Editorial, December
2007
Association of
Reproductive Health Professionals
Family
Planning and Access to Safe and Legal Abortion are Vital to Safeguard
the Environment
Alarming signs
of environmental deterioration include global warming, extinction
of species, waning forests and cropland, the collapse of ocean
fisheries and decreasing fresh water supplies.
Yet, little
attention is paid to the connection between these tragedies and
their most fundamental cause: overuse of the planet's resources
due to the large and still rapidly increasing number of humans
and our excessive consumption.
North America
appeared to have limitless resources to the new European immigrants
in centuries past (who ignored the needs and stewardship of their
indigenous predecessors). More recently, tapping the energy of
fossil fuels has allowed us to better master time and space. Harnessing
highly productive plants such as potatoes and hybrid corn, along
with other agricultural advances, have increased productivity
to the extent that one farmer can produce food for more than 100
people, allowing the rest of us to focus on other activities.
Fortunately,
most people no longer believe that the earth's resources are limitless.
But how does one determine when these limits are reached? One
valid way of quantifying our use of resources is by calculating
our ecological footprint1 (EF)1. This concept is based on the
understanding that all human activities require space — to
live on, to grow food on, for developing resources, and for disposal
of waste. Some people have much larger footprints than others.
The amount of
surface area on the earth is fixed and the planet's entire surface
is not equally useful. If one leaves a small proportion for the
benefit of other animals and plants, there remain about 11 trillion
hectares (28 trillion acres) of “bioproductive” land
and water. Since there are 6.6 billion people on the planet, the
allotment for each human is about 1.8 hectares (4.4 acres).
Ecological footprint
can be calculated by using readily available figures for a country's
population, its gross production and utilization of key resources
or by using the EF website (www.ecofoot.net), which provides information
on the EF of individuals in many countries, as well as the means
to calculate one's own EF.
Using these
calculations, we find that people are using an average of 2.2
hectares (5.5 acres) of the planet's resources per person, a full
0.5 hectares (1.1 acres) more than our fair share. The overuse
is much more marked in richer countries such as the United States,
which has the largest EF. The worldwide overshoot of 30% helps
to explain environmental deterioration.
The recent UN-sponsored
Millennium Ecosystem Assessment examined the effects of ecosystem
change on human health and well-being.2 It found that humans have
changed ecosystems more rapidly and extensively over the past
50 years than during any other period, primarily to meet increasing
demands for food, fresh water, timber, fiber and fuel. Sixty percent
of ecosystem services — the benefits people obtain from ecosystems
— are being degraded or used unsustainably.2
The more people
there are and the more each consumes, the worse the deterioration.
Ultimately, the condition of the planet may reach a level at which
it will be unable to fully support the human population, causing
deaths by starvation, disease and conflict.3
Because our
children and grandchildren will suffer, limiting human numbers
and consumption have become moral issues, if not issues of life
or death. Fortunately, many couples want to limit their childbearing
far below their current fertility. What is missing is access to
good family planning.
In recent years,
the field of reproductive health has focused on the worthy goal
of ensuring that family planning programs are voluntary, respond
to the needs of individual women and men and address the HIV/AIDS
epidemic. Less attention has been paid to the consequences of
rapid population growth for the environment and economic development,
stemming in part from the political dominance of a largely antiabortion
and antienvironmental administration and Congress in the United
States.
The substantial
decline in world birth rates over the past 50 years is a family
planning success story, but it has lulled our sense of urgency
toward increasing annual population growth. In 1950, the world's
population was 2.6 billion; the lifetime average number of children
per woman (total fertility rate, or TFR) was 5.3; and annual population
growth was 48 million.4 Since then, the TFR has decreased to 2.6,
and death rates have declined. This is good news. Unfortunately,
world population has increased to 6.6 billion, and about 78 million
people are now added to the world each year.4
Most of worldwide
population growth will be caused by population momentum —
resulting from large numbers of people entering their childbearing
years — and by unintended or unwanted pregnancy.5 Of 210
million pregnancies annually worldwide, 80 million (38%) are unplanned,
and 46 million (22%) end in abortion.6
More than 200
million women in developing countries would like to delay their
next pregnancy — or stop bearing children altogether —
but rely on traditional, less effective methods of contraception
(64 million) or use no method because they lack access or face
other barriers to using contraception (137 million).7 These barriers
include cultural values that support high fertility, opposition
to use of contraception by family members, and fears about health
risks or side effects of contraception.8
In contrast
to almost all other developed countries, the United States —
the world's third largest country — is experiencing rapid
population growth of nearly three million each year.9 The United
States is projected to grow from 303 million in 2007 to nearly
350 million in 2025 and to 420 million by 2050.10 An estimated
1.4 million of 4.1 million annual US births result from unintended
pregnancy. The other 2.7 million are largely offset by the 2.4
million annual deaths.11 Even with immigration contributing more
than one million people annually, unintended pregnancy is the
source of about half of annual population growth in the United
States.
1. We must improve
access to family planning and safe, legal abortion
According to
Dr. Malcolm Potts: “All societies with unconstrained access
to fertility regulation, including abortion, experience a rapid
decline to replacement levels of fertility, and often lower”.12
The development and introduction of modern contraceptives and
the establishment of organized family planning programs have helped
reduce the TFR of developing countries by half, from 6.0 in 1960
to 3.1.13 But a high unmet need for family planning and safe abortion
services persists.6
2. International
challenges
Recent increases
in assistance for HIV/AIDS are welcome. Unfortunately, donor funding
dedicated to family planning activities decreased in absolute
dollar amounts from $723 million in 1995 to $442 million in 2004,
while funds for STI/HIV/AIDS increased 22-fold to $2.7 billion.
Family planning assistance in 2004 reached only 9% of a 2005 $5
billion annual target.14,15,16,17
3. US challenges
Unintended pregnancy
remains a major problem in the United States, especially for low-income
women. Comprehensive sexuality education — which could help
prevent pregnancy and is favored by a majority of parents and
educational experts — is being replaced by ineffective “abstinence
unless married” programs.
Inflation-adjusted
funding for Title X — the nation's only distinct, federally
funded family planning program — has declined by half since
1980.18 With 17 million women reliant on publicly funded contraceptive
services, an annual expenditure of about $3.5 billion is needed.14,19
But in 2001, public outlays were only $1.26 billion — about
one third of the total required.19
There is almost
no governmental support for research on abortion technologies,
and governmental support for research on contraception has decreased
in the last decade. Even the pharmaceutical industry and private
foundations have decreased or stopped funding in these fields.
4. An agenda
for action
We need to:
* Fully fund
and strengthen reproductive health programs, including programs
that address the HIV/AIDS epidemic.
* Provide comprehensive information about human sexuality and
affordable, high-quality family planning and safe abortion services
for all, including young people and the unmarried.
* Invest in research on contraceptive and abortion technologies
to overcome issues relating to effectiveness, safety, cost, acceptability
and side effects that hamper use of current methods.
Better reproductive
health care and decreased population pressures will not suffice
to preserve the environment. There is also an urgent need for
people — particularly in the United States — to reduce
consumption of critical natural resources and decrease the resulting
waste and pollution. We also need to change our concept of economic
progress that is seemingly based upon ever-expanding consumption.
Redefining Progress (www.redefiningprogress.org) and Brown20 provide
other economic models that deemphasize production of material
goods and place greater value on ecological services and preservation
of natural resources.
The health and
other welfare benefits of preventing unintended pregnancy are
felt most keenly by individual women, men and their families.
At the same time, increased access to family planning in all countries,
combined with measures to reduce consumption in wealthier nations,
offer a powerful strategy for helping ensure environmental sustainability.14,21
J. Joseph Speidel
University of California, San Francisco
San Francisco, CA
Richard A. Grossman
University of Colorado
Durango, CO
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