Editorial
Anadolu Agency/Contributor
Family planning in Iran
See Correspondence pages 1071 and 1072
For the Amnesty International report see https://www. amnesty.org/en/documents/ MDE13/1111/2015/en/ For the 2014 Correspondence see Lancet 2014; 384: 1926–27
Last week, Amnesty International published a report in response to changes in Iranian law, which they say “pose a major threat to the human rights and fundamental freedoms of women and girls in Iran”. Concern about Iran’s changing family planning policies and health were raised by Mehdi Aloosh and Arash Aloosh in a letter in The Lancet last year, and the discussion continues in today’s issue. There are two bills currently under consideration. Amnesty International warns that the combined effect will be to reverse Iran’s progressive family planning laws of the past 20 years, which have successfully controlled population growth and given women control of their own contraception. The Bill to Increase Fertility Rates and Prevent Population Decline includes the prohibition of all voluntary sterilisation and the punishment of health professionals who do such procedures; the withdrawal of emergency contraceptives; and a ban on education about contraception. The Comprehensive Population and Exaltation of Family Bill aims to encourage marriage at young age; to increase multiple children in families;
and to reintroduce discrimination against women in the workplace to keep them at home raising larger families. Amnesty predicts that the effect on women’s equality will be a backwards one, reminiscent of a post-1979 Revolution Iran, in which women lacked fundamental human rights as military targets for population growth were aspired to. In today’s issue, Mohammad Karamouzian and Ali Akbar Haghdoost defend Iran’s need to grow its population, and dispute the severity of the bills’ influences on health, arguing that they might be a necessary step to restore population growth to replacement levels. Mehdi Aloosh responds that his earlier concerns persist. In view of Amnesty’s report, we are alarmed by the potential damage to women and Iranian society, as women’s rights are used as political tools. Repercussions could see a worsening of nationwide poverty, inequality, and even child survival and mortality. We acknowledge the potential problems of Iran’s ageing population, but these bills are not the best solution. The Lancet
ZenShui/Corbis
Water: sustaining the reservoir
For World Water Day 2015 see http://www.unwater.org/ worldwaterday
1046
Water is health. Water is food. Water is industry. These key messages of UN-Water’s World Water Day (March 22) 2015 underscore the importance of one of our most precious resources. The theme this year is Water and Sustainable Development, to highlight the role of water in the sustainable development agenda. Access to safe drinking water is a basic human need, and the provision of clean water and sanitation for everyone worldwide has long been an important issue. Poor quality water causes a substantial proportion of the global disease burden, including 88% of diarrhoeal disease—one of the two leading causes of infectious morbidity and mortality in children worldwide. Millennium Development Goal 7c, to “halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation” has officially been met; since 1990, 2·3 billion people have obtained access to improved drinking water sources and more than a quarter of the global population now has better sanitation facilities. However, 748 million people remain without access to a reliable source of clean
drinking water, 1 billion still practise open defecation, and 2·5 billion lack improved sanitation. Water-borne diseases such as cholera therefore persist, especially in the most populous areas of low-income countries. On behalf of UN-Water, UNESCO’s World Water Assessment Programme released their World Water Development Report on March 20, advising that more sustainable management is urgently needed. Increasing populations, agriculture, and food production mean that a 55% rise in global water demand is expected by 2050. However, 20% of groundwater sources are already overexploited, and a 40% water shortfall by 2030 looms unless we achieve a balance between supply and demand. Reassuringly, provision of clean water and sanitation are included with their own dedicated target in one of the post-2015 sustainable development goals. As the UN prepares to finalise these goals in September, 2015, water should be a key consideration. Water sustains life and is essential for health. Its careful management must therefore be at the very heart of any sustainable development programme. The Lancet www.thelancet.com Vol 385 March 21, 2015
Anadolu Agency/Contributor
Family planning in Iran
See Correspondence pages 1071 and 1072
For the Amnesty International report see https://www. amnesty.org/en/documents/ MDE13/1111/2015/en/ For the 2014 Correspondence see Lancet 2014; 384: 1926–27
Last week, Amnesty International published a report in response to changes in Iranian law, which they say “pose a major threat to the human rights and fundamental freedoms of women and girls in Iran”. Concern about Iran’s changing family planning policies and health were raised by Mehdi Aloosh and Arash Aloosh in a letter in The Lancet last year, and the discussion continues in today’s issue. There are two bills currently under consideration. Amnesty International warns that the combined effect will be to reverse Iran’s progressive family planning laws of the past 20 years, which have successfully controlled population growth and given women control of their own contraception. The Bill to Increase Fertility Rates and Prevent Population Decline includes the prohibition of all voluntary sterilisation and the punishment of health professionals who do such procedures; the withdrawal of emergency contraceptives; and a ban on education about contraception. The Comprehensive Population and Exaltation of Family Bill aims to encourage marriage at young age; to increase multiple children in families;
and to reintroduce discrimination against women in the workplace to keep them at home raising larger families. Amnesty predicts that the effect on women’s equality will be a backwards one, reminiscent of a post-1979 Revolution Iran, in which women lacked fundamental human rights as military targets for population growth were aspired to. In today’s issue, Mohammad Karamouzian and Ali Akbar Haghdoost defend Iran’s need to grow its population, and dispute the severity of the bills’ influences on health, arguing that they might be a necessary step to restore population growth to replacement levels. Mehdi Aloosh responds that his earlier concerns persist. In view of Amnesty’s report, we are alarmed by the potential damage to women and Iranian society, as women’s rights are used as political tools. Repercussions could see a worsening of nationwide poverty, inequality, and even child survival and mortality. We acknowledge the potential problems of Iran’s ageing population, but these bills are not the best solution. The Lancet
ZenShui/Corbis
Water: sustaining the reservoir
For World Water Day 2015 see http://www.unwater.org/ worldwaterday
1046
Water is health. Water is food. Water is industry. These key messages of UN-Water’s World Water Day (March 22) 2015 underscore the importance of one of our most precious resources. The theme this year is Water and Sustainable Development, to highlight the role of water in the sustainable development agenda. Access to safe drinking water is a basic human need, and the provision of clean water and sanitation for everyone worldwide has long been an important issue. Poor quality water causes a substantial proportion of the global disease burden, including 88% of diarrhoeal disease—one of the two leading causes of infectious morbidity and mortality in children worldwide. Millennium Development Goal 7c, to “halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation” has officially been met; since 1990, 2·3 billion people have obtained access to improved drinking water sources and more than a quarter of the global population now has better sanitation facilities. However, 748 million people remain without access to a reliable source of clean
drinking water, 1 billion still practise open defecation, and 2·5 billion lack improved sanitation. Water-borne diseases such as cholera therefore persist, especially in the most populous areas of low-income countries. On behalf of UN-Water, UNESCO’s World Water Assessment Programme released their World Water Development Report on March 20, advising that more sustainable management is urgently needed. Increasing populations, agriculture, and food production mean that a 55% rise in global water demand is expected by 2050. However, 20% of groundwater sources are already overexploited, and a 40% water shortfall by 2030 looms unless we achieve a balance between supply and demand. Reassuringly, provision of clean water and sanitation are included with their own dedicated target in one of the post-2015 sustainable development goals. As the UN prepares to finalise these goals in September, 2015, water should be a key consideration. Water sustains life and is essential for health. Its careful management must therefore be at the very heart of any sustainable development programme. The Lancet www.thelancet.com Vol 385 March 21, 2015
