Intended for healthcare professionals

Editor's Choice

One child, one world, and one permit expired

BMJ 2005; 330 doi: (Published 10 March 2005) Cite this as: BMJ 2005;330:0-h
  1. Kamran Abbasi (kabbasi{at}, acting editor

Demographer Maurice King calls for a one-child world, in which the planet's inhabitants restrict themselves to a solitary heir or heiress for the betterment of humankind and to deliver us from “entrapment,” the deadly curse of exhausted food supplies and civil war that comes with overpopulation. Africa, King argues, is a continent in the throes of entrapment and, although a commission sponsored by politicians and rubber stamped by pop stars has identified governance as the primary obstacle to Africa's emergence from poverty, it would be an error to sideline a debate on demography.

The Commission for Africa promises much—an end to trade distorting subsidies, debt cancellation, and doubling of aid flow—and refreshingly asks rich countries to take responsibility for their contribution to corruption, political instability, and war on the continent. Governance issues in Africa require attention—they always have done—but South Africa's governance, for example, doesn't need an overhaul. African nations have done much themselves to bring a greater political will and urgency to the continent's reform agenda. This debate will live on in our theme issue on Africa, scheduled for September.

A one-child world brings its own problems. The populations of Far East Asia will be dominated by older people with not enough young ones. Japan's population of 127 million will drop by 25% over the next 40 years, but the number of older people will continue to increase. Even China's one-child policy has become too many for some couples enjoying the liberty and wealth of an expanding economy. Ironically, this procreative reluctance casts doubt on economic growth. For now, though, China's rapid expansion is creating a divided society, split between those lifted by the boom and those left behind, an uncomfortable scenario for politicians. We may think we live in one world but it still includes the worlds of the rich and the poor, a debate that will continue in our theme issue on China in early 2006.

Singapore, now certifiably rich, scraps cars after a 10 year permit of ownership expires. Well, my permit, like Martha Stewart's sentence, is up this week. It's been a fun seven and a half months as the BMJ's acting editor, including our indulgence in “peacekeeping operations in the Middle East”—as an imaginative reader described it—a landmark paper on the diagnostic skills of dogs, and the hornets' nest disturbed by our debate on the future of the General Medical Council. Indeed, promoting debate and making the BMJ a journal for the world is what it was all about (p 550, p 557). I hope our own growing population of readers believes that we have achieved that to some degree. I've learned a great deal, particularly that a lively journal is only possible with the support of colleagues—sometimes lawyers—and the patience of readers. I'm back to deputy editor next week as Fiona Godlee begins her reign as the BMJ's 13th editor.


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