Global fears of overpopulation in the '60s and '70s helped fuel India's campaign to slow population growth.
Reviewed by Lily Ramsey, LLMOct 10 2023 Health workers tasked to encourage family planning were dispatched throughout the country and millions of people were sterilized — some voluntarily, some for a monetary reward, and some through force.
The host: Céline Gounder Senior fellow & editor-at-large for public health, KFF Health News @celinegounder Céline Gounder: In the early 1970s, all around the world, worries about overpopulation were mounting.Richard Nixon: Our cities are gonna be choked with people. They’re going to be choked with traffic. They’re gonna be choked with crime. … And they will be impossible places in which to live.
Two million copies of "The Population Bomb" were sold. And the author landed on late-night television, his dire predictions becoming entertainment for Americans sitting at home on their couches. Céline Gounder: A twist of the hand here, a little shimmy there; he did a few hand mudras with a look of delight on his face.Céline Gounder: But even with all that joy, when the music stopped and he shuffled back to his chair, you're reminded that Chandrakant is in his 70s, with more than 50 years of experience in public health.
Chandrakant Pandav: "What is this vaccine? What is this you’re doing us? Maybe it’s a population control measure." So the strongest question they had: "This is the government of India’s new policy for sterilization?" Céline Gounder: Chandrakant didn't want to talk about it. But you can't tell the story of smallpox eradication success without talking about the family planning policies that came first.
Céline Gounder: And if you chose not to get sterilized, Gyan says, the government found other ways to twist the screw. Families would receive food rations for up to only three children — any child beyond that would not be allotted food.Céline Gounder: At one point, the government began to prioritize men for sterilization.Céline Gounder: Gyan says India's family planning campaign created an atmosphere of intimidation and harassment that was nearly impossible to escape.
Céline Gounder: Sanjoy says many Adivasi and Muslim communities, in particular, lost trust in the government. This distrust lingered and simmered for years. Céline Gounder: And Chandrakant says it’s helpful to think of yourself more as a guest than a guest of honor. Céline Gounder: Another tradition his team tapped into was folk songs. They frequently used drums, songs, and the public address systems to communicate with people about smallpox.Remember all that joy for India I witnessed in his office in New Delhi — the flag? The dancing? Imagine that harnessed on behalf of his mission to wipe out smallpox.Chandrakant Pandav: Because it’s part of me, every atom, every molecule residing . So, it became an important method of communication.
Tom Bollyky: I think we all forget that there was, for a period of time, a surprising level of political consensus. Almost all states imposed protective policy mandates and most states imposed them at the same time. But as the fall stretched out, you saw some of those mandates and responses become more politicized.
Tom Bollyky: Such a great question. No, I think it isn’t. I think if we set an agenda for public health to rebuild the cohesiveness of our societies, to make us have a better relationship with our government, with each other, we will fail. Céline Gounder: I remember being in South Africa in the early 2000s. There was a soap opera called "Soul City." We pulled a clip of it, and there’s this one scene where a husband comes home to find his wife has placed a romantic gift by their bedside. He opens it up and sees condoms.
Céline Gounder: People there don’t trust government, they think that people who serve in government do so to enrich themselves and their family and friends. Tom Bollyky: I think there is a greater appreciation for trust as an important issue. You hear that messaging. What I worry about is we’re not seeing it reflected yet in where the money is going. Where the money is going by and large is to developing vaccines faster, better vaccines in the future.
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