As our country contends with its hideously violent and unjust history (and present, as recent incidents illuminate) toward Black people, we should also be examining our national attitude toward equity and inclusion abroad—especially in the poorest countries on earth, most of which happen to be located in sub-Saharan Africa.
—Equity in the form of opportunity to live healthy, productive, fulfilling lives—and at the very least, the ability to survive illnesses and injuries that cause far too many preventable deaths in poor settings, and
—Inclusion in the form of having a voice at the table when it comes to matters that directly affect people’s own lives in marginalized and vulnerable settings around the world
Instead, we have a U.S. government suppressing foreign health organizations through manipulative funding policies that restrict their free speech, deny their patients health care that they desperately want, and result in the needless deaths of far too many. There is simply no arguing against the fact that the Global Gag Rule and the Helms Amendment are oppressive policies that steal the voices of health workers at aid-dependent organizations in poor countries, and steal patients’ lives far too often as well.
Another area where we tend to assume we know better than the people our foreign assistance actually serves is around discussions of population growth. Because of ugly practices in the name of eugenics—a concept popularized in England in the late 19th century and readily adopted by many in high-ranking positions in the U.S. government and in the medical and scientific fields—Americans are sometimes wary of population stabilization messaging, fearing there’s a draconian subtext, given past abuses in the United States, and in certain other countries, including China, India, Peru, and Vietnam.
But to assume that these negative feelings experienced by Americans are shared by people in the least developed countries on earth, living the everyday effects of rapid population growth, is just as bullish as assuming that we should be in charge of whether the aid we provide can be received by organizations that provide abortion counseling, referrals, or services, with their own, non-U.S. money.
As anyone from high-fertility regions can confirm, population concerns are very real at the national, local, and even household level. In this issue, we hear from people who know from firsthand experience just how important it is to stabilize population in their home countries. Pape Gaye, of Senegal, is the head of IntraHealth International and has worked in over 40 countries on international health and development efforts over his decades-long career. Alex Ezeh, of Kenya, is a professor and researcher with 30 years of experience focusing on population, health, education, and development. And Leticia Adelaide Appiah is a Ghanaian medical doctor and the head of Ghana’s National Population Council.
Discussions about population growth tend not to be perceived the same way in high-fertility countries—many of which have official population policies—as they are here in the United States. History will judge us poorly if we allow intolerable past practices to prevent us from addressing current population challenges.