Photo by Finnbarr Webster/Getty Images
- According to new research at the University of Washington, a significant population decline will begin after 2064.
- The reasons include more access to contraception and better education for girls and women.
- Many countries will have to grapple with the social and financial consequences of their decline.
<p>After two centuries of unprecedented growth, human population will begin to shrink after 2064. This is good news for a number of reasons, most importantly because it signals an increase in education of girls and women.</p><p>That's the word from a large team of researchers at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington's School of Medicine. Their <a href="https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(20)30677-2.pdf" target="_blank">findings</a> were recently published in The Lancet. </p><p>The team predicts that global population will peak at 9.7 billion around 2064 before dropping to 8.8 billion at the turn of the century. While that contradicts previous findings by the UN, it's still a billion more people than inhabit the earth today. </p><p>For humans to replace the population, the total fertility rate (TFR) has to maintain a level of 2.1 births per woman. Due to improvements in contraception access and more available education for girls and women, the impetus for having children has declined. </p><p>In some regions, the decline has been dramatic. For example, the TFR in Italy and Spain is now 1.2 while in Poland it's 1.17. Even in "high-fertility" regions, the tide is changing. Sub-Saharan African women averaged 4.6 births per woman in 2017; that number is predicted to drop to 1.7 in 2100. Niger has the highest fertility rate in the world: 7 births per woman. In 2100, that is predicted to fall to 1.8. </p><p>Population decline will have major financial consequences; the researchers believe nations have to begin planning for this now. Discussing working-age individuals (aged 20-64 years), they write, </p><p style="margin-left: 20px;">"Huge declines in the number of workers were forecasted in China and India, alongside steady increases in Nigeria. By 2100, India was forecasted to still have the largest working-age population in the world, followed by Nigeria, China, and the USA." </p>
Mapping global population and the future of the world | The Economist
<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="e2cc6601e6772f8d94e215e973ba61fe"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/Ur77lDetI9Q?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>Dr. Richard Horton, editor-in-chief of The Lancet, <a href="https://www.sciencedaily.com/releases/2020/07/200715150444.htm" target="_blank">comments</a> on the study, writing, </p><p style="margin-left: 20px;">"It offers a vision for radical shifts in geopolitical power, challenges myths about immigration, and underlines the importance of protecting and strengthening the sexual and reproductive rights of women. The 21st century will see a revolution in the story of our human civilisation. Africa and the Arab World will shape our future, while Europe and Asia will recede in their influence."</p><p>Indeed, the populations that will shrink the fastest include Asia and central and eastern Europe. Japan, which has been <a href="https://qz.com/1295721/the-japanese-population-is-shrinking-faster-than-every-other-big-country/" target="_blank">grappling with this reality</a> for years, will drop from 128 million in 2017 to 60 million in 2100; Thailand, from 71 to 35 million; Portugal, 11 to 5 million; and South Korea, 53 to 27 million. </p><p>The study focuses on expansion, though it doesn't discuss how quickly we've reached current levels. After 350,000 years of <em>Homo sapiens</em> on Earth, we hit one billion people in 1804. It took 123 years to add another billion; 33 years to get to three billion; 14 years to four billion. If we hit eight billion by the end of this decade, we'll have quadrupled our population in just a century. </p><p>Those are unsustainable numbers. As the COVID-19 pandemic has proven, supply chain management and health care systems in many countries are broken, especially in America. Thanks to the outsourcing of labor and our for-profit health care model, income inequality is breaking our society. Adding more humans to our population during a pandemic, with seniors being the most vulnerable population, should give us pause.</p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMzUwMzI0MS9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTYyMzQwNTU5N30.o9DFv9PFbzzX5zQNq1Ya_3ZwqmFbCyZBTivvxxoxZUc/img.png?width=980" id="571d0" class="rm-shortcode" data-rm-shortcode-id="7d824e65060bfb1c887081d246f7757f" data-rm-shortcode-name="rebelmouse-image" />
Stein Emil Vollset, et al.
<p>Of course, procreation is more a biological process than a philosophical one. Survivability is the goal of every species. That said, we've mitigated the potential damage of overcrowding by contraception and education, as the study suggests. Either we need to more fairly distribute resources around the world—tough to imagine in a capitalist system—or pay the price for birthing too many humans. The latter could be quelled if we have fewer children.</p><p>Stein Emil Vollset, Professor of Global Health at IHME and lead author of the study, <a href="https://www.sciencedaily.com/releases/2020/07/200715150444.htm" target="_blank">weighs</a> the costs and benefits:</p><p style="margin-left: 20px;">"While population decline is potentially good news for reducing carbon emissions and stress on food systems, with more old people and fewer young people, economic challenges will arise as societies struggle to grow with fewer workers and taxpayers, and countries' abilities to generate the wealth needed to fund social support and health care for the elderly are reduced."</p><p>The researchers believe immigration will be an even more pressing issue in the coming decades. This might mean less surface area being inhabited as people crowd into environmentally and financially robust regions—a forthcoming reality due to climate change anyway.</p><p>In conclusion, Professor Ibrahim Abubakar at University College London comments on the study, noting, "The distribution of working-age populations will be crucial to whether humanity prospers or withers." Depending on your age, you might not have to worry about this, but our children and grandchildren certainly will. </p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a>, <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank">Facebook</a> and <a href="https://derekberes.substack.com/" target="_blank">Substack</a>. His next book is</em> "<em>Hero's Dose: The Case For Psychedelics in Ritual and Therapy."</em></p>
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When is a quarantine justified? A group of philosophers offers an answer.
Quarantines are worth the trouble to keep the next pandemic at bay but they need to be applied intelligently.
18 September, 2018
A trainee, wearing personal protective Equipment (PPE), takes part in a training session held by the military trained Civil Security (Securite civile), on checking and treating suspected victims of the Ebola virus. (JEAN-FRANCOIS MONIER/AFP/Getty Images)
- A new essay argues that quarantines are often needed, but require strict guidelines on when they can be used.
- Pandemics are inevitable, and actions that can save lives must be planned now.
- The arguments in this essay will undoubtedly be of use during the next outbreak.
<p>
The use of isolation and quarantine has a
<a href="https://www.cdc.gov/quarantine/historyquarantine.html" target="_blank">history of success</a> going back to the black plague. The practice of isolating sick people form healthy ones intuitively strikes many of us as useful, and many of us do it on our own accord when we fall ill. It seems like a simple step up from that to the idea of quarantining people who are sick or have been exposed to deadly diseases to stop them from spreading.
</p>
<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="2514b784ef7368fa0264ad679cc38b40"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/uzsYGdNzkXE?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>However, the impositions on individuals that quarantine requires, such as isolation from friends, family, and activity is a rather <a href="https://www.ncbi.nlm.nih.gov/pubmed/25618243" target="_blank">steep price to pay</a>. Besides, the use of force to limit people's freedoms for the greater good is always a moral minefield. Deciding exactly when, where, and how to implement a quarantine is a tricky business.</p><p><a href="https://onlinelibrary.wiley.com/doi/full/10.1111/dewb.12165" target="_blank">A paper</a> by <a href="https://www.philosophy.ox.ac.uk/people/alberto-giubilini" target="_blank">Alberto Giubilini</a>, <a href="https://hannahmaslen.wordpress.com/" target="_blank">Hannah Maslen</a>, <a href="https://www.philosophy.ox.ac.uk/people/tom-douglas" target="_blank">Tom Douglas</a>, and <a href="http://www.ox.ac.uk/news-and-events/find-an-expert/professor-julian-savulescu" target="_blank">Julian Savulescu</a> of the Oxford Uehiro Centre for Practical Ethics might have a solution. By taking a moral approach to the problem, one that seeks the most robust possible foundation for intervention, the authors hope to provide sound guidelines to people considering the question of when to intervene and when to take no action. </p>
What is a quarantine exactly?
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xODYzMzkwMy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY2MTgzODg5N30.AvlbgVUQwDSo0SrDgWa-EwHUaXiWig7lOzy35KLSYPM/img.jpg?width=1245&coordinates=0%2C0%2C0%2C122&height=700" id="e546d" class="rm-shortcode" data-rm-shortcode-id="7779ac5059618e73bbd1697876c8d133" data-rm-shortcode-name="rebelmouse-image" />Health workers are seen with a young patient under quarantine at the Nongo Ebola treatment unit in Conakry, Guinea on August 21, 2015. The World Health Organization WHO has lost track of 45 people under surveillance, who had been in contact with a patient who contracted Ebola, in Guinea. (CELLOU BINANI/AFP/Getty Images)
<p>For the purposes of this paper, isolation and quarantine had two different meanings. As the authors define them: "Isolation separates sick people with a contagious disease from people who are not sick. Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick."</p>Why would quarantine be a good idea? After all, they aren't sick yet!
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xODYzMzkzMy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0NzI1ODg3OX0.RIT9_b3XhEJ5n5Aohr0PkWCBV7Lv8Y9dhHh6zq1EFT0/img.jpg?width=1245&coordinates=0%2C0%2C0%2C1&height=700" id="7d62a" class="rm-shortcode" data-rm-shortcode-id="4065a9a1ceb5bbb228cdc9cc6daeb0de" data-rm-shortcode-name="rebelmouse-image" />"Typhoid" Mary Mallon, far left, in quarantine. Her refusal to wash her hands while carrying typhoid fever bacteria may have killed fifty people. She was forced into quarantine for the safety of the public.
(Public Domain)
<p>The first argument that the authors make is the obvious one, society benefits a great deal from quarantining a person who might be carrying a deadly disease at a relatively low cost to that society and a moderate cost to the person quarantined. A person who is exposed to Ebola <em>might </em>contract the disease and start spreading it before they are aware of their illness. Quarantines try to prevent this by hiding away anybody who might have been exposed to a disease, even if they are asymptomatic. <br></p><p>This <a href="https://bigthink.com/scotty-hendricks/how-much-we-trust-someone-depends-on-their-response-to-this-moral-dilemma" target="_blank">consequentialist</a> stance is the one typically invoked by governments and state agencies when quarantines are introduced, but the authors don't think it is the best ethical foundation. After all, it might be for everybody's benefit to lock away anybody exposed to the common cold for a week to keep infection rates down. This seems excessive, suggesting that the final answer lies elsewhere. </p>Personal responsibility
<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="a55a6c0e463e3d07dad75d666f5d9b43"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/W3BmxyA3QPQ?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>The authors then argue that, in many cases, the individual exposed to a potentially deadly disease will have a moral duty to quarantine themselves; making what the authorities do merely the enforcement of what a person ought to do anyway.<br></p><p>They use the example of <a href="https://bigthink.com/scotty-hendricks/seven-thought-experiments-thatll-make-you-question-everything" target="_blank">Peter Singer's drowning child</a>. Singer famously asked if we had a moral obligation to save a drowning child if the act of saving them was at a low cost to us. He concluded that we do, and many people agree with him. The authors call this the duty of "easy rescue" and argue that it applies in many quarantine cases since the cost of a person hiding in their room until they know they won't make others sick is typically low while the payoff could include saving lives.</p><p>The authors then suggest that, "when the cost to us of engaging in some activity is small, and the harm to others which is prevented is great, the state may permissibly compel us to engage in that activity." They place this inside of certain parameters, however. </p><p>Most of us would agree that we must keep other people from getting sick when we are ill. However, the suggestion here is that in severe cases, like when the illness in question is deadly, that the state has legitimate power to make sure we stay home. This is more limited than just comparing costs and benefits and doing whatever gives the best payoff, but still allows for interventions during the worst outbreaks.</p>But what about the freedom of the individual?
<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="854435b868180f092dbd4a553a2b5408"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/gKYmVIUwEAw?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>The authors don't suggest that the authorities should always start with quarantines and use them whenever the mood strikes. They make it clear at the beginning of their paper that, "we will argue that authorities ought to implement quarantine and coercion in such a manner that they have the strongest justification possible for those measures.<em>"</em><br></p><p>They also point out that any rational use of quarantines would be limited to severe cases. As they note, while it might be a social net-positive to quarantine people with the stomach flu, the lack of threat it poses makes the action unthinkable. Ebola, on the other hand, is enough of a threat to people that quarantines would be justified. </p><p>At some point though, the freedom of a person to do what they like would be infringed on for the sake of the public health. Many people are put off by this. The question is determining when an individual poses enough of a threat to the people around them that forcing them into quarantine is justified. The authors are of the mind that this is permissible when a person might have a very deadly disease. </p><p>In some cases, quarantine laws are overused and not based on a cost-benefit analysis, such as when New Jersey introduced a quarantine of people who had been in certain African countries during the 2014 Ebola outbreak. The poorly thought out law was changed after a lawsuit was <a href="https://www.nytimes.com/2017/07/27/nyregion/new-jersey-accepts-rights-for-people-in-quarantine-to-end-ebola-suit.html" target="_blank">brought against the state</a>. This case should be a warning against over-application of quarantines, but not against their use when they are correctly implemented. </p><p>The idea of using force to lock people in their rooms to assure that others don't get sick is a tricky one. It makes perfect sense when we're healthy, but seems like a potential use of excessive force when we might be on the sick bed. Nevertheless, the ethics surrounding this issue are far from settled though. Given that we're already preparing for the <a href="https://www.scientificamerican.com/custom-media/jnj-champions-of-science/preparing-for-the-next-pandemic/" target="_blank">next pandemic</a>, we may be ruminating more moral questions sooner than we think.</p><span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="bde4bf7d8c80c8aa9a1ef0abcc417207"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/xrqrXvV2aL8?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
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Fair Trade Pharma: A Plan for More Affordable Prescription Drugs
Why do first-world ailments get cured faster than global health crises? Because Big Pharma doesn’t serve sick people, it serves rich people—let's change that.
22 September, 2017
One of the world's open secrets is that we don't look after all sick people in the same way. Why does back pain in the U.S. get a treatment developed faster than fatal dysentery in Central Africa? It's not a huge riddle: research and development programs of the pharmaceutical industry treat the diseases and ailments that will turn the highest profit. To solve a problem this large and unjust, Nicole Hassoun, a residential fellow with the Hope & Optimism Project at Cornell University, is employing the virtue she terms 'creative resolve'. When obstacles get in our way, Hassoun says we need to think innovatively about how can we change the problem or look at it differently. If we can't appeal to Big Pharma's better nature, then we have to come up with more creative solutions. And Hassoun has one: fair trade pharmaceuticals. Here, she explains her idea to incentivize cheaper drugs and medical access to combat global health crises. This video was filmed as part of the Los Angeles Hope Festival, a collaboration between Big Think and Hope & Optimism.
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