Spotlight Spotlight: Climate Change

Climate change: what needs to be done

BMJ 2012; 344 doi: (Published 19 March 2012) Cite this as: BMJ 2012;344:e1358

Re: Climate change: what needs to be done

Missed opportunity in Climate Change articles, BMJ March 24 2012.

How sad, that even now in 2012, in 19 pages of the current print BMJ devoted to unremitting Climate Change, voluntary, accessible, rights-based family planning as a relevant ‘green’ intervention is only mentioned in two of 9 articles, and not at all in the article titled “What needs to be done” by Tom Burke.

Credit goes to Tony McMichael et al and Robin Stott for those mentions, but even so the message is somewhat muted. Where population growth is alluded to at all elsewhere in the March 24 issue, it is (as so often) assumed as a “given” to which we must try hopelessly to adapt, rather than something we can do something about.

Why hopelessly? Because all the words, and endless handwringing, haven’t reduced and realistically won’t reduce humankind’s gluttonous use of fossil fuels in time to prevent the >2 degrees Celsius rise in mean global temperature that leads to uncontrollable positive feedbacks.

As the BMJ articles show, the needed scale of reduction in greenhouse gas production is not happening, indeed we are told that emissions have increased by c 49% since 1990. Most of that failure is down to over 2000 million new arrivals on the planet, all striving for and many (eg in China, India and Brazil) achieving the increased energy consumption that cannot be separated from escaping poverty. Reduced carbon footprints are not enough, we also must by all wise and compassionate means reduce the number of feet (doing the footprinting).

More than 4 decades ago Ehrlich and Holden showed there are only 3 factors or drivers of human environmental impact, namely the ‘green-ness’ or otherwise of technology - on average, per person on the planet; ongoing resource consumption and pollution, again per person – and the number of persons (population). Since there are only those 3 factors, is it not foolhardy to continue to neglect any one of them? We in the medical profession must share responsibility here, since through successful public health, starting with Dr John Snow of Soho in 1854, the ongoing imbalance between world death-rates and birth-rates was primarily caused - inadvertently - by us.

As never before, shouldn’t all the world’s children be born not by chance but be caring parental choice? definitely including potential parents in the rich North, since calculates that one less high consumer equates to a lifetime carbon dioxide saving of c 750 tonnes of carbon, equivalent to driving 3.75 million miles in a car at 50 mpg. In the interests of sustainability of all life, as well as for women's own benefit, let’s remove the many barriers to women who would like the choice of using contraception. These include inter alia inadequate funding, inaccessibility of the methods and services, plus much misinformation - which is removable through education in schools plus the media, see

John Guillebaud
Emeritus Professor of Family Planning and Reproductive Health
University College London

Competing interests: I receive fees for Lectures on family planning, population and related environment/development issues; and royalties for my books on the same subjects.

27 March 2012
Emeritus Professor, Family Planning and Reproductive Health
University College London
Elliot-Smith Clinic, Churchill Hospital, Oxford 0X3 7LJ