Population management, not ‘control’

It is sad to see the 2020 budget of the Department of Health for contraceptive implants which have been cleared by the Food and Drug Administration as non-abortifacient being cut by about P200 million. The decrease would negatively impact the government’s socioeconomic agenda which aims to cut poverty incidence to 14 percent by 2022.

No less than President Duterte has approved the full and intensified plan for the national family planning program that would give access to contraceptives to a greater majority of Filipinos. Socioeconomic Planning Secretary Ernie Pernia also reiterated the crucial role of family planning in poverty reduction as “it enables couples to plan and invest on their children better,” adding that there is a real link between population and economic growth.

Many studies have also shown the link between overpopulation and traffic congestion – a nightmarish reality that residents of Metro Manila go through every single day. There are now close to 15 million people living in Metro Manila when in fact, the metropolis is supposed to accommodate only five million inhabitants.  

My brother, the late Dr. Alberto “Quasi” Romualdez Jr., was a strong advocate of population management not only when he was the Secretary of Health but even long before he joined President Erap’s Cabinet. During speaking engagements, he would lament “the lack of a clearly pro-poor reproductive health policy,” noting that the poorest of women have little or no access to information and services that would help them manage the number of children in their family.

Dr. Quasi intensely worked with Senator Pia Cayetano for the passage of the Responsible Parenthood and Reproductive Health Law of 2012 which faced fierce opposition from the Catholic Church and critics who questioned the constitutionality of the bill. These anti-RH groups elevated the issue before the Supreme Court – which ultimately upheld the bill in 2014.

Quasi also teamed-up with non-government organizations like the Friendly Care Foundation, an organization of family care clinics focused on providing reproductive and family planning services, where he served as president. Friendly Care was founded by Mrs. Lizzie Zobel (Jaime’s wife) who is also a staunch advocate of family planning. She was a firm believer that family planning should be accessible not only to the educated and the rich, but the poor as well.

More often than not, lack of information can result in unintended pregnancies that can become high-risk, putting the health of both the mother and unborn child in jeopardy. I remember there was one community in Batangas where couples kept having children, afraid to seek help from the family planning center because the priest threatened to excommunicate them. 

Although 85 percent of Filipinos are practicing Catholics, more couples are beginning to see the need to plan the size of their family and only have children they can afford to care for responsibly. Even Pope Francis has urged parents to have fewer children, saying that avoiding pregnancy is not an absolute evil. 

A couple of years ago, I had a driver who had three children. He came to me asking for a loan because his wife was about to give birth to their fourth child. I willingly gave him the money, but also told him to manage having a large family so he could better provide for them and live within his means. He readily agreed.

A year and a half later, he came back to me, borrowing money again. I asked, “Why?” It turns out, his wife was having their fifth child. Mama mia! So I asked him, “Why do you keep having children when you are already having a hard time?” His reply: “With five children, maybe I will be lucky with at least one who will take care of us in the future.”

It was so sad to see people who think having more children is like playing the lotto, giving them more chances of winning the jackpot, hoping one of them could end up being successful or get a lucky break in the future. Some may disagree, but no doubt there is a direct correlation between poverty incidence and a high fertility rate and over population.

The Population Commission places the number of Filipinos today at about 109 million (CIA Factbook estimates it at 115 million), with some projections saying that the number of Filipinos will reach 142 million by 2045. While the country’s fertility rate has dropped in recent years, it remains one of the highest in Southeast Asia.

According to a Population Commission regional director, the two million added yearly to our population poses a critical challenge to socioeconomic development. The higher the fertility rate, the higher the poverty incidence, he said. This is also one of the reasons why many Filipinos are forced to leave the country and work overseas – which ultimately could have a negative social effect with families becoming dysfunctional.

On the other hand, we also know what underpopulation can do to countries like Japan which is facing an ageing population. There are many places almost abandoned because there are no young people inhabiting them as fewer and fewer children are born every year. Aside from higher costs for healthcare and pension, the Japanese government also faces the prospect of a decreasing workforce which could also shrink the tax base. According to experts, this is “a recipe for economic stagnation.”

The example of Japan, as well as Spain and Singapore facing dwindling populations, where the old will soon outnumber the young – demonstrates that it all boils down to a balancing act, and that it is really all about managing – not controlling – the population.

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