754 



controlling the rate of reproduction. The widely acclaimed 

 family planning program of Taiwan may, at most, have 

 somewhat speeded the later phase of fertility decline that 

 would have occurred anyway because of modernization. Even 

 so, the aim of the program is that women should have the 

 numbers of children they want, a number that currently aver- 

 ages 4.5 children each. Even if social choices change and the 

 Taiwanese women decrease their wishes for children to the 

 United States level for 1966 of 3.4, this would yield a long- 

 run rate of natural increase of 1.7 percent per year and a dou- 

 bling of population in forty-one years. 



Davis points out that the characteristics that make family 

 planning acceptable are the very characteristics that make it 

 meffective for population control. By stressing the right of 

 parents to have the number of children they want, it evades 

 the basic question of population policy — how to give societies 

 the number of children they need. By offering only the means 

 for couples to control fertility, it neglects the means for 

 societies to do so. By sanctifying the doctrine that each 

 woman should have the number of children she wants, and hy 

 assuming that if she has only that number this will automat- 

 ically curl) population growth to the necessary degree, the 

 leaders of current policies escape havittg to ask why 

 icomen desire so many children and. how this desire can he 

 in-fiuenced.^^' [Emphasis supplied.] 



Policy Issues of World Health — A Sum,mary 



In this section on what, in effect, is an approach to establishing a 

 better dialogue between the international health profession and the 

 people, Congress, and Government of the United States, an attempt 

 is made to extract from the literature examples of how one might some- 

 how close this very serious communications gap. The arguments from 

 these examples is more convincing where the cost/benefit equation is 

 obviously attractive, less convincing when questions of goals and man- 

 agement are raised, and difficult in connection with the population 

 problems. But the international health literature shows that better 

 cost/effective programs are being established as time goes on, that 

 definitive goal setting and improved management practices are mak- 

 ing headway in the less developed countries, and that there is some 

 progress with the dilemma of health and population. On the latter 

 problem it was pointed out ( 1 ) that developing nations can be expected 

 to go through a transition of high population growth, (2) that in a 

 Colombian community ignorance rather than indifference was the 

 cause of failure to limit the size of families, (3) and that McDermott's 

 thesis concerning improved health as a precondition to fertility con- 

 trol is biologically and historically sound. 



While it is true that governments of poor countries which have popu- 

 lation policies do not have very effective ones, it might be noted that 

 any government of a rich or poor country which utilized coercion 

 today to control the birth rate would very soon be out of power. 



At any rate, until the countries understand and agree on the number 

 of human beings which can be supported by the earth and its resources, 



^»' Ibid., pages 101-102. 



