The miraculous conquest of death in the less developed areas springs mainly from the application of new scientific and medical discoveries to the control of infectious diseases. These discoveries—new knowledge of diseases, new means of treatment (from insecticides to antibiotics), new modes of public health organization—do not originate in the underdeveloped regions. They come chiefly from the advanced countries, which furnish much of the money and personnel for their application.
In Ceylon, for example, it was the DDT destruction of malaria mosquitos that smashed the death rate—not only from malaria itself but from other connected causes as well. This technique has achieved startling success in many other countries, such as Cyprus, Sardinia, India, Greece, Taiwan, Iran and the Philippines. Not only more efficient than older malaria measures, it is also cheaper. In India a whole household can receive a year's protection from malaria at less cost to the Government than an American spends on one haircut. Health experts believe that malaria can be eradicated from whole regions before the mosquitos develop DDT immunity, thus making even the negligible expense of spraying unnecessary.
In Yugoslavia a WHO and UNICEF campaign utilizing penicillin wiped out endemic syphilis among half a million people. Related diseases such as yaws and bejel have been successfully attacked under international auspices in Haiti, Indonesia, Iraq, the Philippines and Thailand. The cost of eliminating these widespread diseases is expected to fall to as little as 10 cents per person examined and to $1 per person treated. Such mass health programs, with bulk purchase of supplies and use of governmental authority, can wipe out at a low individual cost one after another of the infectious diseases that formerly afflicted millions.
Further reductions in death rates can confidently be expected from the same international effort. The United States, for instance, is currently planning a world-wide war on malaria, to be managed by international agencies at a cost of more than half a billion dollars, a fifth of this sum to come from us. And whether the non-industrial countries develop economically or not, their death rates will be further reduced by additional discoveries, funds and technical personnel from the advanced nations.
If birth rates were dropping as fast as death rates, no acceleration of world population growth would be occurring. But birth rates in most countries have not declined. The recent baby boom has given the industrial nations—particularly the new ones—a greater increase than the experts anticipated. In the agrarian countries birth rates have remained high, largely because the amazing reduction of mortality has been accomplished with minimum disturbance to local customs and often without any rise in the level of living.
The old attitudes that encouraged prolific childbearing—necessary when death took most of the children before adulthood—thus persist even when high fertility no longer makes sense. The same industrial nations that have helped the poorer nations to get rid of diseases have done little to help them get rid of excessive reproduction. Actually, a sharp decline in mortality tends to raise the birth rate, because women are healthier, have fewer miscarriages and are less frequently widowed. For these reasons the birth rate in underdeveloped areas is currently about twice as high as it is in the advanced countries.
How will the acceleration of the earth's population growth and the spectacular increase among backward peoples affect future economic development? Too often this question is misunderstood as simply the problem of getting enough food to feed the world's people. To do this requires economic expansion, and certainly such expansion is actually taking place; otherwise the huge population increase could not have occurred. But a rise in production that just matches the increase in human beings is not economic development. What brings prosperity is an increase in production per unit of human labor.
The product per unit is not enhanced by merely multiplying workers, but rather by adding things to human labor—fuels, hydroelectric power, machinery, rational organization. The task of economic development is therefore not to keep up with population growth but to get ahead of it. An increase in national income just sufficient to support ever more people at a near-subsistence level offers no solution to the problem of poverty; instead, it makes that problem bigger.