On 25-26 May, I attended a conference in London, organised by University College London Centre for Global Health, called Population Footprints, on sustainability.

The prediction that we humans have only a 50–50 chance of surviving to the end of the 21st century serves to focus the mind wonderfully. It is based on the seriousness of the environmental problems created by climate change and rising carbon emissions, over-consumption, scarcity of education and employment, population growth, scarcity of resources such as potable water, failure to develop renewable energy, maldistribution of food, the threat of rising sea levels, which could destroy coastal cities and change coastlines worldwide. Health in the context of environmental stress. Urbanisation. Migration. And so on.

Sitting there, I asked myself: What will I do differently starting tomorrow morning, in response to this prediction? In fact, shame on me, I didn’t do anything different. And that’s the problem!

Then I thought: If you were told you had a disease that, only with treatment and only if you changed your behaviour, you would have a 50-50 chance of surviving, would you change your behaviour then? What about 60-40 or 70-30? Not good odds for the whole of humanity, is it? But this is where we stand.

So what’s it got to do with sexual and reproductive health and rights? Some people came to the conference to push for renewed efforts to reduce population growth – a group called Population Matters, for example (no relation to RHM). What was heartwarming, then, was the fact that almost everyone else there had realised that it was a whole string of issues calling for radical change in the direction of sustainability that matter. Including policy on development, trade and health care, and food distribution; access to clean water, education and social welfare; care of the environment and recycling of waste; the role of war; the damage caused by both wealth and poverty; changing economic policy from a 19th century growth model; stabilising population levels, increasing family planning, and seeking demographic balance in population age. But above all, dealing with climate change by capping and reducing carbon emission levels as soon as possible. Family planning  was no longer being presented as the solution on its own. Whew!

We (that is, my generation) who opposed population “control” policies in the 1970s and 80s that abused the right of women and couples to decide the number and spacing of their children, don’t have to go back to square one and start over. But wait – family planning needs to go back on national agendas, with increased funding, with choice of methods and generic production, and popular education about the importance of planning one’s family. The fertility rate is falling almost everywhere but the unmet need for contraception and safe, legal abortion remains enormous; as does the broader need, for reproductive and sexual health.

I started to think about policies in the past that said: one kid or two kids and you’re sterilised. The Chinese have had a one-child policy for 30 years now, and their population has stopped growing. The policy is open to abuse, yes, and it’s incredibly controversial, but it is also widely supported, seen to be a necessity. Could anyone do better, being responsible for a quarter of the whole world’s population? The debate about whether the policy can be relaxed, and when, and how much, is heated, according to the one Chinese participant there. Fantastic! In what other country is population policy the subject of heated public debate?

I’m worried about carbon emissions. We’re already at the stage of not-OK. What happens if we don’t bring down carbon emissions soon enough? Will we get the equivalent of ‘two kids and then you’re sterilised’? For example, you won’t be allowed to fly more than so many miles and once a year. Trains instead of planes. Imagine that! Grounded on a global scale.

Uganda is worried about how they will ever feed, educate, house and find jobs for the 50% of their population who are currently under 15 years of age. Even if things weren’t falling apart there, it would be near impossible.

On the other hand, I was so heartened to hear someone say we have to drop the 19th century model of economic growth and find a 21st century way to organise our economies. Fantastic! Could it lead to the end of production of junk?? A move away from a militarised economy which is expensive and wasteful? Required recycling of all waste? Acknowledgement of wealth and over-consumption as a major source of problems? Limitations on upper income levels? Solar and wind power a must? Less complex technology, more jobs? Yes, yes, yes!

Sustainability. That’s the key. Roll up your sleeves – we have work to do!!