On World Health Day, paediatrics expert Peter Le Souëf explains why unsustainable population growth hurts children the most and calls for placing current and future child welfare at the centre of the need to combat overpopulation.

Despite obvious and overwhelming evidence that almost every aspect of our planet has been damaged by billions of humans, governments and global health organisations have embraced the need for action to stop humans damaging the planet, but ignored calls for similar strong action to combat overpopulation. One problem they would be unable to ignore is the effect of an increasingly overpopulated planet on the health of children, since children face a dire future as the group most affected by both environmental change and overpopulation. Indeed, authorities report that children will bear up to 90% of the impact of climate change on human health. As a sentient species, care for the health and welfare of future generations of our children should be the strongest guide to our moral compass.

Almost every aspect of the current environmental decline affects children disproportionately. The effects on children are most evident in low- and middle-income countries that already do not have sufficient resources to counter the effects of climate change. In addition, these countries are currently unable to produce enough food to prevent widespread childhood malnutrition. This problem will worsen as climate change intensifies and reduces crop yields, and these countries will not have the resources to counter this. Nor are they well-placed to be able to protect children from the direct effects of higher temperatures, deteriorating air quality, and reduced freshwater resources. Compounding these problems is that higher population densities themselves will further compromise the health of the natural environment, creating a vicious circle and accelerating adverse impacts on children’s health.

Climate change has been taken very seriously with massive efforts being made to counter it. Why hasn’t overpopulation been given similar prominence? There are likely to be several reasons for this. Firstly, authoritarian attempts to forcibly control population in some countries last century not unreasonably created a backlash against ‘population control’. This may also have resulted in high-income countries not wanting to help fund family planning education and services in low- and middle-income countries for fear of being seen to be advocating population control. In addition, in high-income countries, exponential growth in population is seen by economists and politicians as an important driver of economic growth, with no concern that this is a ‘Ponzi’ scheme that must eventually collapse when ‘capital’ (in the form of environmental resources) dries up. A further problem is that some religions actively discourage the use of modern contraceptives.

Putting the health and welfare of future children at the centre of the need to counter overpopulation creates a strong moral case for overpopulation to be taken seriously. Addressing overpopulation appropriately does not need to be controversial. Providing free, non-coercive, readily available, culturally acceptable, locally sensitive family planning education and services for men and women can be seen as addressing a human right. Such services provide men and women with the opportunity to have a family the size they want, and in many low- and middle-income countries have been shown to correlate well with lower fertility rates. Reducing fertility rates can be expected to reduce disease and death in children by reductions within families (given that mortality rates increase with increasing numbers of children per family) and within societies (given that low- and middle-income countries are unable to provide a healthy environment for current numbers of children and will be less able to cope with increasing numbers). Over the remainder of this century, this is likely to stop the death of millions of children. It will also help reduce both environmental damage and population growth.

In short, doing nothing to reduce current fertility is unacceptable because this will result in the world’s population continuing to increase, thereby condemning millions of children to suffering premature death, and risking irreparable damage to the planet.

Peter Le Souëf is a Professor of Paediatrics at the University of Western Australia. He has worked over the past 5 years to establish an international research group looking into how environmental decline and population increase affect child health.

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