AFRICA'S POPULATION CHALLENGE: ACCELERATING
PROGRESS IN REPRODUCTIVE HEALTH. James
E. Rosen and Shanti R. Conly. Washington, DC: Population
Action International. 1998. Pp. 82. $ 9.00 paper. ©
Thomas Malthus and Paul Ehrlich would
be delighted with this book which concludes that "Africa's ability
to slow current high rates of population growth is key to achieving
its full potential for development" (p. 77). Rosen and Conly fear
the consequences of growing ranks of Africans: will starvation, famine,
disease and deprivation grow along with the population?
The authors are pleased that certain African countries view family planning
as a form of preventive health care and are moving from curing health
problems to prevention. However, they express dismay that African governments
spend less on health care than on their militaries and seem reluctant
to recover the cost from poor rural families who possess little cash.
Donor nations insist that African nations have exceeded the carrying
capacity of their land and therefore suffer from overpopulation. Any
economic gains will mean less because they must be shared by many people
rather than a few. Thus, Western donors argue that to improve the living
standards of their citizens, African governments should encourage birth
control and family planning.
Anything less will condemn African economies to slow growth and force
the populace to view governments as institutions incapable of delivering
the standards of living promised at independence. The authors urge Africa
to take the easy way out by reducing fertility rates and slowing population
growth. Isn't this faster, cheaper and easier than keeping up with the
needs of a fast growing population? The authors argue that "a rapid
decline in population growth rates would make it much easier for the
continent to achieve food self-sufficiency" (p. 15). They feel
that investing in people is key to progress, but African growth rates
are overwhelming every public service, feeding the cycle of poverty,
poor health, and low educational attainment.
Lester Brown has argued that only 32 countries have achieved population
stability. With the exception of Japan, all are European (Brown, 1999).
Brown argues that Ethiopia, Nigeria and 64 other nations will double
or even triple their populations within the next 50 years. These countries
will face "demographic fatigue" soon.
Yet, the authors are optimistic that their Malthusian views are gaining
popularity in Africa. In 1986, only two African nations even had population
policies. Today more than 25 nations have them and 35 nations think
that their fertility rates are "too high" (p. 23) . To varying
degrees African health services are incorporating family planning into
their national health systems. Private groups such as family planning
associations and the IPPF (International Planned Parenthood Federation)
provide technical experts, information and advice.
Rosen and Conly view family planning as only one aspect of total health
care and encourage family planning clinics to cure sexually transmitted
diseases, as well as prevent their spread by encouraging condom use
for women and for men. Part of the new preventive health care initiative
promoted by family planning clinics in Africa also advises women to
abandon the practice of female circumcision. If incorrectly administered,
it may cause scarring which makes birth difficult and can lead to urinary
tract infection. Thus, Western supported family planning clinics have
discouraged female circumcision. But in countries such as Sierra Leone,
Senegal, or Sudan, where it remains a volatile political issue, the
wisdom of linking eradication of FGM (female genital mutilation) with
family planning seems questionable. Such policies could destroy family
planning programs or set them back decades.
This book is recommended for anyone interested in learning more about
family planning in Africa. It should be useful to health care professionals,
political scientists, anthropologists, economists, sociologists, historians,
public policy experts, aid workers, NGO's, and students of African affairs.
Rosen and Conly provide a great overview of the current state of family
planning, especially for those who feel that Africa can not attack other
problems unless it first controls population growth.
However, readers should be warned that the assumption that population
growth is always a negative has been challenged by economists such as
Julian Simon. He believes that free market capitalism can solve any
problem, even overpopulation. More people create more demand for food,
which stimulates production. This generates larger markets, putting
more wealth into the hands of many more people, and leading to higher
national standards of living. Simon would argue that Malthus was wrong
about nineteenth-century England. Likewise, Rosen and Conly are wrong
about 20th century Africa.
Paul Kennedy's book Preparing for the Twenty-First Century reminds
us that Thomas Malthus worried because population had more than doubled
in the England that he knew. But Kennedy argues that human understanding
grew even faster. New technology and communications helped Europe solve
its population crisis. Perhaps Kennedy is right, more people may simply
mean bigger markets to consume what is produced in Africa, as well as
the U.S. and Europe. Kennedy reminds us that during the nineteenth century,
Britain's population grew fourfold but its productive capacity grew
fourteen fold (Kennedy, p. 8). Rapid population growth was neutralized
by technology and the ultimate resource, "human ingenuity."
The European population explosion posed one challenge which was answered
by another force: technology in the service of capitalist expansion.
Thus, Kennedy argues that rapid population growth does not necessarily
lead to lower standards of living if productivity increases as fast
Is Africa's growing population a blessing or a scourge? While Rosen
and Conly see rapid population growth as a scourge, Simon sees it as
a blessing. Rosen and Conly urge Africa to avoid the needs of a rapidly
growing population through reduction of birth rates. Simon urges Africans
to attack poverty by creating jobs, marketable skills and products to
trade on the international market that people on other continents want
to buy. Through capitalism's unlimited productive potential, Africa
could grow its way out of the population challenge, rather than trying
to make the problem go away. Is this the ultimate challenge of population
in Africa? Time will tell us who is right. When Europe's population
exploded, technology solved its problems. Should we expect any less
Dallas L. Browne
Department of Anthropology
Southern Illinois University
Brown, Lester and Gary Gardner. Beyond
Malthus: Ninetten Dimensions of the Population Challenge. Washington,
D.C. Worldwatch Institute. 1999.
Ehrlich, Paul. The Population Bomb.
Random House. New York. 1968.
Kennedy, Paul. Preparing for the Twenty-First
Century. Vintage Books. A Division of Random House, Inc. New York.
Malthus, Thomas. An Essay on the Principle
of Population As It Affects the Future Improvement of Society. London,
1798; reprinted with notes by J. Bonar, New York. 1965.
Rosen, James E. and Shanti R. Conly.
Africa's Population Challenge: Accelerating Progress in Reproductive
Health. Country Study Series #4. Population Action International.
Washington D.C. 1998.
Simon, Julian. The Ultimate Resource.
Princeton. Princeton University Press. 1981.