Anti-Nairobi: A Statement against the Nairobi Statement

Overview

Objective: Science does not need to start with science. It can start with philosophy. This work follows the great works of the past, namely Julius Caesar’s Anti-Cato and especially Friedrich Engels’ Anti-Dühring. It is built upon the threefold thesis – antithesis – synthesis approach of Hegelian dialectics. This Statement considers the Nairobi Statement a thesis and brings forth a critique of its flaws and incompleteness, thus becoming its antithesis.

Design: Position statement.

Setting: Center for Outpatient Gynecology, Brno, Czech Republic; Center for Prenatal Diagnosis, Brno, Czech Republic; Department of Philosophy, Faculty of Arts, Masaryk University, Brno, Czech Republic.

Methods: This Statement is based on a critical analysis of the Nairobi Statement.

Results: The Nairobi Statement (2019) reaffirms the Cairo Summit’s Programme of Action (1994), which emphasized individual human beings while excluding population from the discourse, and by extension recommended a wide range of sexual and reproductive health and rights instead of specific family planning endeavors. Cairo’s failure is largely visible through the increase in world population from 5.6 billion in 1994 to 7.8 billion in 2019 (also projected to grow through the end of the century). The Nairobi Statement’s flaw is that it ignores the problem of overpopulation and its vast environmental and other implications. However, the most significant missed opportunities are A) lack of acknowledgment that there cannot be sustainable development without sustainable population and B) non-existent calls for small families worldwide, which helps combat population momentum and thus end and reverse population growth.

Conclusion: Anti-Nairobi goes against the current leading paradigm on “sustainable” development as expressed in the Nairobi Statement. While acknowledging the Statement’s triple zero goals, it suggests an additional set of goals. Finally, in the spirit of Hegelian dialectics, it implicitly awaits a synthesis to bridge both the thesis and its antithesis.

Keywords:

population – overpopulation – sustainable development – United Nations – Sustainable Development Goals – contraception – family planning – small family size norm

PREFACE

The following work is by no means the fruit of any “inner urge”. On the contrary. When the Nairobi Statement was released last November, suddenly issuing challenges to our age, friends in Europe repeatedly urged me to subject this new document to critical examination in the central view of sustainable development. They thought this absolutely necessary. To paraphrase the preface of Frederick Engels’ Anti-Dühring, it was not my fault that I had to follow authors of the Nairobi Statement, supposedly dealing with population and development, into the vast territory in which they dealt with all things under the sun and with some others as well [1], except for population.

LAYING THE FOUNDATION

Every once in a while, an event comes along that is a catalyst for everything that will happen afterward. In 1994, it was the International Conference on Population and Development (ICPD), held in Cairo, Egypt. This conference recognized sexual and reproductive health and rights, girls’ and women’s empowerment, and gender equality as the pathways to sustainable development. The 179 countries present adopted and signed the landmark Programme of Action, which put individual human beings in the centre of sustainable development. These 179 countries promised to strive to provide universal access to sexual and reproductive health care for all by no later than 2015 [10]. In 2015, the international community reaffirmed the commitment to achieving remaining unmet goals and objectives of the Programme of Action and adopted the 2030 Agenda for Sustainable Development and the Sustainable Development Goals [10].

Twenty-five years later, in 2019, the International Conference of Population and Development, or the Nairobi Summit on ICPD25, took place in Nairobi, Kenya; more than 9,500 delegates attended. The Summit attempted to complete the unfinished business of the ICPD Programme of Action:  advancing the promises of achieving universal access to the full range of sexual and reproductive health information, education and services, girls’ and women’s empowerment, and gender equality [12]. For this reason, the Nairobi Statement was formulated after six months of global consultations led by the International Steering Committee on ICPD25, with hundreds of organizations and thousands of people involved.

The Nairobi Statement provides a global framework for the formulation of government and partner commitments to the sustainable development goals through the lens of sexual and reproductive health. The main targets to be met by 2030 are the so-called triple zero goals: (1) zero unmet need for contraceptive information and supplies, (2) zero preventable maternal deaths, and (3) zero gender-based violence. The Statement was agreed to by the more than 170 countries that attended [13].

CAIRO-NAIROBIAN FALLACY

As Professor of Public Health Malcolm Potts, an attendee to the Cairo Summit, observed, a small group of women advocates at the 1994 Cairo Summit demanded that the focused family planning programs should be replaced with a broad range of sexual and reproductive health goals [6, 7]. This ultimately resulted in the Summit taking its focus away from the subjects of population and overpopulation.

By eliminating any emphasis on actual human NUMBERS in relationship to sustainability, the Cairo Summit gave no motivation – through that perception of “enlightened self-interest,” as the 1992 World Scientists’ Warning to Humanity phrases it – for governments to allocate funds to finance voluntary family planning plus education on the necessary scale to (ultimately)  end  population growth, and so help to minimize or prevent the  existential environmental crises addressed by the 1992 Scientists’ Warning [4].

That was the great failure of Cairo, combined with an emphasis on the term “sexual and reproductive health,” which led to much of the too-little financing to go into HIV, and other sexual and reproductive endeavors than family planning. Family-planning budgets collapsed [3, 6]. Cairo’s failure is largely visible through the increase of the world’s population from 5.6 billion in 1994 to 7.8 billion in 2019.

The 2019 Nairobi Summit was a unique opportunity to address overpopulation and its vast environmental (and other) consequences; instead, Nairobi continued the trend started in Cairo. Due to the stigma of the word “population” due to fears about past discredited and long since abandoned population control excesses, the issue was consciously omitted from the agenda in Nairobi, and the P-word was pushed out of public discourse there and left only in its title. Yet what could be more absurd than the topic of population being absent at the premier conference about population! To me, it seems like an extreme case of ignoring the extremely obvious.

Just as Cairo twenty-five years ago, Nairobi ignored recent, relevant data evaluations: the 2017 World Scientists’ Warning to Humanity: A Second Notice [8] and the 2019 Scientists’ Warning of a Climate Emergency [9], along with the 2020 warnings of NGOs such as the UK’s Population Matters [5]. Had they heeded those warnings, they may have put a much larger emphasis on reversing population growth.

Given that environmental myopia, it is not surprising the Statement lacks any mention of population growth and does not evaluate its impact on development, sustainability, and environment or the urgent need to curb it – exclusively, of course, by well-attested benign and rights-based measures.

However noble and right the above triple zero goals of the Statement are, only the first – zero unmet need for contraceptive information and supplies – truly has something to do with slowing population growth. Emphasis on this goal is also essential because it is the very strongest means there is, worldwide, for achieving the second goal, zero preventable maternal deaths.

The Nairobi Statement does at least contribute to curbing two roots of population growth. To briefly remind the reader, there are five sources of population growth: (1) unintended pregnancies, (2) coerced motherhood, (3) wanted fertility, (4) population momentum, and (5) mortality decline.

The Statement addresses the first two: unintended pregnancies, and, by promoting women’s rights and empowerment, coerced motherhood. However, that is not enough. To get world population down to sustainable long-term levels, wanted fertility and population momentum can and should be influenced, meaning that the “small family norm” becomes MUCH smaller, i.e. less than two on world-average.

It is tempting to focus on the decline of total fertility rates and slowing world population growth that been occurring, but it is misleading, for it clouds the fact that it is the absolute number of humans and their ecological footprints that matter [15, 16].

Empowering women to choose smaller families reduces environmental degradation, and must therefore be intrinsic to any strategy to protect the environment and also to mitigate climate change [7, 8, 9]. Unfortunately, any such notion is missing in the Nairobi Statement. The non-existent calls for small families, especially in the countries where there is a total fertility rate above 2.1 or where is a large ‘bulge’ of young people, is the biggest missed opportunity of the Nairobi Statement.

ON HEGELIAN DIALECTICS

To paraphrase Frederick Engels’ On Dialectics, we often encounter theories in which the real relation is stood on its head and the reflection is taken for the original form, whereby it must consequently be turned right-side up again. Such theories quite often dominate for a considerable time [2]. Such was the case of Karan Singh, leader of the Indian delegation at the 1974 Bucharest Conference. His aphorism “Development is the best contraceptive” dominated the Conference and misled listeners. In 1993, Karan Singh acknowledged that the right strategy is precisely the opposite: “Contraception is the best development” [7].

Many contemporary policymakers, however, continue to cling to a flawed paradigm that persists despite evidence to the contrary [7]. As a result, budgets that should go primarily to family-planning programs are diluted and squandered elsewhere. As Malcolm Potts points out, the neglect of family planning, and a stubborn unwillingness to accept the impact of rapid population growth are the greatest follies of the development community of the past 50 years [7].

For the reason mentioned above, it is wise to read philosophers and remind ourselves that there is still Hegelian dialectics. To paraphrase Engels again, it needs to be our merit that – in contrast to the peevish, arrogant, mediocre epigones who now talk large all around the world – we bring to the fore again the forgotten dialectical method [2].

Hegelian dialectic is usually presented in a threefold manner. First, there is a thesis, which suggests a flaw or an incompleteness. As such, it gives rise to its reaction, an antithesis, which contradicts or negates the thesis. The tension between the two is resolved by a synthesis that bridges the conflict by mediation and completes the process by presenting a new and higher thesis. In more simplistic terms, the three dialectic stages of development can be considered as a problem – reaction – solution approach.

In the spirit of this approach, I aim to turn the Nairobi Statement, currently standing on its head, right-side up again, and bring forth its antithesis, the Anti-Nairobi Statement, so that its flaws can be corrected.

ANTI-NAIROBI STATEMENT

Anti-Nairobi wholeheartedly supports strengthening progress on women’s freedom, rights, and empowerment and declares full support to the Nairobi Statement’s Three Zeros, especially to the first one, as a woman cannot die from a pregnancy she doesn’t have. It also declares that all family-planning programs must be right-based.

However, Anti-Nairobi demands that more funding must go into family-planning budgets than other sexual and reproductive endeavors with less (or no) effect on population size.

Anti-Nairobi states that it is utterly foolish to seriously act on a sustainable future, development and environment without sustainable population levels. For this reason, Anti-Nairobi calls for bringing population and concern about its growth to the fore once again; however politically incorrect people today may consider it to be. Anti-Nairobi calls for acknowledgment of both major drivers of our current problems – namely, overpopulation and overconsumption – and simultaneously facing them head-on to bring a truly sustainable future for all.

To this end, Anti-Nairobi also urges the UN to acknowledge the link between population and Sustainable Development Goals and to add Sustainable Population to the current 17 Goals. In addition, it calls for a campaign to expand literacy regarding population and overpopulation and against a pro-growth bias.

Furthermore, Anti-Nairobi calls for us to begin discussing populations at large as well as individuals and their rights, important as they are. Put in other words, it calls for us to cease failing to see the proverbial forest for the trees: to stop putting individual (and often selfish) human rights above the rights of future generations to decent life as well as of other species that suffer dearly due to human overpopulation. Overall, it advocates for us to better balance human rights with human duties – and obligations to the future generations, other species, and planet Earth itself – which are largely ignored not only in the Nairobi Statement but in other documents on human rights.

Finally, Anti-Nairobi urges governments, NGOs, and OBGYNs around the world to campaign for small families worldwide, especially in countries with fertility rates above 2.1 and/or with a ‘bulge’ of young people (to combat population momentum). And to promote a maximum of two children as a necessary ethical norm.

Even if the recent global population projections in The Lancet – more optimistic than those of the UN – prove correct, with a peak of 9.7 billion in 2064 and falling to 8.8 in 2100 [14], we must avoid complacency and indeed strive hard to make those still unsustainable numbers even lower.  You do not call off the firefighters at the first sign that a forest fire is coming under control.

CONCLUSION

We are now in a phase of existence called the Anthropocene in which human numbers, human activity, and human consumption have led to excessive carbon emissions, climate change, biodiversity loss, species extinction, environmental degradation, pollution, emerging diseases, water scarcity, conflicts, wars, and more disheartening problems for life on Earth. Overpopulation and overconsumption are the root causes of these planetary crises. To paraphrase the famous words of Joshua Lederberg, the single biggest threat to the continued existence of human and other life on the planet is the human himself (and herself).

The ultimate question is this: as we continue further into the 21st century, how will we respond to the addition of billions more human inhabitants? And what planet do we want to leave to our children and grandchildren [11]? A planet bustling with life, including a sustainable number of human beings? OR, an Earth that has been inundated by a massive flood of humans who prize individual rights above collective long-term potential to do more than just survive, overwhelmed by domestic cattle, rats, cockroaches, and garbage?

ACKNOWLEDGMENT

I want to thank Professor Josef Krob, Masaryk University, Brno, for his inspirational course History of Ontology; Professor John Guillebaud, University College London, for his friendship, his constant support and mind-food; and Professor Malcolm Potts, University of California, Berkeley, for his kind feedback and comments.

MUDr. Bc. Jan Greguš 

Centrum ambulantní gynekologie 

Orlí 10 

602 22 Brno 

e-mail: jangregus@seznam.cz