Today marks the much anticipated advent of the estimated day when seven billion people will inhabit the Earth, according to the United Nations Population Fund who have just published their latest report – State of the World population 2011- ‘People and Possibilities in a World of 7 Billion'. In fact, the announcement of the birth of the “seven billionth baby” has already been proclaimed in Manila, Philippines with the arrival of Baby Danica May Camacho. However, the debate in some parts of the media over the past few weeks have been rather accusatory, polemic and have focussed on the numbers rather than an opportune time for constructive discussion. Dr Chris Lemoh, a consultant infectious disease physician specialising in refugee health in Melbourne, Australia explains: “I always thought each First World baby consumes more resources than one born in poor countries. Yet all the media is about the teeming masses in poor countries”. Explaining further: “All seven billion people could be well-fed, well-housed and healthy if resources were distributed equitably and used ethically. For example, just the money we spend keeping people out, or policing their entry, plus subsidising inefficient and wasteful agriculture practices located where they aren't needed and flinging billions into maintaining and building military forces that increase instability”. In fact, the population debate has longstanding been a contentious issue. Dr Olusimbo Ige, a physician and epidemiologist in Nigeria explains that there are two distinct schools of thought on the population increase, “the optimists think we can always produce more to meet the increasing demand but the pessimists think we are already out paced.” Such reductionist views, focussing solely on numbers reveal a grave oversimplification. Dr Shyam Thapa, from the WHO Department of Reproductive Health and Research is well versed on such matters, with over 20 years of experience. Speaking with Dr Thapa he explains: “In hindsight, those who focused much on the numbers often failed to make a strong case for quality. Rather, they sort of assumed that once the numbers are under control, quality will begin to gain momentum and become stronger”. “It is about both quantity and quality. And, the latter includes equity issues (education, income, rights) as well, that should be the way to analyze the issues and identify solutions and strategies”. Indeed, many of the issues concerning population are interlinked and multi factorial. Professor Williams, medical director of the Hamlin Fistula hospital in Ethiopia, a country with one of the highest maternal and neonatal deaths, believes that Ethiopia's population rise, akin to many poor countries “demonstrates a failure of the availability of contraception and the inequality of health care spending”. Undeniably, the issue of access to contraception is crucial. Roger Ingham is a leading Professor of Sexual health, at Southampton University and considers the availability of adequate sex and relationship education as central. Ingham explains: “Too many of the world's population currently do not have access to basic knowledge about their own bodies, do not have the opportunity to consider their values and exercise their own choices about when to have babies and how many to have, do not have access to safe abortion if that is what they decide is best for them at that time of their lives, and so on.” Professor Ingham calls for the need of a more comprehensive understanding of the impact of “poverty and general education on child-bearing”. In addition, he highlights that in his opinion, “there is no contradiction between having a faith and supporting comprehensive sex and relationships education. Given adequate preparation, people can choose how they wish to exercise that knowledge in line with the values they hold”. This appreciation of the values people hold and being culturally and religiously sensitive is vital, especially in countries which adhere to strongly held views. One case in point is Papua New Guinea, which I visited last year under invitation of Dame Carol Kidu, MP for community development and cherished national champion. Papua New Guinea is a country experiencing a surge in population, a rise from 2.5 to over 6.5 million since independence in 1975; it is also a country that espouses to central Christian beliefs and thus requires sensitivity when discussing population issues. The rising population in Papua New Guinea has contributed to health disparities, such as high infant and maternal mortality as well as the lack of equity of food and education. In fact, the need for equity is perhaps, most clearly visible in the case of humanitarian disasters. Dr Jemilah Mahmood, a senior Research fellow at the Humanitarian Futures Programme, Kings College London states vehemently “Numbers are not what is important, but equity”. “There is enough food production and resources to support the population but is it getting to the most vulnerable?” she asks adamantly. “We need to examine how the seven billion is distributed more closely and the impact of urbanization in particular; how it affects the way we prepare, reduce risks and respond to humanitarian crises”. “Business as usual will not work” she warns. It seems that in an era of seven billion, we need to move beyond the paradigm that focuses exclusively on discussions regarding numbers. The fundamental question one should be asking is whether in such an egalitarian society all seven billion are treated equally? BM
