Scrupulous Attention to Human Rights in Population Discourse

Laurie Mazur

A constructive approach would set standards for how we talk about – and act on -- on population and environment issues: taking care not to overstate the role of population growth and ensuring scrupulous attention to human rights in discourse, communications, advocacy and programs.

Like Michelle, I was struck by the emphasis on population growth, which has indeed been a taboo topic in recent years. And I agree that the conversation about population is now “roaring back.” (For just one example, check out this debate on Alternet.)

The new emphasis on population growth has again raised the specter of “population control,” but it could also reinvigorate support for sexual and reproductive health and rights. So how should advocates for women’s rights and health approach this debate? Frances Kissling, the former director of Catholics for a Free Choice, grapples with this question in a terrific essay that will be published in my forthcoming book (A Pivotal Moment: Population, Justice and the Environmental Challenge). Some organizations, she argues, must continue to insist that women’s rights are an end in themselves. “At the same time,” writes Kissling, “there is no need for these groups to attempt to prohibit all organizations from making links between population, environment, development and reproductive health.”

Instead, a constructive approach would set standards for how we talk about – and act on — on population and environment issues: taking care not to overstate the role of population growth and ensuring scrupulous attention to human rights in discourse, communications, advocacy and programs.

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Commentary Sexual Health

Why are Human Rights so Central to the AIDS Response in Eastern Europe, Central Asia, and Everywhere Else?

Michel Kazatchkine

We will only be able to get people into treatment early, and retain them in treatment, if we finally move from rhetoric to real action on HIV and human rights.

Cross-posted in partnership from the HIV Human Rights blog and part of Rewire’s coverage of the International AIDS Conference, 2012.

I am thrilled to have been appointed this month as the United Nations Secretary-General’s Special Envoy for HIV/AIDS in Eastern Europe and Central Asia.

Eastern Europe is the region of the world that has witnessed the largest increase in HIV prevalence in the last ten years and where the epidemic continues to expand. While the overall HIV incidence has decreased globally, seven countries of the world have seen the number of new infections increase by more than 25 percent in the last ten years. Five of these countries are in the region.

The number of people in the region living with HIV now reaches 1.5 million. In 2011 alone, 170 000 people were newly infected with HIV, and there is no sign that the epidemic is slowing down. HIV prevalence is estimated to be one percent or higher in the Russian Federation and in Ukraine which, together, account for almost 90 percent of the newly reported cases in the region. The epidemic is concentrated mainly among people who inject drugs and their sexual partners, as well as among sex workers and, to a lesser extent, men having sex with men.

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It has been estimated that one-fourth of the 3.7 million people who inject drugs in the region are living with HIV. High HIV prevalence has also been found in prison populations, particularly among prisoners who inject drugs. Aggressive drug law enforcement and lack of adequate access to harm reduction programs in most countries of the region drive people who use drugs away from public health services and into environments where there is a much higher risk of contracting HIV, as well as tuberculosis and viral hepatitis.

Access to HIV treatment in the region remains very low, with only 23 percent of those estimated to be in urgent need of anti-retroviral treatment accessing it, compared to 55 percent in the African region. This is even more troubling now that it has been shown that HIV treatment is also a powerful public health tool to suppress transmission of HIV.

The above factors, plus a number of specific political, societal, cultural, and policy-related challenges, pose formidable obstacles to the fight against the epidemic in the region. I sincerely hope I will be able to make a difference and am committed to encouraging countries in the region to turn the tide of the epidemic and save millions of lives. An urgent mobilization is needed to respond to the epidemic in Eastern Europe and Central Asia, including much greater attention to, and involvement of marginalized and criminalized populations, particularly people who use drugs, sex workers, and gay men, and other men who have sex with men.

I vividly remember the fantastic march and rally for human rights at the last International AIDS Conference in Vienna two years ago. At the press conference that preceded the event, I said that we all needed to use the conference, and the march and rally, to re-invigorate the AIDS movement as a human rights movement. This is as true today as it was two years ago.

Why are human rights so central to the AIDS response, in Eastern Europe and Central Asia, as everywhere else? For all the 10 reasons that are so well articulated in the “Human Rights and HIV/AIDS: Now More Than Ever” declaration, that remains as important today as it was when it was first released six years ago. But also because new approaches, such as treatment as prevention, simply will not work without much greater attention to human rights. We will only be able to get people into treatment early, and retain them in treatment, if we finally move from rhetoric to real action on HIV and human rights.

Many good news stories are emerging at AIDS 2012 in Washington this week, about the scale up of access to anti-retroviral treatment, the decreasing AIDS-related mortality and the decrease in the overall incidence of new HIV infections. I am happy about the progress that has been achieved, demonstrating the feasibility and effectiveness of large-scale prevention and treatment programs in poor settings, something that, even five years ago, many experts did not believe could happen. But I remain troubled about the lack of attention to human rights issues and the large inequities we are seeing in access to prevention and treatment. Discrimination against, and marginalization of, people vulnerable to HIV remain formidable obstacles to the control of the epidemic. Inappropriate laws and policies continue to fuel the epidemic. People who use drugs, sex workers, gay men, and other men who have sex with men, and other stigmatized populations have a right to the same support, including social and medical support, as everybody else, but too often suffer exclusion, police harassment, arrest, violence and prison. I strongly believe that efforts to fight the epidemic among vulnerable populations will continue to fail unless human rights are truly brought to the forefront of everything we do.

We must pursue efforts to reduce HIV incidence among these populations with the same energy and determination from which efforts directed at reducing mother-to-child transmission of HIV are currently benefiting. Everyone has a right to prevention, and to support and treatment, if needed. In this context, I deplore the fact that so many sex workers and people who use drugs were not able to attend the conference. We all can and must listen and learn from them – not prevent them from participating in our debates!

As Special Envoy, I will continue to speak out loudly and clearly about the need to devote much greater attention to human rights. And I pledge to listen to the voices of those who too often are excluded.


Will Renewed Attention to Climate Change Bring Back “Population Control?”

Jade Sasser

The attention being paid to climate change is much deserved but some advocates worry that it will revive many of the old alarmist debates on population and with it the calls for "population control" that almost always target poor women and women of color.

This fall, world population will reach seven billion people at a time of accelerated environmental disruption. This article is part of a series commissioned by Rewire, with Laurie Mazur as guest editor. The series examines the causes and consequences of population and environmental changes from various perspectives, and explores the policies and actions needed to both avoid and mitigate the inevitable impacts of these changes.

Here, graduate student Jade Sasser discusses the danger that the renewed attention to climate change will revive some of the old debates about population and that arguments in favor of “population control” will resurface.

All of the articles in this series can be found here.

Who’s afraid of climate change? Well, I am but not necessarily for the reasons you may think. I’m afraid that the recent, much-deserved attention to climate change will revive some of the old alarmist debates on population. And with those debates, I’m worried that the specter of population control will rear its ugly head again.

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You see, as a woman of color, I am particularly sensitive to population control arguments. After all, claims of “overpopulation” usually target women who look like me.

Throughout the 20th century, coercive welfare policies led to thousands of African-American women in the United States being sterilized without their consent in a procedure that came to be known as the “Mississippi Appendectomy.”  In the 1950s, Puerto Rican women’s bodies were used as the testing grounds for controversial and experimental contraceptive trials, in part due to government perceptions that these experiments could help solve the island’s “population problem.” Around the same time, population control became enshrined within development programs in India and Bangladesh, where use of contraceptives and permanent sterilization were attached to food aid programs and the allocation of land and medical care. And, as recently as the late 1990s, hundreds of thousands of poor and indigenous women were sterilized against their will by the government of Peru under the banner of fighting poverty and overpopulation.

What does all of this have to do with the environment? Well, a lot. In the United States, fears of a “population crisis” exploded onto the scene back in the 1960s and 1970s with the rise of the environmental movement, with environmentalists blaming population growth for everything from deforestation and desertification to global food shortages. Neo-Malthusian scholars and activists called for reducing food aid to starving populations in developing countries, and one well-known biologist famously suggested that sterilizing agents be placed into the American water supply.

Population alarmism gained quite a bit of support at the time, both among the general American public and among some members of the international development sector, who felt that controlling and reducing population growth would be beneficial to the global environment and the security of U.S. borders.

Luckily, population controllers were stopped in their tracks by a coalition of women’s health and rights reformers in the mid-1990s. At the 1994 International Conference on Population and Development (ICPD) meetings in Cairo, world leaders agreed that universal access to reproductive health services, within a broader focus on women’s rights and empowerment, would replace population control as the leading paradigm for the international family planning movement. Focused on meeting women’s reproductive health needs, as opposed to controlling and reducing their fertility, this new paradigm was enshrined in a document known as the Cairo Consensus, which was ratified by 179 countries.

At around the same time, the population bubble burst. According to the Population Reference Bureau, nowadays the average woman in a developing country gives birth to 2.5 children, compared to 6 children in 1950. In the industrialized world, this figure is even lower, with women having an average of 1.64 kids. Although in some regions like sub-Saharan Africa, rapid population growth continues to be carried along by demographic momentum, the trend toward the average woman giving birth to fewer children is a long-term, global phenomenon.

But is this enough to keep population controllers at bay? I’m not sure. Climate change has received much well-deserved attention lately in the news. And along with it comes the old, familiar population debate.

In 2009, the Vice Minister of China’s National Population and Family Planning Commission told an international audience that the Chinese one-child policy had proved to be an environmental success, adding that the 400 million births that have been prevented since the introduction of the policy have resulted in 1.8 billion fewer tons of carbon dioxide being emitted into the atmosphere. At the same time, several professors in the United States and Australia have proposed carbon taxes for every child born beyond the replacement fertility level of two children per couple.

In addition, the British charity Optimum Population Trust published a report arguing that spending just $7 on international family planning projects could reduce carbon emissions by one ton, concluding that family planning as a method of reducing future emissions of carbon dioxide is significantly cheaper than many low-carbon technologies. The organization created a website which offers consumers the opportunity to offset their carbon footprint by investing in family planning in developing countries. The site argues that investing in family planning is a “cost-effective and permanent way of reducing CO2 emissions and climate change” with “no downsides,” and  offers wealthy Westerners the opportunity to consume their way into reducing their carbon footprints through reducing the childbearing of other women, rather than changing their own greenhouse gas emitting behaviors.

Not only do these approaches get into an ethical gray zone, they are based on faulty logic. We have to remember that the United States is the leading global emitter of greenhouse gases, producing 25 percent of the world’s emissions every year, even though our population accounts for just 4.5 percent of the world total. Many global South countries with rapidly growing populations, like Kenya, emit far fewer greenhouse gases than we do; the average Kenyan produces 0.3 tons of emissions every year, compared with the average American’s average 20 tons of emissions. Clearly, it is what we do, rather than how many of us there are, that drives the climate bus.

As Lisa Hymas argued in her recent article, not all Americans consume the same volume of resources in the same way. Middle and upper class Americans who drive multiple vehicles, build vacation homes, and race to buy every new technological gizmo that comes on the market have a significantly higher carbon footprint than the working class and poor. At the same time, we have to think about the bigger actors that dwarf all of us in their climate-changing behaviors. Mega oil corporations, for example, earn billions of dollars in profits when they extract, burn, refine, and sell fossil fuel products.  And, how could we ever forget the role of the military in this conversation. Its atmosphere-polluting activities are often hidden in the debates over climate change and population growth—a shocking fact, considering that the U.S. military is the single largest consumer of oil in the world.

Despite the fact that they consumer fewer environmental resources, women, communities of color, and the poor suffer more of the impacts of climate change. Climate-related natural disasters, which are on the rise, disproportionately impact women around the world, who are much more likely to drown or die in accidents. Those who survive are more likely to experience domestic violence, sexual abuse, and poor reproductive health outcomes.

Climate change does, however, offers us opportunities to address women’s human and reproductive rights, but the connections must be made in the right way. Ensuring universal access to comprehensive reproductive health services, including emergency obstetric care, both hormonal and barrier methods of contraception, diagnosis and treatment of sexually transmitted infections, HIV testing, counseling and treatment, and referrals for services for gender-based violence, promotes basic human rights–all women have the right to control their reproductive and sexual lives–and are important components of a gender-sensitive approach to adapting to the effects of climate change. Supporting coercive population interventions among the poor as a means of mitigating or preventing climate change, on the other hand, is not a defensible approach.

We must be ever vigilant, keeping the principles of reproductive health, reproductive rights, and reproductive justice for women at the heart of the approach. Through this framework, and the protection of women’s rights to have children, not to have children, and to parent the children that they do have, we can remain on the right side of both the climate justice and reproductive justice debates.