The controversy at the core of this chapter is whether current and anticipated trends in economic and social development, combined with projections for population growth, are compatible with maintaining good health for all. Whereas there has been a doubling of life expectancy over the past century, there are still considerable uncertainties about how the health transition will continue. The way in which such trends are interpreted depends to a large extent on the perspectives held by scientists and policy-makers. In this chapter, developments in population that are related to policy and health dynamics are interpreted according to the three perspectives outlined in Chapter 10 and are compared to UN projections. The consequences for population size and the health risks of stagnating economic growth and of food and water crises are assessed in four cases.

Controversies related to population and health

World population has more than tripled between 1900 and 1996, rising from about 1.6×109 (Kuznets, 1966) to 5.8×109 (UNFPA, 1996), i.e. an average annual growth of 1.3%. Such a rate of growth is extremely rapid by any historical perspective. Population growth and its potential consequences for people and the environment have long been an issue of concern. Since the time of Malthus (1789) the population issue has been the subject of a furious debate, both in the scientific and the policy community (Ehrlich, 1968; Cohen, 1995). Specific concerns about population growth have varied from one generation to the next.