Intended for healthcare professionals

Choice

Benign uproar

BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7215.0 (Published 09 October 1999) Cite this as: BMJ 1999;319:0

One man casts his shadow over this week's issue on overpopulation and overconsumption—Maurice King. Profiled on p 942, King suggested we should have a theme issue in the week when the world's population tops 6 billion. Many readers will be surprised by his view that the US constrains discussion on world population because it doesn't want to act on overconsumption (p 998). But few, we hope, will disagree that the subject of population and consumption growth deserves “benign uproar” —intense debate.

And indeed, there is much debate in this issue—over whether the threat is from sheer numbers of people or, as Tony McMichael (guest editor of this issue) and J W Powles argue, it comes as this enlarging population tries to “generalise production and consumption patterns typical of today's rich countries” (p 977). They want policymakers to use indicators that show whether our paths of economic development are sustainable, such as the “living planet index,” a measure of forest, freshwater, and seawater ecosystems. Set at 100 in 1975, it had fallen to 68 by 1995. There's also disagreement on whether food production can keep up with the growth in world population, as argued by Tim Dyson (p 988), though he concedes that “food prospects would be better if the population's size and growth rate were less.”

A major point of agreement that emerges from this issue is the importance of contraception. In his editorial Tim Black cites “strong evidence…that couples everywhere, under virtually all circumstances, will use contraception if armed with the knowledge and means” (p 932). The message is reinforced by Malcolm Potts, who criticises the Cairo conference on population for “portraying any quantitative concern for population as intrinsically coercive” (p 933). John Caldwell portrays a more complex picture, in which family planning has been important, but so have government policy, advocacy, economic development, and the education and employment of women (p 985). As for the future, David Baird and Anna Glasier outline scientific developments in contraception, while Tim Black argues that doctors are a barrier to improved family planning—being “expensive, overworked, based in cities, overqualified, and scarce” (p 932).

Given the emphasis on sustainability, it's appropriate (though coincidental) that our bicycle symbol marking a fast track paper appears for the first time this week. We chose the bicycle because it moves efficiently through congested traffic; we fast tracked the paper because the British government is considering a schools programme to reduce teenage smoking—and the study by Paul Aveyard and colleagues (p 948) shows that it doesn't work.

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