Summary

World population is expected to reach 7 billion within the next month. It is therefore timely to consider the relationship of contraceptive services, with their focus on the individual, to implications for population dynamics. The various facets include individual choice, human rights, health benefits, socioeconomic implications and the demographic goals of governments. These all have their own rationale, with the common approach that contraception is much needed for fertility control in society, despite certain views that might limit its availability. Many obstacles still need to be overcome for the widespread provision of contraception to become an integral part of comprehensive health services.

Population growth

Twenty-five years ago, in 1986, this Journal published a report on the XIIIth Current Fertility Control Symposium, held in London on 31 October 1985. In his opening presentation, Professor Norman Morris had addressed the issue of population control.1 It was then anticipated that the world population would reach 5 billion on 11 July 1987, 13 years after the milestone of 4 billion in 1974. Morris pointed out the disparity between zero population growth in Europe and the “alarming” high fertility in developing countries, associated with their youth bulge. He alluded to the relationship to global food needs before specifying the roles of literacy, late marriage, strong family planning programmes and “a more equitable distribution of income and services and a world-wide effort to raise the status of women”.1 Thus, a clinical meeting in London already had perspectives that, 15 years later, were at centre stage for the calls for poverty reduction and gender equity that were to be among the Millennium Development Goals in 2000.

In 1986, population growth had long been perceived as leading to a strain on world resources. But the contribution of modern methods of contraception to population control was recognised to be …