amid the teeming streets
of Cairo, representatives of 179 nations hammered
out a new way of thinking about global population.
It was already received wisdom that overpopulation
cause poverty, hunger, and disease. But the
delegates to the United Nations Conference
on Population and Development dared to consider
the equation the other way around: What if
poverty and disease actually created the conditions
for unsustainable population growth? The words
"paradigm shift" are almost a cliche,
but the agreement reached that year to attack
poverty, illiteracy, and ill health -- especially
among women -- as a means to achieve sustainable
development had profound implications.
The focus shifted from top-down policies promoting
birth control in traditional societies to a
bottom-up approach aimed at improving education
and opportunities for women and girls. Simple
public health strategies such as clean water,
nutrition, and training midwives improved infant
survival rates. Local community and religious
leaders were invited to join international
aid workers, who addressed people in their
native or tribal languages. Contraception became
more widely accepted, part of a holistic health
approach including vaccines, vitamins, and
prevention of sexually transmitted diseases
such as AIDS.
Today, though the world's population has climbed
to 6.3 billion, the rate of growth has slowed
considerably, and a worldwide Malthusian disaster
seems unlikely. Thanks to the programs of action
outlined in Cairo, more girls are in school
and more women have economic and social opportunities.
Still, teenage pregnancy rates are alarmingly
high, and with half the world's population
under age 24, sex education and reproductive
health care are more crucial than ever. "This
is the largest youth generation in human history,"
said Thoraya Obaid, director of the United
Nations Population Fund. "There must be
services available to allow this generation
to control their lives."
Obaid and others are in London this week for
a 10-year retrospective on the Cairo conference.
Tim Wirth, the former Colorado senator who
is president of the UN Foundation, says the
United States has become "obstructionist."
The Bush administration's insistence on abstinence-only
approaches, he says, and its global gag rule
preventing women's health clinics from discussing
abortion -- even in countries where the procedure
is legal -- as well as its refusal to fund
its share of UN family planning services have
made the United States "no longer a gracious
and progressive force in the world."
Ultimately, the issue of sustainable population
is not about abortion but whether women and
children in the world's poorest countries will
live or die. In sub-Saharan Africa, one in
16 women dies in childbirth, compared with
one in 2,800 in the developed world. A woman
dies every 7 minutes from an unsafe abortion.
Five million people were infected last year
Far from political poll results or fund-raising
totals, these are the numbers that should command
attention this campaign year.
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