Breaking Out or Breaking Down

8/14/2019 Breaking Out or Breaking Down

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Breaking Out or Breaking Downby Lester R. Brown and Brian Halweil

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Reprinted from WORLD WATCH, September/October 1999

1999 Worldwatch Institute

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___148 Natures Cornucopia: Our Stake inPlant Diversity John Tuxill

___147 Reinventing Cities for People andthe Planet Molly OMeara

___146 Ending Violent Conflict Michael Renner

___145 Safeguarding the Health of OceansAnne Platt McGinn

___144 Mind Over Matter: Recasting the Roleof Materials in Our Lives Gary Gardnerand Payal Sampat

___143 Beyond Malthus: Sixteen Dimensions ofthe Population Problem Lester R.Brown, Gary Gardner, and Brian Halweil

___142 Rocking the Boat: Conserving Fisheriesand Protecting JobsAnne Platt McGinn

___141 Losing Strands in the Web of Life:Vertebrate Declines and the Conser-vation of Biological Diversity John Tuxill

___140 Taking a Stand: Cultivating a NewRelationship with the Worlds Forests

Janet N. Abramovitz

___139 Investing in the Future: HarnessingPrivate Capital Flows for Environ-mentally Sustainable DevelopmentHilary F. French

___138 Rising Sun, Gathering Winds: Policiesto Stabilize the Climate and StrengthenEconomies Christopher Flavin and Seth Dunn

___137 Small Arms, Big Impact: The NextChallenge of DisarmamentMichael Renner

___136 The Agricultural Link: How Environ-mental Deterioration Could DisruptEconomic Progress Lester R. Brown

___135 Recycling Organic Waste: From UrbanPollutant to Farm Resource Gary Gardner

___134 Getting the Signals Right: Tax Reformto Protect the Environment and theEconomy David Roodman

___133 Paying the Piper: Subsidies, Politics,and the Environment David Roodman

___132 Dividing the Waters: Food Security,Ecosystem Health, and the NewPolitics of Scarcity Sandra Postel

___131 Shrinking Fields: Cropland Loss in aWorld of Eight Billion Gary Gardner

___130 Climate of Hope: New Strategies forStabilizing the Worlds AtmosphereChristopher Flavin and Odil Tunali

___129 Infecting Ourselves: How Environ-mental and Social Disruptions TriggerDisease Anne E. Platt

___128 Imperiled Waters, Impoverished Future:The Decline of Freshwater Ecosystems

Janet N. Abramovitz

___127 Eco-Justice: Linking Human Rights andthe Environment Aaron Sachs

___126 Partnership for the Planet: An Environ-

mental Agenda for the United NationsHilary F. French

___125 The Hour of Departure: Forces ThatCreate Refugees and Migrants Hal Kane

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20 WORLDWATCH September/October 1999

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On October 12 of this year, the worldshuman population is projected to pass 6billion. The day will be soberly observedby population and development experts,

but media attention will do nothing to immediatelyslow the expansion. During that day, the global total

will swell by another 214,000enough people to filltwo of the worlds largest sports stadiums.

Even as world population continues to climb, it isbecoming clear that the several billion additionalpeople projected for the next half century are notlikely to materialize. What is not clear is how thegrowth will be curtailed. Unfortunately, in somecountries, a slowing of the growth is taking placeonly partly because of success in bringing birth ratesdownand increasingly because of newly emergentconditions that are raising death rates.

Evidence of this shift became apparent in late

October, 1998, when U.N. demographers releasedtheir biennial update of world population projec-tions, revising the projected global population for2050. Instead of rising in the next 50 years by morethan half, to 9.4 billion (as computed in 1996), the1998 projection rose only to 8.9 billion. The goodnews was that two-thirds of this anticipated slow-down was expected to be the result of falling fertili-tyof the decisions of more couples to have fewerchildren. But the other third was due to rising deathrates, largely as a result of rising mortality from

AIDS.This rather sudden reversal in the human death

rate trend marks a tragic new development in worlddemography, which is dividing the developing coun-tries into two groups. When these countriesembarked on the development journey a half centuryor so ago, they followed one of two paths. In thefirst, illustrated by the East Asian nations of South

Korea, Taiwan, and Thailand, early efforts to shift tosmaller families set in motion a positive cycle of risingliving standards and falling fertility. Those countriesare now moving toward population stability.

In the second category, which prevails in sub-Saharan Africa (770 million people) and the Indiansubcontinent (1.3 billion), fertility has remained highor fallen very little, setting the stage for a viciousdownward spiral in which rapid population growthreinforces poverty, and in which some segments ofsociety eventually are deprived of the resources need-ed even to survive. In Ethiopia, Nigeria, and

Pakistan, for example, demographers estimate thatthe next half-century will bring a doubling or near-tripling of populations. Even now, people in theseregions each day awaken to a range of daunting con-ditions that threaten to drop their living standardsbelow the level at which humans can survive.

We now see three clearly identifiable trends thateither are already raising death rates or are likely todo so in these regions: the spread of the HIV virusthat causes AIDS, the depletion of aquifers, and theshrinking amount of cropland available to supporteach person. The HIV epidemic is spiraling out ofcontrol in sub-Saharan Africa. The depletion of

Breaking Out or

Breaking Down

b y L e s t e r R . B r o w n a n d B r i a n H a l w e i l

ILLUSTRATIONS BY JANET HAMLIN

In some parts of the world, the historic trend toward

longer life has been abruptly reversed.


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WORLDWATCH September/October 1999 21

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aquifers has become a major threat to India, where water tables are falling almost everywhere. Theshrinkage in cropland per person threatens to forcereductions in food consumed per person, increasingmalnutritionand threatening livesin many partsof these regions.

Containing one-third of the worlds people, thesetwo regions now face a potentially dramatic shorten-ing of life expectancy. In sub-Saharan Africa, mortal-ity rates are already rising, and in the Indiansubcontinent they could begin rising soon. Withoutclearly defined national strategies for quickly lower-ing birth rates in these countries, and without a com-mitment by the international community to supportthem in their efforts, one-third of humanity couldslide into a demographic black hole.

Birth and DeathSince 1950, we have witnessed more

growth in world population than during thepreceding 4 million years since our humansancestors first stood upright. This post-1950explosion can be attributed, in part, to sev-eral developments that reduced deathrates throughout the developing

world. The wider availability ofsafe drinking water, childhoodimmunization programs, antibi-otics, and expanding food pro-

duction sharply reduced thenumber of people dying ofhunger and from infectiousdiseases. Together thesetrends dramatically low-ered mortality levels.

But while death ratesfell, birth rates remainedhigh. As a result, inmany countries, popula-tion growth rose to 3percent or more per

yearrates for which therewas no historical precedent. A 3percent annual increase in popula-tion leads to a twenty-fold increase

within a century. Ecologists havelong known that such rates of popu-lation growthwhich have now beensustained for close to half a century in many coun-triescould not be sustained indefinitely. At somepoint, if birth rates did not come down, disease,hunger, or conflict would force death rates up.

Although most of the world has succeeded inreducing birth rates to some degree, only some 32

countriescontaining a mere 12 percent of theworlds peoplehave achieved population stability.In these countries, growth rates range between 0.4percent per year and minus 0.6 percent per year. Withthe exception of Japan, all of the 32 countries are inEurope, and all are industrial. Although other indus-trial countries, such as the United States, are stillexperiencing some population growth as a result ofa persistent excess of births over deaths, the popula-tion of the industrial world as a whole is not project-ed to grow at all in the next centuryunless,perhaps, through the arrival of migrants from morecrowded regions.

Within the developing world, the most impressiveprogress in reducing fertility has come in East Asia.South Korea, Taiwan, and Thailand have all reducedtheir population growth rates to roughly one percentper year and are approaching stability. (See table, next

page.) The biggest country in LatinAmericaBrazilhas reduced its popula-

tion growth to 1.4 percent per year. Mostother countries in Latin America are alsomaking progress on this front. In con-trast, the countries of sub-Saharan Africa and the Indian subcontinenthave lagged in lowering growth rates,and populations are still rising omi-

nouslyat rates of 2 to 3percent or more per year.

Graphically illustrating

this contrast areThailand and Ethiopia,each with 61 millionpeople. Thailand isprojected to add 13million people overthe next half centuryfor a gain of 21 per-cent. Ethiopia, mean-

while, is projected toadd 108 million for again of 177 percent.

(The U.N.s projectionsare based on such factorsas the number of children

per woman, infant mortality,and average life span in each

countryfactors that couldchange in time, but meanwhile

differ sharply in the two countries.) The deep povertyamong those living in sub-Saharan Africa and theIndian subcontinent has been a principal factor in theirrapid population growth, as couples lack access to thekinds of basic social services and education that allowcontrol over reproductive choices. Yet, the population


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growth, in turn, has only worsened their povertyperpetuating a vicious cycle in which hopes of break-ing out become dimmer with each passing year.

After several decades of rapid population growth,governments of many developing countries are sim-ply being overwhelmed by their crowdingand aresuffering from what we term demographic fatigue.The simultaneous challenges of educating growing

numbers of children, creating jobs for the swellingnumbers of young people coming into the job mar-

ket, and confronting such environmental conse-quences of rapid population growth as deforestation,soil erosion, and falling water tables, are underminingthe capacity of governments to cope. When a majornew threat arises, as has happened with the HIV

virus, governments often cannot muster the leader-ship energy and fiscal resources to mobilize effective-ly. Social problems that are easily contained inindustrial societies can become humanitarian disastersin many developing ones. As a result, some of the lat-ter may soon see their population growth curvesabruptly flattened, or even thrown into decline, not

because of falling birth rates but because of fast-risingdeath rates. In some countries, that process hasalready begun.

Shades of the Black Death

Industrial countries have held HIV infection ratesunder 1 percent of the adult population, but in manysub-Saharan African countries, they are spiralingupward, out of control. In Zimbabwe, 26 percent ofthe adult population is infected; in Botswana, the rateis 25 percent. In South Africa, a country of 43 millionpeople, 22 percent are infected. In Namibia,

Swaziland, and Zambia, 18 to 20 percent are. (Seetable, opposite page.) In these countries, there is littleto suggest that these rates will not continue to climb.

In other African nations, including some withlarge populations, the rates are lower but climbingfast. In both Tanzania, with 32 million people, andEthiopia, with its 61 million, the rate is now 9 per-cent. In Nigeria, the continents largest country with

111 million people, thelatest estimate now putsthe infection rate also at 9percent and rising.

What makes this pic-ture even more disturbingis that most Africans carry-ing the virus do not yetknow they are infected,

which means the diseasecan gain enormousmomentum in areas where

it is still largely invisible.This, combined with thesocial taboo that surroundsHIV/AIDS in Africa, hasmade it extremely difficultto mount an effective con-trol effort.

Barring a medical mir-acle, countries such asZimbabwe, Botswana, and

South Africa will lose at least 20 percent of their adultpopulations to AIDS within the next decade, simply

because few of those now infected with the virus canafford treatment with the costly antiviral drugs nowused in industrial countries. To find a precedent forsuch a devastating region-wide loss of life from aninfectious disease, we have to go back to the decima-tion of Native American communities by the intro-duction of small pox in the sixteenth century fromEurope or to the bubonic plaque that claimed rough-ly a third of Europes population in the fourteenthcentury (see table, page 24).

Reversing Progress

The burden of HIV is not limited to those infect-ed, or even to their generation. Like a powerfulstorm or war that lays waste to a nations physicalinfrastructure, a growing HIV epidemic damages anations social infrastructure, with lingering demo-graphic and economic effects. A viral epidemic thatgrows out of control is likely to reinforce many of the

very conditionspoverty, illiteracy, malnutritionthat gave it an opening in the first place.

Using life expectancythe sentinel indicator ofdevelopmentas a measure, we can see that the HIV

virus is reversing the gains of the last several decades.

1999 2050 Growth From 1999 to 2050

(millions) (millions) (percent)

Developing Countries That Have Slowed Population Growth:

South Korea 46 51 5 + 11Taiwan 22 25 3 + 14

Thailand 61 74 13 + 21

Developing Countries Where Rapid Population Growth Continues:

Ethiopia 61 169 108 +177Nigeria 109 244 135 +124Pakistan 152 345 193 +127

Source: United Nations, Global Population Projections, 1998.

Projected Population Growth in Selected DevelopingCountries, 1999 to 2050


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For example, in Botswana life expectancy has fallenfrom 61 years in 1990 to 44 years in 1999. By 2010,it is projected to drop to 39 yearsa life expectancymore characteristic of medieval times than of what wehad hoped for in the twenty-first century.

Beyond its impact on mortality, HIV also reducesfertility. For women, who live on average scarcely 10

years after becoming infected, many will die longbefore they have reached the end oftheir reproductive years. As the symp-toms of AIDS begin to develop,

women are less likely to conceive. Forthose who do conceive, the likelihoodof spontaneous abortion rises. Andamong the reduced number who dogive birth, an estimated 30 percent ofthe infants born are infected and anadditional 20 percent are likely to beinfected before they are weaned. Forbabies born with the virus, life

expectancy is less than 2 years. Therate of population growth falls, butnot in the way any family-planninggroup wants to see.

One of the most disturbing socialconsequences of the HIV epidemic isthe number of orphans that it pro-duces. Conjugal sex is one of thesurest ways to spread AIDS, so if oneparent dies, there is a good chance theother will as well. By the end of 1997,there were already 7.8 million AIDS

orphans in Africaa new and rapidlygrowing social subset. The burden ofraising these AIDS orphans falls firston the extended family, and then on society at large.Mortality rates for these orphans are likely to bemuch higher than the rates for children whose par-ents are still with them.

As the epidemic progresses and the symptomsbecome visible, health care systems in developingcountries are being overwhelmed. The estimated costof providing antiviral treatment (the standard regi-men used to reduce symptoms, improve life quality,

and postpone death) to all infected individuals inMalawi, Mozambique, Uganda, and Tanzania wouldbe larger than the GNPs of those countries. In somehospitals in South Africa, 70 percent of the beds areoccupied by AIDS patients. In Zimbabwe, half thehealth care budget now goes to deal with AIDS. As

AIDS patients increasingly monopolize nurses anddoctors schedules, and drain funds from health carebudgets, the capacity to provide basic health care tothe general populationincluding the immunizationsand treatments for routine illnesses that have under-pinned the decline in mortality and the rise in lifeexpectancy in developing countriesbegins to falter.

Worldwide, more than half of all new HIV infec-tions occur in people between the ages of 15 and24an atypical pattern for an infectious disease.Human scourges have historically spread throughrespiratory exposure to coughing or sneezing, orthrough physical contact via shaking hands, foodhandling, and so on. Since nearly everyone is vulner-able to such exposure, the victims of most infectious

diseases are simply those among society at large whohave the weakest immune systemsgenerally the

very young and the elderly. But with HIV, becausethe primary means of transmission is unprotectedsexual activity, the ones who are most vulnerable toinfection are those who are most sexually active

young, healthy adults in the prime of their lives. According to a UNAIDS report, the bulk of theincrease in adult death is in the younger adult ages

a pattern that is common in wartime and has becomea signature of the AIDS epidemic, but that is other-wise rarely seen.

One consequence of this adult die-off is anincrease in the number of children and elderly whoare dependent on each economically productiveadult. This makes it more difficult for societies to saveand, therefore, to make the investments needed toimprove living conditions. To make matters worse, in

Africa it is often the better educated, more sociallymobile populations who have the highest infectionrate. Africa is losing the agronomists, the engineers,and the teachers it needs to sustain its economic

Country Population Share of Adult Population Infected

(millions) (percent)

Zimbabwe 11.7 26Botswana 1.5 25

South Africa 43.3 22Namibia 1.6 20

Zambia 8.5 19Swaziland 0.9 18Malawi 10.1 15Mozambique 18.3 14

Rwanda 5.9 13Kenya 28.4 12Central African Republic 3.4 11Cote dIvoire 14.3 10

Source: UNAIDS

Countries Where HIV Infection Rate Among AdultsIs Greater Than Ten Percent


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development. In South Africa, for example, at theUniversity of Durban-Westville, where many of thecountrys future leaders are trained, 25 percent of thestudents are HIV positive.

Countries where labor forces have such highinfection levels will find it increasingly difficult toattract foreign investment. Companies operating in

countries with high infection rates face a doubling,tripling, or even quadrupling of their health insur-ance costs. Firms once operating in the black sud-denly find themselves in the red. What has begun asan unprecedented social tragedy is beginning totranslate into an economic disaster. Municipalitiesthroughout South Africa have been hesitant to pub-licize the extent of their local epidemics or scale upcontrol efforts for fear of deterring outside invest-ment and tourism.

The feedback loops launched by AIDS may bequite predictable in some cases, but could also desta-

bilize societies in unanticipated ways. For example,where levels of unemployment are already highthepresent situation in most African nationsa growingpopulation of orphans and displaced youths couldexacerbate crime. Moreover, a country in which asubstantial share of the population suffers fromimpaired immune systems as a result of AIDS is muchmore vulnerable to the spread of other infectious dis-eases, such as tuberculosis, and waterborne illness. InZimbabwe, the last few years have brought a rapidrise in deaths due to tuberculosis, malaria, and eventhe bubonic plagueeven among those who are not

HIV positive. Even without such synergies, in the

early years of the next century, the HIV epidemic ispoised to claim more lives than did World War II.

Sinking Water Tables

While AIDS is already raising death rates in sub-Saharan Africa, the emergence of acute water short-

ages could have the same effect in India. Aspopulation grows, so does the need for water. Hometo only 358 million people in 1950, India will passthe one-billion mark later this year. It is projected toovertake China as the most populous nation aroundthe year 2037, and to reach 1.5 billion by 2050.

As Indias population has soared, its demand forwater for irrigation, industry, and domestic use hasclimbed far beyond the sustainable yield of the coun-trys aquifers. According to the International WaterManagement Institute (IWMI), water is beingpumped from Indias aquifers at twice the rate the

aquifers are recharged by rainfall (see Sandra Postelsarticle in this issue). As a result, water tables arefalling by one to three meters per year almost every-

where in the country. In thousands of villages, wellsare running dry.

In some cases, wells are simply drilled deeperifthere is a deeper aquifer within reach. But many vil-lages now depend on trucks to bring in water forhousehold use. Other villages cannot afford suchdeliveries, and have entered a purgatory of decliningoptionslacking enough water even for basichygiene. In Indias western state of Gujarat, water

tables are falling by as much as five meters per year,

Description of Plague andEpidemic and Date Mode of Introduction and Spread Its Effects on Population

Black Death Originating in Asia, the plague bacteria One fourth of the population of Europe

in Europe, moved westward via trade routes, entering was wiped out (an estimated 25 million14th century Europe in 1347; transmitted via rats as well deaths); old, young, and poor hit hardest.

as coughing and sneezing.

Smallpox in the Spanish conquistadors and European Decimated Aztec, Incan, and native Ameri-New World, colonists introduced virus into the can civilizations, killing 10 to 20 million.16th century Americas, where it spread through

respiratory channels and physical contact.

HIV/AIDS, Thought to have originated in Africa; a More than 14 million deaths worldwide worldwide, primate virus that mutated and spread to thus far; an additional 33 million1980 to present infect humans; transmitted by the exchange infected; one-fifth of adult population

of bodily fluids, including blood, semen, infected in several African nations; strikes

and breast milk. economically active population hardest.

Source: Jared Diamond, Guns, Germs, and Steel: The Fates of Human Societies , 1997; UNAIDS.

Profiles of Major Epidemics Throughout Human History


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and farmers now have to drill their wells down tobetween 700 and 1200 feet to reach the recedingsupply. Only the more affluent can afford to drill tosuch depths.

Although irrigation goes back some 6,000 years,aquifer depletion is a rather recent phenomenon. It isonly within the last half century or so that the avail-ability of powerful diesel and electric pumps hasmade it possible to extract water at rates that exceedrecharge rates. Little is known about the total capac-ity of Indias underground supply, but the unsustain-ability of the current consumption is clear. If thecountry is currently pumping water at double the rateat which its aquifers recharge, for example, we knowthat when the aquifers are eventually depleted, therate of pumping will necessarily have to be reduced tothe recharge ratewhich would mean that theamount of water pumped would be cut in half. Withat least 55 percent of Indias grain production nowcoming from irrigated lands, IWMI speculates that

aquifer depletion could reduce Indias harvest byone-fourth. Such a massive cutback could prove cat-astrophic for a nation where 53 percent of the chil-dren are already undernourished and underweight.

Impending aquifer depletion is not unique toIndia. It is also evident in China, North Africa andthe Middle East, as well as in large tracts of theUnited States. However, in wealthy Kuwait or Saudi

Arabia, precariously low water availability per personis not life-threatening because these countries caneasily afford to import the food that they cannot pro-duce domestically. Since it takes 1,000 tons of water

to produce a ton of grain, the ability to import foodis in effect an ability to import water. But in poornations, like India, where people are immediatelydependent on the natural-resource base for subsis-tence and often lack money to buy food, they are lim-ited to the water they can obtain from theirimmediate surroundingsand are much moreendangered if it disappears.

In Indiaas in other nationspoorer farmers arethus disproportionately affected by water scarcity,since they often cannot get the capital or credit toobtain bigger pumps necessary to extract water from

ever-greater depths. Those farmers who can nolonger deepen their wells often shift their croppingpatterns to include more water-efficientbut lower-

yieldingcrops, such as mustard, sorghum, or millet.Some have abandoned irrigated farming altogether,resigning themselves to the diminished productivitythat comes with depending only on rainfall.

When production drops, of course, poverty deep-ens. When that happens, experience shows that mostpeople, before succumbing to hunger or starvation,

will migrate. On Gujarats western coast, for exam-ple, the overpumping of underground water has ledto rapid salt-water intrusion as seawater seeps in to fill

the vacuum left by the freshwater. The groundwaterhas become so saline that farming with it is impossi-ble, and this has driven a massive migration of farm-ers inland in search of work.

Village communities in India tend to be ratherinsular, so that these migrantsuprooted from theirhomescannot take advantage of the social safetynet that comes with community and family bonds.Local housing restrictions force them to camp in thefields, and their access to village clinics, schools, andother social services is restricted. But while attempt-ing to flee, the migrants also bring some of theirtroubles along with them. Navroz Dubash, aresearcher at the World Resources Institute whoexamined some of the effects of the water scarcity inGujarat, notes that the flood of migrants depressesthe local labor markets, driving down wages anddiminishing the bargaining power of all landlesslaborers in the region.

In the web of feedback loops linking health and

water supply, another entanglement is that when thequantityof available water declines, the qualityof the

water, too, may decline, because shrinking bodies ofwater lose their efficacy in diluting salts or pollutants.In Gujarat, water pumped from more than 700 feetdown tends to have an unhealthy concentration ofsome inorganic elements, such as fluoride. As vil-lagers drink and irrigate with this contaminated

water, the degeneration of teeth and bones known asfluorosis has emerged as a major health threat.Similarly, in both West Bengal, India and Bangladesh,receding water tables have exposed arsenic-laden sed-

iments to oxygen, converting them to a water-solubleform. According to UNDP estimates, at least 30 mil-lion people are exposed to health-impairing levels ofarsenic in their drinking water.

As poverty deepens in the rural regions of Indiaand is driven deeper by mutually exacerbating healththreats and water scarcitiesmigration from rural tourban areas is likely to increase. But for those wholeave the farms, conditions in the cities may be no bet-ter. If water is scarce in the countryside, it is also likelyto be scarce in the squatter settlements or other urbanareas accessible to the poor. And where water is scarce,

access to adequate sanitation and health services ispoor. In most developing nations, the incidence ofinfectious diseases, including waterborne microbes,tuberculosis, and HIV/AIDS, is considerably higher inurban slumswhere poverty and compromised healthdefine the way of lifethan in the rest of the city.

In India, with so many of the children under-nourished, even a modest decline in the countrysability to produce or purchase food is likely toincrease child mortality. With Indias populationexpected to increase by 100 million people perdecade over the next half century, the potential loss-es of irrigation water pose an ominous specter not


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In the first case, Homer-Dixon finds that over thelast few decades, land scarcity has caused millions ofBangladeshis to migrate to the Indian states of Assam,Tripura, and West Bengal. These movements expand-ed in the late 1970s after several years of flooding inBangladesh, when population growth had reducedthe grainland per person in Bangladesh to less than0.08 hectares. As the average persons share of crop-land began to shrink below the survival level, the lureof somewhat less densely populated land across theborder in the Indian state of Assam became irre-

sistible. By 1990, more than 7 million Bangladeshishad crossed the border, pushing Assams populationfrom 15 million to 22 million. The new immigrants inturn exacerbated land shortages in the Indian states,setting off a string of ethnic conflicts that have so farkilled more than 5,000 people.

In the second case, Homer-Dixon and a col-league, Peter Gizewski, studied the massive rural-to-urban migration that has taken place in recent yearsin Pakistan. This migration, combined with popula-tion growth within the cities, has resulted in stagger-ing urban growth rates of roughly 5 percent a year.

Karachi, Pakistans coastal capital, has seen its popu-

lation balloon to 11 million. Urban services havebeen unable to keep pace with growth, especially forlow-income dwellers. Shortages of water, sanitation,health services and jobs have become especially acute,leading to deteriorating public health and growingimpoverishment.

This migration. . . aggravates tensions and vio-lence among diverse ethnic groups, according toHomer-Dixon and Gizewski. This violence, in turn,threatens the general stability of Pakistani society.The cities of Karachi, Hyderabad, Islamabad, and

Rawalpindi, in particular, have become highlyvolatile, so that an isolated, seemingly chance inci-dentsuch as a traffic accident or short-term break-down in servicesignites explosive violence. In1994, water shortages in Islamabad provoked wide-spread protest and violent confrontation with policein hard-hit poorer districts.

Without efforts to step up family planning inPakistan, these patterns are likely to be magnified.Population is projected to grow from 146 milliontoday to 345 million in 2050, shrinking the grainlandarea per person in Pakistan to a miniscule 0.036

hectares by 2050less than half of what it is today. A

2When people of parenting age die, the elderly are often left alone to care for thechildren. Meanwhile, poverty worsens with the loss of wage-earners. In other situa-tions, poverty is worsened by declines in the amounts of productive land or freshwater available to each person and here, too, death may take an unnatural toll.


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family of six will then have to produce its food onroughly one-fifth of a hectare, or half an acrethe

equivalent of a small suburban building lot in theUnited States.

Similar prospects are in the offing for Nigeria,where population is projected to double to 244 mil-lion over the next half century, and in Ethiopia,

where population is projected to nearly triple. Inboth, of course, the area of grainland per person willshrink dramatically. In Ethiopia, if the projected pop-ulation growth materializes, it will cut the amount ofcropland per person to one-third of its current 0.12hectares per persona level at which already morethan half of the countrys children are undernour-

ished. And even as its per capita land shrinks, its long-term water supply is jeopardized by the demands ofnine other rapidly growing, water-scarce nationsthroughout the Nile River basin. But even these pro-

jections may underestimate the problem, becausethey assume an equitable distribution of land amongall people. In reality, the inequalities in land distribu-tion that exist in many African and South Asiannations mean that as the competition for decliningresources becomes more intense, the poorer andmore marginal groups face even harsher deprivationsthan the averages imply.

Moreover, in these projections we have assumed

that the total grainland area over the next half-centu-ry will not change. In reality this may be overly opti-

mistic simply because of the ongoing conversion ofcropland to nonfarm uses and the loss of croplandfrom degradation. A steadily growing populationgenerates a need for more homes, schools, and facto-ries, many of which will be built on once-productivefarmland. Degradation, which may take the form ofsoil erosion or of the waterlogging and salinization ofirrigated land, is also claiming cropland.

Epidemics, resource scarcity, and other societalstresses thus do not operate in isolation. Several dis-ruptive trends will often intersect synergistically,compounding their effects on public health, the envi-

ronment, the economy, and the society. Such combi-nations can happen anywhere, but the effects arelikely to be especially perniciousand sometimesdangerously unpredictablein such places asBombay and Lagos, where HIV prevalence is on therise, and where fresh water and good land are increas-ingly beyond the reach of the poor.

Regaining Control of Our Destiny

The threats from HIV, aquifer depletion, andshrinking cropland are not new or unexpected. Wehave known for at least 15 years that the HIV virus

Overwhelmed by multiple attacks on its health, the society falls deeper intopoverty and as the cycle continues, more of its people die prematurely.3


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could decimate human populations if it is not con-trolled. In each of the last 18 years, the annual num-ber of new HIV infections has risen, climbing froman estimated 200,000 new infections in 1981 tonearly 6 million in 1998. Of the 47 million peopleinfected thus far, 14 million have died. In the absenceof a low-cost cure, most of the remaining 33 million

will be dead by 2005.It may seem hard to believe, given the advanced

medical knowledge of the late twentieth century, thata controllable disease is decimating human popula-tions in so many countries. Similarly, it is hard tounderstand how falling water tables, which mayprove an even greater threat to future economicprogress, could be so widely ignored.

The arithmetic of emerging resource shortages isnot difficult. The mystery is not in the numbers, butin our failure to do what is needed to prevent suchthreats from spiraling out of control.

Todays political leaders show few signs of com-

prehending the long-term consequences of persistentenvironmental and social trends, or of the intercon-nectedness of these trends. Despite advances in ourunderstanding of the complexoften chaoticnature of biological, ecological, and climatologicalsystems, political thought continues to be dominatedby reductionist thinking that fails to target the rootcauses of problems. As a result, political action focus-es on responses to crises rather than prevention.

Leaders who are prepared to meet the challengesof the next century will need to understand that uni-

versal access to family planning not only is essential to

coping with resource scarcity and the spread ofHIV/AIDS, but is likely to improve the quality of lifefor the citizens they serve. Family planning compris-es wide availability of contraception and reproductivehealthcare, as well as improved access to educationalopportunities for young women and men. Lowerbirth rates generally allow greater investment in eachchild, as has occurred in East Asia.

Leaders all over the worldnot just in Africa andAsianow need to realize that the adverse effects ofglobal population growth will affect those living innations such as the United States or Germany, that

seem at first glance to be relatively protected from theravages now looming in Zimbabwe or Ethiopia.Economist Herman Daly observes that whereas inthe past surplus labor in one nation had the effect ofdriving down wages only in that nation, global eco-nomic integration will be the means by which theconsequences of overpopulation in the Third Worldare generalized to the globe as a whole. Large infu-sions of job-seekers into Brazils or Indias work forcethat may lower wages there may now also mean largeinfusions into the global workforce, with potentiallysimilar consequences.

As the recent Asian economic downturn further

demonstrates, localized instability is becoming ananachronistic concept. The consequences of socialunrest in one nation, whether resulting from a cur-rency crisis or an environmental crisis, can quicklycross national boundaries. Several nations, includingthe United States, now recognize world populationgrowth as a national security issue. As the U.S.Department of State Strategic Plan, issued inSeptember 1997, explains, Stabilizing populationgrowth is vital to U.S. interests . . . . Not only willearly stabilization of the worlds population promoteenvironmentally sustainable economic developmentin other countries, but it will benefit the UnitedStates by improving trade opportunities and mitigat-ing future global crises.

One of the keys to helping countries quickly slowpopulation growth, before it becomes unmanage-able, is expanded international assistance for repro-ductive health and family planning. At the UnitedNations Conference on Population and Develop-

ment held in Cairo in 1994, it was estimated that theannual cost of providing quality reproductive healthservices to all those in need in developing countries

would amount to $17 billion in the year 2000. By2015, the cost would climb to $22 billion.

Industrial countries agreed to provide one-thirdof the funds, with the developing countries providingthe remaining two-thirds. While developing countrieshave largely honored their commitments, the indus-trial countriesand most conspicuously, the UnitedStateshave reneged on theirs. And in late 1998, theU.S. Congressmired in the quicksand of anti-abor-

tion politicswithdrew all funding for the U.N.Population Fund, the principal source of internation-al family planning assistance. Thus was thrown asidethe kind of assistance that helps both to slow popula-tion growth and to check the spread of the HIV virus.

In most nations, stabilizing population willrequire mobilization of domestic resources that maynow be tied up in defense expenditures, crony capi-talism or government corruption. But without out-side assistance, many nations may still struggle toprovide universal family planning. For this reason,delegates at Cairo agreed that the immense resources

and power found in the First World are indispensablein this effort. And as wealth further consolidates inthe North and the number living in absolute povertyincreases in the South, the argument for assistancegrows more and more compelling. Given the socialconsequences of one-third of the world heading intoa demographic nightmare, failure to provide suchassistance is unconscionable.

Lester Brown is president of the WorldwatchInstitute and Brian Halweil is a staff researcher at theInstitute.

Documents

Breaking Out or Breaking Down