Intended for healthcare professionals

Rapid response to:


Are cost effective interventions enough to achieve the millennium development goals?

BMJ 2005; 331 doi: (Published 10 November 2005) Cite this as: BMJ 2005;331:1093

Rapid Response:

Improving Health in Developing Countries

In 1950, the population in that arc of high human fertility made up
of Africa and the Middle East to Pakistan (excluding Turkey) amounted to
310 million. It now stands at 1200 million, and is estimated to be over
2,400 million by 2050. (Figures from United Nations World Population
Prospects 2004 Revision)

This population increase of over two billion people in a century is
in great part due to the spread of western medical expertise. It has been
a great feat, and last week’s BMJ with four articles dealing with the
developing world shows that we hope – now with the help of many others –
to sustain the effort.

The scale of this success in saving lives can be illustrated by a few
examples of population increase in the decade 1990-2000. In those ten
years, Iraq increased by over 6 million to bring the number of Iraqi’s to
25 million; Afghanistan increased by 9 million to reach 24 million;
Pakistan increased by 31 million taking the total to 142 million; and
Nigeria increased by 27 million to total 117 million.

(In 1950, the population of these four countries was 5 million, 8
million, 37 million, and 33 million respectively. In 2050, the population
of these four countries - as estimated by the UN - will become
63 million, 97 million, 304 million, and 258 million, respectively.)

In the 1950’s and 1960’s it was generally accepted that this rate of
population increase, if left unchecked, would make the eradication of
poverty impossible. In recent decades this insight has been almost
completely lost. Nevertheless, even coming fifty years too late, family
planning remains by far the most effective - and cost effective – means of
relieving poverty and improving health in developing countries.

Gerald Danaher

Retired NHS GP

Competing interests:
None declared

Competing interests: No competing interests

18 November 2005
James G Danaher
Retired NHS GP
33 Ashby Road Ravenstone Coalville Leicestershire LE67 2AA