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also help other countries to make contraception and sterilisation
widely available. There is a fair chance that these measures will
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Practical Ethics
hasten the onset of the demographic transition and bring population
growth down to a manageable level. According to
United Nations estimates, in 1965 the average woman in the
third world gave birth to six children, and only 8 per cent were
using some form of contraception; by 1991 the average number
of children had dropped to just below four, and more than half
the women in the third world were taking contraceptive measures.
Notable successes in encouraging the use of contraception
had occurred in Thailand, Indonesia, Mexico, Colombia, Brazil,
and Bangladesh. This achievement reflected a relatively low
expenditure in developing countries - considering the size and
significance of the problem - of $3 billion annually, with only
20 per cent of this sum coming from developed nations. So
expenditure in this area seems likely to be highly cost-effective.
Success cannot be guaranteed; but the evidence suggests that
we can reduce population growth by improving economic security
and education, and making contraceptives more widely
available. This prospect makes triage ethically unacceptable. We
cannot allow millions to die from starvation and disease when
there is a reasonable probability that population can be brought
under control without such horrors.
Population growth is therefore not a reason against giving
overseas aid, although it should make us think about the kind
of aid to give. Instead of food handouts, it may be better to give
aid that leads to a slowing of population growth. This may mean
agricultural assistance for the rural poor, or assistance with education,
or the provision of contraceptive services. Whatever
kind of aid proves most effective in specific circumstances, the
obligation to assist is not reduced.
One awkward question remains. What should we do about
a poor and already overpopulated country that, for religious or
nationalistic reasons, restricts the use of contraceptives and refuses
to slow its population growth? Should we nevertheless
offer development assistance? Or should we make our offer
conditional on effective steps being taken to reduce the birth-
240
Rich and Poor
rate? To the latter course, some would object that putting conditions
on aid is an attempt to impose our own ideas on
independent sovereign nations. So it is - but is this imposition
unjustifiable? If the argument for an\Jbligation to assist is sound,
we have an obligation to reduce absolute poverty; but we have
no obligation to make sacrifices that, to the best of our knowledge,
have no prospect of reducing poverty in the long run.
Hence we have no obligation to assist countries whose governments
have policies that will make our aid ineffective. This could
be very harsh on poor citizens of these countries - for they may
have no say in the government's policies - but we will help
more people in the long run by using our resources where they
are most effective. (The same principles may apply, incidentally,
to countries that refuse to take other steps that could make
assistance effective - like refusing to reform systems of land
holding that impose intolerable burdens on poor tenant
farmers.)
Leaving it to the government. We often hear that overseas aid
should be a government responsibility, not left to privately run
charities. Giving privately, it is said, allows the government to
escape its responsibilities.
Since increasing government aid is the surest way of making
a significant increase to the total amount of aid given, I would
agree that the governments of affluent nations should give much
more genuine, no-string~-attached, aid than they give now. Less
than one-sixth of one per cent of GNP is a scandalously small
amount for a nation as wealthy as the United States to give.
Even the official UN target of 0.7 per cent seems much less than
affluent nations can and should give - though it is a target few
have reached. But is this a reason against each of us giving what
we can privately, through voluntary agencies? To believe that
it is seems to assume that the more people there are who give
through voluntary agencies, the less likely it is that the government
will do its part. Is this plausible? The opposite view - that
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Practical Ethics
if no one gives voluntarily the government will assume that its
citizens are not in favour of overseas aid, and will cut its programme
accordingly - is more reasonable. In any case, unless
there is a definite probability that by refusing to give we would
be helping to bring about an increase in government assistance,
refusing to give privately is wrong for the same reason that triage
is wrong: it is a refusal to prevent a definite evil for the sake of
a very uncertain gain. The onus of showing how a refusal to
give privately will make the government give more is on those
who refuse to give.
This is not to say that giving privately is enough. Certainly
we should campaign for entirely new standards for both public
and private overseas aid. We should also work for fairer trading
arrangements between rich and poor countries, and less domination
of the economies of poor countries by multinational
corporations more concerned about producing profits for shareholders
back home than food for the local poor. Perhaps it is
more important to be politically active in the interests of the
poor than to give to them oneself - but why not do both?
Unfortunately, many use the view that overseas aid is the government's
responsibility as a reason against giving, but not as
a reason for being politically active.
Too high a standard? The final objection to the argument for an