1. We take the population problem to comprise all those difficulties which are made worse by there being 10,000 more of us every hour, and which include our vanishing forests, our increasingly unmanageable megacities, and our declining global per capita grain. 
 

2. The 2-child paradigm is the view of the word that, if all the unmet need for family planning is eventually met, and a 2-child norm ultimately achieved, this will be demographically sufficient, and no account need be taken of carrying capacity limitations, or of entrapment meanwhile 
 

3. A photon-efficient diet is a largely grain based diet which converts sunlight into food calories with the greatest efficiency. There are so many interpretations of the term 'vegetarian' that a new term is needed. * 

4. It has been said that the term demographic 'entrapment'     should not be used, since it has harmful connotations. (see also Dyson's argument) We argue that it has been the accepted term over many years, and whatever term was used, it would soon have the same unhappy associations. It was not invented by us and is said to have been first used by economists in the 1950s. However this reference is to the 'low-level equilibrium    trap of Nelson (1956) and Leibenstein (1954), which as we argue below is different. It has long been discussed under the less specific term of 'overpopulation' (Milton Siegel 1993).

               There are several other usages of the term 'entrapment' which do not have the  attributes of an adequate definition. Although all these usages express some part of the entrapment process, none is adequate as it stands, in that they do not consider the lack of opportunities for migration, or lack of the economic development that could produce goods and services for exchange, nor do they lend themselves to the early diagnosis of entrapment. Other authors have used entrapment to mean:

               (i) A prolongation of the middle phase of the demographic transition. This usage is incomplete, since there are several countries in the middle East, Saudi Arabia, for example, where the birth rate has yet to fall significantly, but are not trapped.

               (ii) A rise in mortality, and thus an abnormality of the third phase of the transition. Not only is this too late for preventive action, but there is also the problem of the causes of the rise, and the extent to which it is to be attributed to factors other than entrapment.

               (iii) A stage in which carrying capacity is exceeded   (Brown, 1987).

               (iv) A stage of ecological destruction; this is important but is accounted for by the carrying capacity factor in our definition.

               (v) A situation in which population growth overwhelms the social services, and leads to an increasingly vicious circle (hence the trap) of high fertility, increasing poverty, and deterioration in the socio-economic conditions that might ultimately have reduced fertility. This ends in a state of anarchy which eventually destroys the state (Homer-Dixon: 1994).

               (vi) Geertz (1 963) described a process of agricultural and cultural involution, which has been confused with entrapment, but which is distinct from it in that he did not discuss the consequences of a population exceeding its carrying capacity.

               (vii) Aid agency executives appear to use entrapment to mean a condition of increasing population density, progressive imiseration,     and pessimistic prospects for food supplies.

               (vii) We discuss the low level equilibrium trap of Nelson (1956) and Leibenstein (1956) below. 

5. The private appreciation of entrapment (double-think) is such that in May 1993, one of us (MK) gave a seminar to three WHO divisions, at which there was general agreement that the phenomenon was real. John Seaman, Medical Director of Save the Children Fund (UK), reported that in 1995 he was at a meeting of NGOs which took entrapment so much for granted that there was not even any reference to papers by ourselves. 
 

6. The term 'Hardinian taboo' is a new one. It appears to have been first used by Paul Demeny rejecting an earlier version of this paper for the Population and Development Review: in which he said "...other elements, such as the Hardinian discussion of taboo are familiar from the general literature...... However no reference to 'Hardinian taboo' can be found in any database (POPLINE, etc.) We suggest that Demeny's actually naming the population taboo as 'the Hardinian taboo' may have been a critical step in eventually abolishing it. Hardin himself had never heard of the term until we told him of Demeny's usage of it. 
 

7. Concerning our survival as a species, Hardin (1 993:252) cites CP Snow speaking of his earlier book The Two Cultures, in which he regretted that he had avoided speaking of population out of compassion for his friends. and later regretted it. Snow CP. The State of Siege. New York, Scribners, 19-20. 
 

8. We have examined the extensive Belgian data on Rwanda's      entrapment elsewhere (King and Elliott, 1996). Its population was already causing anxiety in the 1920s (Henri Jaspar: 1929). In the 1960s and increasingly thereafter Belgian observers were estimating that its carrying capacity could not exceed 6-7 millions. It had reached 7.6 million before the 1994 genocide. A model by Wils (1986: 120) predicted that of its 1995 population 1.5 million would have to be fed by imported food.

               We have argued that the "ordinary" level of slaughter endemic in that region would not have suddenly escalated ten fold in the way it did, if it had riot been trapped - had there been ample land and jobs for everyone, and/or adequate connectedness in the form of opportunities for migration, or an export oriented economy that provided enough jobs, food and consumer goods. The fact that slaughter reached its climax at exactly the point at which carrying capacity was expected to be exceeded seems unlikely to have been coincidental. As it is, the genocide is commonly ascribed to human rights abuses and demographic entrapment is usually elided, perhaps because it is even more disturbing.

               Should there be any doubt as to whether Rwanda has exceeded its present carrying capacity, we argue that there is no knowing what its future population will be. At  the time of the genocide  it has the highest fertility in the world. As to migration, although Rwandans may, for example, be arriving in Zambia (Alan Howarth, personal communication) a thousand at a time (less than two days equivalent of Rwanda's annual population increment), we see total migration out of Rwanda as being inadequate for disentrapment. especially of its anticipated future population.

              (1) Pressure on land is intense with the result that Malawi appears to have exceeded its carrying capacity. (UN in Malawi)

           (2) Population densities in the Southern region range from 2.3 to 4.6 per hectare.

           (3) Half Malawi's households cultivate less than a hectare, and a quarter of the them less than 0.5 ha. (UN in Malawi)

           (4) By the year 2000 the average per capita holding of smallholder families will have reached 0.3 ha.  (UN in Malawi)
 

           (5) By 2014, by which time population is expected to have  doubled, present land holdings will have halved. (UN in Malawi)

          (6) Half the under fives are stunted and a quarter of them severely so. (UN in Malawi)

          (7) Even in a year of average rainfall, most households are unable to meet their food requirements.  (UN in Malawi)

          (8) Per capita maize production (now 160 kg annually) and calorie consumption are falling.   The need for food aid is now continuous and rising. [check]

          (9) Total fertility averaged 7.5 nationally in 1993, and has recently been rising (World Bank: 1994 Fig 1-1).  In one district it had reached 9.6.  [In 1997 it had fallen to  6.69 for Malawi as a whole, UNFPA]

          (I0) The desired family size is 6, and the birth rate is 53. (UN in Malawi)

          (11) Only 7% of married women use modern contraceptive methods, and less than half the health units provide them. [In 1997 the CPR for any method was 13% and for any modern method 7%, UNFPA]  (UN in Malawi)

          (12) If total fertility were to start falling in 2000 and reach replacement level in 15 years, a difficult achievement with conventional family planning programmes, and totally insufficient for disentrapment, its population would increase from its present 8.8 millions to 21 million (John Blacker, personal communication).

          (13) Even the worst AIDS scenario will only lower its population growth rate from 3.3% to 2.1%.  [The population growth rate is 2.5% in 1997]  (UN in Malawi)

          (14)10% of its population are refugees, and are now returning home.  (UN in Malawi)

          (15) Opportunities for further migration are limited. (UN in  Malawi)

          (16) Even if all the estates growing sugar and tobacco were to grow maize or cassava, this would only increase the area presently growing staples by 9 %. (UN in Malawi)                In the absence of any reasonable hope of creating a manufacturing economy which would allow it to import food and necessities from elsewhere in the world, Malawi must be considered  severely trapped. So far there is little violence. Although structural adjustment programmes have greatly improved macro-economic performance, a significant proportion of the population have seen a real decline in their incomes in the last 10 years. Twice as much is spent servicing debt as on the social services. 

10. Our concern with 'benign uproar' stems from a debate with Richard Jolly, then Deputy Director Of UNICEF, after which he warned one of us (MK) that "to argue for the recognition of entrapment was to play with fire". We argue that not to recognize it plays with fire of malignant uproar, and that our aim should be for 'benign uproar' of heated argument. We suggest that the release of emotional heat may necessary for the change in fixed positions on so many fronts. The major challenge is to try to channel released emotions in constructive directions. In practice, several factors which we mention, but do not condone, promise to mitigate the release of emotions in international meetings and to reduce the likelihood of their breaking up in disorder:

               (i) Many of the Southern elite, and spokespersons for the South have in practice assumed the lifestyle of the North. They are in the process of emigrating, with their families, and have sided with it.

               (ii) The world seems to be moving from a North/South orientation towards a rich/poor one. These meetings are only attended by the rich. Since the poor are powerless, they will not be at the meetings to cause the necessary uproar.

               (iii) A 1 -child world should not be too difficult for the North, where many countries already approach it. 

11. UNDP's World Development Report 1996 page 2 gives the wealth of the world's 358 billionaires as being greater than the combined annual incomes of 45% of the world's people. This must be close to 500 people owning as much wealth as half of humanity. 

12. There is a misleading impression in the literature that modern famines do not involve a food availability decline. Dyson (1996 footnote 21) argues they do, and that such a decline contributed to all five of Sen's famines (Sen 1981). We argue that food availability decline, due to pressure of population on carrying capacity, contributes to chronic malnutrition, particularly stunting. Its contribution to famine has been mitigated by food aid (UN in Malawi 1993). 
 

13. If entrapment is a severe as we suggest, why has mortality not yet increased dramatically? We argue that it has in Rwanda, and that data which are poor, absent or badly aggregated may be hiding lesser increases. Other reasons are food aid and migration in that when people see Malthusian crashes coming, they migrate if they can, either to another rural area, or to a city. If the city is in a food deficit country, urban migration may merely be postponing famine. 

14. As adaptations to a 1-child world, we give as examples,

               (i) in an ageing society the able-bodied 60 and 70 year-olds with time on their hands must somehow care for those in their 80s and 90s.

               (ii) Single children need to be shared between families so that they can have temporary siblings. 
 

15. While aware of the many abuses of the term 'paradigm shift', and of Kuhn's many uses of the term, as well as  his own ambiguities, we still think that 'paradigm shift' is  preferable to 'school' or 'ideology. We agree with the colleague who remarked that 'having contemplated entrapment, the world never looked quite the same again'. We agree with Kuhn that a theory choice,  or paradigm switch,  is not a wholly rational act,  and that 'As in political revolutions, so in paradigm choice, there is no standard higher than the assent of the relevant community (Kuhn 1970.94). We sympathize with our demographer colleagues in that political pressures put upon them from outside demography make a paradigm shift particularly difficult. 
 

16. As an example of conflicting premisses, we cite those concerning abortion:

               (i) 'the obligation not to destroy life', and

               (ii) the right of a mother to have the right of decision over her own body.

               There is no logical way of deciding which of these takes precedence. As the result of much argument society commonly chooses a compromise, such that abortion shall, for example be allowed up to but not beyond the 24th week of pregnancy, a rule that is apt to change from time to time - and does not mean apply a wider licence to kill (the 'slippery slope', or 'gas chambers argument). The many conflicting premises underlying entrapment needed to be decided by similar discussion and dynamic compromise. 

17. We suggest that the dilemmas raised by entrapment exceed the ethical and political limits of The Lancet, since it was unwilling to discuss the implications of entrapment in Rwanda as described in our paper (King and Elliott 1996a).See  Since not to publish a dilemma is to opt automatically for the default position, we hold that it is a cardinal principle of editorial  integrity to hold no dilemma too awesome to be published, the editor being justified in taking any position in the dilemma that he wishes. 

18. This view of the stillness of the international health scene, is that of Patrick Vaughan, then of the London School of  Hygiene. 

19. Hardin (1993) argues that we fail to mandate economic sanity because our minds are addled by compassion. Compassion is complex in that a narrower compassion may on occasions need to give way to a wider one. 

20. As to our own metaphysical position, we answer with St Augustine "For thou has made us for thyself .. (A St Augustine, Confessions) 

21. The Universal Declaration of Human Rights, adopted by General Assembly Resolution 217 (A) IH) (1948), states that "the recognition of the inherent dignity and of equal and unalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world".

22. Concerning the making of wheels, a missionary colleague in south Tanzania recently observed that although his community  could change the wheel on a LandRover, they never themselves made wheels of any kind.  An economic take-off is thus still a long way off.

23. We argue that many aspects of food and fertility are matters of free will which are in human hands, which we cannot expect the Almighty to always provide. 

24. In 1990 President Kenneth Kaunda's attempt to increase the price of mealie meal led to a week of student-led food riots, arson and looting, in which the poor turned against the rich (anyone with a car), and led to the fall of the government. The provocation to violence was reported to be the poor seeing their children go hungry for want of food they could see, but not afford (Dr Alan Howarth eyewitness). 

25. The neo-malthusian theory holds that, whereas Malthus was correct in believing that, below a certain per capita income, population presses inexorably on the means of subsistence, above a critical per capita income level population growth declines, thus eliminating the slowing down and ultimately the reversal of increases in per capita income. 

26. Samiran Nundi, Editor, National Medical Journal of India, personal communication on entrapment in India.

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