Intended for healthcare professionals


Unfettered economic growth will destroy us: we need an alternative

BMJ 2022; 378 doi: (Published 26 September 2022) Cite this as: BMJ 2022;378:o2326
  1. Richard Smith, chair
  1. UK Health Alliance on Climate Change

Economic growth is supposed to save Britain, but sadly it’s more likely to destroy us.

Growth as the central concern of economics is, points out Geoff Mann in the London Review of Books, a relatively recent phenomenon.1 Adam Smith never mentioned it, and one of the main Bibles of growth, Stages of Economic Growth: A Non-Communist Manifesto by Walt Rostow, was published in 1960. Growth was the answer to the Great Depression, the Cold War, domestic instability, and decolonisation. It was also an antidote to redistribution of wealth: instead of dividing the cake between rich and poor the cake would be bigger, the rich could keep their cake, and everybody would have more cake.

The cake is Gross Domestic Product (GDP), the monetary value of a country’s annual output. But as Robert Kennedy famously said, “it measures everything…except that which makes life worthwhile.” It certainly doesn’t measure health. As Mann reminds us, “if you get hit by a bus, and it costs thousands to save you (or fail to), both you and the bus driver have made a positive contribution to GDP.” Nevertheless, GDP is currently the way that we measure economic progress. Other measures like the Human Development Index or the Genuine Progress Indication have not achieved the same status.

There are philosophical and political objections to the pursuit of growth, but the central problem with our current formula for growth—which depends on extracting and destroying parts of the earth—is that it’s unsustainable in a finite planet. I remember Paul Ekins, who is now professor of resources and environment policy at UCL, saying to me in the 1980s when we collected wastepaper together in Wandsworth, “you can’t have infinite growth on a finite planet.” That’s obvious, I thought. (Elon Musk, Jeff Bezos, Richard Branson, and others who have made billions through growth have recognised it as well, explaining their enthusiasm for space travel.) Yet at the Stanford Business School in 1989 I was taught that a company must either grow or die.

What was a radical idea in the 1980s is now mainstream. As Mann writes, “Even the likes of the International Monetary Fund, the Financial Times, the European Central Bank, Deutsche Bank and the US military now acknowledge that modern economic growth has been ecologically destructive, and is a principal driver of the looming climate cataclysm.”

But can we have “healthy growth” rather than “unhealthy growth”? That is now a central question in economics, and people like the former governor of the Bank of England Mark Carney are leaders in the idea of “green growth.” Innovation and technology, including carbon capture and green buildings, will save us. These “techno-optimists” believe that we need to recognise that capitalism isn’t going away any time soon and that we don’t have time to invent an alternative and therefore we need to pull the levers of capitalism with measures like carbon taxes and trading. I heard Aiden Turner, chair of the Energy Transitions Commission, the first chair of the UK Climate Change Committee, and former director-general of the Confederation of British Industry, argue this line in 2020—and he convinced me.2 But at the end of the debate he answered a question about the chance of green growth saving the planet at 30%. I doubt that he’d put it so high now.

The alternative to green growth is now termed “degrowth.” Less Is More by Jason Hickel is one of the Bibles on this movement. Degrowthers don’t favour shutting down the global economy, recognising that this would cause social chaos with the poor and marginalised suffering the most, but, as Mann writes, “a combination of purposeful downsizing and global redistribution.” Degrowthers advocate policies like active transport over driving, plant-based diets, ecological agriculture, insulating homes, sharing, repairing, and favouring second-hand products over new ones. (These, BMJ readers will recognise, are all policies friendly to health.) But will this be enough to keep the global economy going and lift people out of poverty? And how do you make it happen?

These are big questions that degrowthers haven’t adequately answered, but green-growthers policies are also more aspirations (think carbon capture on an adequate scale) than realities. Mann, coauthor with Joel Wainwright of Climate Leviathan: A Political Theory of our Planetary Future, concludes that “by any reasonable standard of argument, the burden of proof doesn’t lie with the degrowthers: it lies with those who hold fast to growth.”

I found myself wondering, as I walked on Clapham Common, if we could build an economy—or rather an acceptable way of living—based around Maslow’s hierarchy. A victim or beneficiary of current growth strategies (and despite having a leaning towards austerity and a disdain for fashion), I’m surrounded by things I don’t need—shirts, books, records, crockery, discarded electronics. I think of the ads for razors, bringing out a new razor with the most marginal or even non-existent benefit every couple of years. I fell victim to several iterations, but I now have a 10-year old model that fits my needs. But do I need a razor at all? Perhaps a long beard would make me look wiser.

Our first needs in Maslow’s hierarchy are physiological: air, water, food, sleep, shelter, and sanitation. (He includes sex, but I know plenty of people who do without that.) Our present economy does not give us clean air; our polluted air kills some seven million a year, and the pollution of our air with greenhouse gases is set to kill us all. A degrowth economy would concentrate not only on avoiding further pollution through renewable energy but also on cleaning up our polluted air through nature-friendly methods like planting trees and replacing land given over to animals for us to eat to plants we can eat. But we will also need technology to remove greenhouse gases. Degrowth like healthy growth will need innovation and nature-friendly technology.

One thing we don’t lack is people, and a degrowth economy would have many more people working on the land to grow our food, building homes, repairing our material goods, and caring for others. At the moment, we have food left to rot because there is nobody to pick it or absurdly because the fruit and vegetables don’t look right. Working all day picking fruit for a minimum wage is backbreaking work, but horticulture can be pleasurable rather than onerous, particularly if you are growing food for your family, friends, and community. Waiting lists for allotments are long.

I’m veering towards the romantic and must stop, but if we have our basic physiological needs met in a degrowth economy then we could have much more time for love and belonging, friendship, esteem, and self-actualization, the other needs in Maslow’s hierarchy.

Ultimately it is not economics that will decide our future but politics—who has the power, how will they get power, and how will power be removed? The present UK government seems to be committed to growth in any form (hence lowering the barrier for companies to be able to drill for oil and gas in the North Sea), but to have a future we will need either green growth or degrowth. Unfortunately, we don’t have a clear picture of how either will work, but we do know that unfettered growth will destroy us.


  • Competing interests: none declared.

  • Provenance and peer review: not commissioned, not peer reviewed.