Image: photo of Maurice King and Colin Butler, London, probably early 1997 (photographer uncertain) - on some relevant books. Photographer: Colin Butler (2024)
From King M. The population demons. In: King M, Mola G, Thornton J, et al., eds. Primary Mother Care (Definitive Edition). Stamford, UK: Spiegl Press; 2003: Ch 29 (17 pp).
Maurice wore this on his coat, the last time we met. It is possibly obscured by his red scarf (in the other photos on this page).
Maurice was our public health advisor from 1990 (soon after I met him) until his death in late 2024, aged 97.
We at BODHI wish to offer our condolences to Maurice's wife, Dr Felicity Savage-King and to his extended family. An obituary that Felicity wrote is at https://secretariat.leeds.ac.uk/home/obituaries/maurice-king/
Their surviving son, Ben published one in the Guardian at https://www.theguardian.com/society/2024/nov/15/maurice-king-obituary
The British Medical Journal also published an obituary (at Colin's suggestion) - this is behind a paywall; its link is: https://www.bmj.com/content/387/bmj.q2603
Colin
***
Written March 2025, adapted from my response to an obituary of Dr Maurice King published (November 2024) in the BMJ (formerly the British Medical Journal).
It is now slightly over 40 years since I first went to what was then called the “Third World” – today called the global South. I wanted to get a sense of whether the effort involved in striving for a career in global public health could be sustained by its rewards. As a medical student, my investment was minor; expectations of any sustained commitment to the populations I was learning from (chiefly in Nigeria, India and Nepal) were absent.
To help prepare, my future supervisor in Nigeria had suggested that I study King’s edited book Medical Care in Developing Countries. [2] I found it second hand in Newcastle, Australia, thus becoming one of the far more than 50,000 people who must have at least skimmed it (considering its 2nd hand circulation). In 1990 I was fortunate to meet Maurice, when he gave an invited lecture at the London School of Hygiene and Tropical Medicine (LSH&TM). Among many other topics, he mentioned climate change, a risk that few health workers then took seriously. I was deeply impressed. Maurice was very generous with his time; we spoke, that same evening, in the lounge in the LSH&TM basement, for 3 hours. Soon after, I visited Maurice and his family in Leeds; again we talked non-stop. While there, King gave me a draft of Health is a Sustainable State [3] the title of which reflected his appeal for the World Health Organization (WHO) to improve its definition of health by including the word “sustainable”.
In 1992 I again visited Maurice in Leeds, this time with Susan (BODHI's co-founder), en route to India. Again, we talked continuously. I last saw Maurice in 1997, back at the LSHTM, where I was again studying (see figures). King had been invited to lecture our class by Professor Tony McMichael. In 1999 McMichael was to be a guest co-editor of a themed BMJ issue to mark six billion day; [4] an issue which featured King’s ideas. [5,6]
From here, the text is very similar to that which was published in the BMJ, and which is open access. (See https://www.bmj.com/content/387/bmj.q2603/rr).
The words “population control” in the title of the BMJ obituary for Maurice could easily be misinterpreted, perhaps even hinting that King shared most of the views of Garret Hardin, infamous for his “lifeboat ethics” proposition. Such an interpretation (if gleaned by any reader) would be deeply unfortunate. Hardin explicitly opposed a prolonged and more equitable global distribution of resources, claiming that this would overload spaceship Earth, eventually “producing a catastrophe of scarcely imaginable proportions.” [7] In contrast, as your obituary acknowledges, King had genuine and deep concern and affection for Africa’s people; [6] his many books (some in the stack underneath the photo, below) also illustrate his sustained effort to try to reduce inequity.
Again unlike Hardin, King repeatedly stressed the need for the affluent to reduce their over-consumption of resources, including of the global ecosystem. He wrote, for example, “for those in the industrial North, with its unsustainable economy, a sustainable lifestyle means consumption control”. [3] He also noted that if the North “questions Southern fertility, its own 50-fold greater per capita resource consumption will also be questioned”. [8]
The harmful effect of rapid population growth on development and the risk of civil war in countries in the global South was a strong theme of the later phase of King’s work (approximately 1990-2007). For example: “if the Hardinian taboo on entrapment is not removed, there will be increasing slaughter and starvation throughout much of Africa and elsewhere (malignant uproar), as recently shown in Rwanda”. [9]
King did not coin the term “demographic entrapment”. [10] King traced precursors of this concept to prominent economists who published in the 1950s, including Harvey Leibenstein [11] and Richard Nelson. For example, a paper by Nelson, published in 1956, had proposed the theory of a “low-level equilibrium trap” in “underdeveloped economies”, countries which would now be categorised as in the global South. [12]
Economists Catherine André and Jean-Philippe Platteau argued in explicit support of King, though without citing him, in their 47 page paper “Land relations under unbearable stress: Rwanda caught in the Malthusian trap.” [13] Their conclusion was based on detailed and repeated surveys, undertaken in north-western Rwanda between 1988 and 1993.
Less scholarly support for this core thesis can be inferred by the words of some of the convicted killers in the genocide, such as Adalbert, who told his interviewer:
We at BODHI wish to offer our condolences to Maurice's wife, Dr Felicity Savage-King and to his extended family. An obituary that Felicity wrote is at https://secretariat.leeds.ac.uk/home/obituaries/maurice-king/
Their surviving son, Ben published one in the Guardian at https://www.theguardian.com/society/2024/nov/15/maurice-king-obituary
The British Medical Journal also published an obituary (at Colin's suggestion) - this is behind a paywall; its link is: https://www.bmj.com/content/387/bmj.q2603
Colin
***
Written March 2025, adapted from my response to an obituary of Dr Maurice King published (November 2024) in the BMJ (formerly the British Medical Journal).
It is now slightly over 40 years since I first went to what was then called the “Third World” – today called the global South. I wanted to get a sense of whether the effort involved in striving for a career in global public health could be sustained by its rewards. As a medical student, my investment was minor; expectations of any sustained commitment to the populations I was learning from (chiefly in Nigeria, India and Nepal) were absent.
To help prepare, my future supervisor in Nigeria had suggested that I study King’s edited book Medical Care in Developing Countries. [2] I found it second hand in Newcastle, Australia, thus becoming one of the far more than 50,000 people who must have at least skimmed it (considering its 2nd hand circulation). In 1990 I was fortunate to meet Maurice, when he gave an invited lecture at the London School of Hygiene and Tropical Medicine (LSH&TM). Among many other topics, he mentioned climate change, a risk that few health workers then took seriously. I was deeply impressed. Maurice was very generous with his time; we spoke, that same evening, in the lounge in the LSH&TM basement, for 3 hours. Soon after, I visited Maurice and his family in Leeds; again we talked non-stop. While there, King gave me a draft of Health is a Sustainable State [3] the title of which reflected his appeal for the World Health Organization (WHO) to improve its definition of health by including the word “sustainable”.
In 1992 I again visited Maurice in Leeds, this time with Susan (BODHI's co-founder), en route to India. Again, we talked continuously. I last saw Maurice in 1997, back at the LSHTM, where I was again studying (see figures). King had been invited to lecture our class by Professor Tony McMichael. In 1999 McMichael was to be a guest co-editor of a themed BMJ issue to mark six billion day; [4] an issue which featured King’s ideas. [5,6]
From here, the text is very similar to that which was published in the BMJ, and which is open access. (See https://www.bmj.com/content/387/bmj.q2603/rr).
The words “population control” in the title of the BMJ obituary for Maurice could easily be misinterpreted, perhaps even hinting that King shared most of the views of Garret Hardin, infamous for his “lifeboat ethics” proposition. Such an interpretation (if gleaned by any reader) would be deeply unfortunate. Hardin explicitly opposed a prolonged and more equitable global distribution of resources, claiming that this would overload spaceship Earth, eventually “producing a catastrophe of scarcely imaginable proportions.” [7] In contrast, as your obituary acknowledges, King had genuine and deep concern and affection for Africa’s people; [6] his many books (some in the stack underneath the photo, below) also illustrate his sustained effort to try to reduce inequity.
Again unlike Hardin, King repeatedly stressed the need for the affluent to reduce their over-consumption of resources, including of the global ecosystem. He wrote, for example, “for those in the industrial North, with its unsustainable economy, a sustainable lifestyle means consumption control”. [3] He also noted that if the North “questions Southern fertility, its own 50-fold greater per capita resource consumption will also be questioned”. [8]
The harmful effect of rapid population growth on development and the risk of civil war in countries in the global South was a strong theme of the later phase of King’s work (approximately 1990-2007). For example: “if the Hardinian taboo on entrapment is not removed, there will be increasing slaughter and starvation throughout much of Africa and elsewhere (malignant uproar), as recently shown in Rwanda”. [9]
King did not coin the term “demographic entrapment”. [10] King traced precursors of this concept to prominent economists who published in the 1950s, including Harvey Leibenstein [11] and Richard Nelson. For example, a paper by Nelson, published in 1956, had proposed the theory of a “low-level equilibrium trap” in “underdeveloped economies”, countries which would now be categorised as in the global South. [12]
Economists Catherine André and Jean-Philippe Platteau argued in explicit support of King, though without citing him, in their 47 page paper “Land relations under unbearable stress: Rwanda caught in the Malthusian trap.” [13] Their conclusion was based on detailed and repeated surveys, undertaken in north-western Rwanda between 1988 and 1993.
Less scholarly support for this core thesis can be inferred by the words of some of the convicted killers in the genocide, such as Adalbert, who told his interviewer:
“Before, when we came home from the fields, we’d find almost nothing in the cooking pots, only our usual beans or sometimes even just cassava gruel. When we got back from the marshes, in the cabarets of Kibungo we snapped up roast chickens, haunches of cow and drinks to remedy our fatigue. We found women or children everywhere offering them to us for reasonable prices. And brochettes of goat meat, and cigarettes for those who wanted to try them.
We overflowed with life for this new job. we were not afraid of wearing ourselves out running around in the swamps. And if we turned lucky at work we became happy. We abandoned the crops, the hoes and the like. We talked no more among ourselves about farming. Worries let go of us.” [14]
We overflowed with life for this new job. we were not afraid of wearing ourselves out running around in the swamps. And if we turned lucky at work we became happy. We abandoned the crops, the hoes and the like. We talked no more among ourselves about farming. Worries let go of us.” [14]
A Report of the Rwandan National Agriculture Commission (1990-1991) [15], chaired by James Gasana (then the Rwandan minister for agriculture) warned:
“It can be concluded that if the country does not operate profound transformations in its agriculture, it will not be capable of feeding adequately its population under the present growth rate. Contrary to the tradition of our demographers who show that the population growth rate will remain positive over several years in the future, one can not see how the Rwandan population will reach 10 million inhabitants unless important progress in agriculture as well as other sectors of the economy were achieved. Consequently it is time to fear the Malthusian effects that could derive from the gap between food supply and the demand of the population, and social disorders which could result from there.” (This report can be downloaded for free at https://www.researchgate.net/publication/292667977_Remember_Rwanda).
Support for these ideas also is found among some of the most recognised levels of economists, such as a paper [16] authored by two of the three economists awarded the 2024 Nobel Prize; Darren Acemoglu and Simon Johnson. Before then, Kenneth Arrow, another Nobel economics Prize laureate was involved with several publications on human “carrying capacity” and its related aspects. [17,18]
King repeatedly and convincingly argued that these concepts were suppressed. He categorised 25 reasons for this, not counting the qualifier “etc” which he added to this long list. [19] One of the most important was the risk to capitalism, should his concepts of ecological public health be widely appreciated. King asserted that disturbing the “Hardinian taboo” put at risk “the economic foundations of the global society, its materialist, consumerist, market economy, driven by the diabolical processes of advertizing to promote ever more luxurious and unsustainable lifestyles.” [19]
Aspects of King’s work continues to be suppressed, marginalised and misinterpreted – not only by the UN Population Fund [20] but also by many critics of neoliberalism, including the polemicist George Monbiot. [21] The schism between those who (like King) advocate greatly increased human rights-based family planning in the South [22] and most on the Left is a trap laid by US neoliberals in the 1980s, during the administration of President Ronald Reagan, and greatly influenced by the cornucopian futurist Julian Simon. [23] However, some on the Left would disagree with Monbiot, were they still alive. The leading Marxist scholar Joan Robinson wrote “In his anxiety to combat the reactionary views of Malthus he (i.e. Marx) refused to admit that a rapid growth of population is deleterious to the interests of the working class.” [24] The late and great ecological economist Herman Daly cited this passage by Robinson, [25] and in other ways also championed concepts well understood by King and many other interpreters [26-28] of the vast literature that underpins King’s work on demography and development. [29]
In recognition of King’s enormous and highly relevant legacy, it is hoped that the BMJ will gradually publish a series of peer reviewed articles reflecting on the relevance of his work to global development and health. These will be guest edited by myself, Prof. Mala Rao CBE and Kamran Abbasi, together with a small advisory board yet to be announced.
Before Maurice passed away he was aware of the impending publication of the book “Climate Change and Global Health” [30] and that this was dedicated not only to him, but to two other champions and pioneers of planetary health: Tony McMichael (1942-2014) [31] and Will Steffen (1947-2023). [32] There is increasing, though greatly belated recognition that the global eco-social system is generating perverse feedbacks that will further accelerate the polycrisis. Some of these have been described as “traps”. [33] These feedbacks include inflation fuelled by rising energy costs and disasters worsened by climate change, which in turn, elevate insurance costs. These, with the fear and resentment of asylum seekers and “economic” migrants who seek admission to the North, are generating increasing support for populist politicians, the misplaced policies of whom will simply worsen humanity’s plight. [34] Maurice not only understood but foresaw much of this. It is of vital importance that a new generation of scholars (particularly health workers) not only consider his key ideas afresh, but seek to reverse these extremely worrying trends. [35]
References
“It can be concluded that if the country does not operate profound transformations in its agriculture, it will not be capable of feeding adequately its population under the present growth rate. Contrary to the tradition of our demographers who show that the population growth rate will remain positive over several years in the future, one can not see how the Rwandan population will reach 10 million inhabitants unless important progress in agriculture as well as other sectors of the economy were achieved. Consequently it is time to fear the Malthusian effects that could derive from the gap between food supply and the demand of the population, and social disorders which could result from there.” (This report can be downloaded for free at https://www.researchgate.net/publication/292667977_Remember_Rwanda).
Support for these ideas also is found among some of the most recognised levels of economists, such as a paper [16] authored by two of the three economists awarded the 2024 Nobel Prize; Darren Acemoglu and Simon Johnson. Before then, Kenneth Arrow, another Nobel economics Prize laureate was involved with several publications on human “carrying capacity” and its related aspects. [17,18]
King repeatedly and convincingly argued that these concepts were suppressed. He categorised 25 reasons for this, not counting the qualifier “etc” which he added to this long list. [19] One of the most important was the risk to capitalism, should his concepts of ecological public health be widely appreciated. King asserted that disturbing the “Hardinian taboo” put at risk “the economic foundations of the global society, its materialist, consumerist, market economy, driven by the diabolical processes of advertizing to promote ever more luxurious and unsustainable lifestyles.” [19]
Aspects of King’s work continues to be suppressed, marginalised and misinterpreted – not only by the UN Population Fund [20] but also by many critics of neoliberalism, including the polemicist George Monbiot. [21] The schism between those who (like King) advocate greatly increased human rights-based family planning in the South [22] and most on the Left is a trap laid by US neoliberals in the 1980s, during the administration of President Ronald Reagan, and greatly influenced by the cornucopian futurist Julian Simon. [23] However, some on the Left would disagree with Monbiot, were they still alive. The leading Marxist scholar Joan Robinson wrote “In his anxiety to combat the reactionary views of Malthus he (i.e. Marx) refused to admit that a rapid growth of population is deleterious to the interests of the working class.” [24] The late and great ecological economist Herman Daly cited this passage by Robinson, [25] and in other ways also championed concepts well understood by King and many other interpreters [26-28] of the vast literature that underpins King’s work on demography and development. [29]
In recognition of King’s enormous and highly relevant legacy, it is hoped that the BMJ will gradually publish a series of peer reviewed articles reflecting on the relevance of his work to global development and health. These will be guest edited by myself, Prof. Mala Rao CBE and Kamran Abbasi, together with a small advisory board yet to be announced.
Before Maurice passed away he was aware of the impending publication of the book “Climate Change and Global Health” [30] and that this was dedicated not only to him, but to two other champions and pioneers of planetary health: Tony McMichael (1942-2014) [31] and Will Steffen (1947-2023). [32] There is increasing, though greatly belated recognition that the global eco-social system is generating perverse feedbacks that will further accelerate the polycrisis. Some of these have been described as “traps”. [33] These feedbacks include inflation fuelled by rising energy costs and disasters worsened by climate change, which in turn, elevate insurance costs. These, with the fear and resentment of asylum seekers and “economic” migrants who seek admission to the North, are generating increasing support for populist politicians, the misplaced policies of whom will simply worsen humanity’s plight. [34] Maurice not only understood but foresaw much of this. It is of vital importance that a new generation of scholars (particularly health workers) not only consider his key ideas afresh, but seek to reverse these extremely worrying trends. [35]
References
- Lyall, J. 2024. Maurice King: physician and author of textbooks for doctors working in the developing world and researcher on population control. BMJ, doi: 10.1136/bmj.q2603
- King, M. (ed.) 1966. Medical Care in Developing Countries. A Primer on the Medicine of Poverty and a Symposium from Makerere, Nairobi, Kenya: Oxford University Press.
- King, M. 1990. Health is a sustainable state. Lancet, 336, 664-667, doi: 10.1016/0140-6736(90)92156-C
- McMichael, A.J. & Powles, J.W. 1999. Human numbers, environment, sustainability, and health. BMJ, 319, 977-980, doi: 10.1136/bmj.319.7215.977
- King, M. 1999. The US Department of State is policing the population policy lockstep. BMJ, 319, 998-1001, doi: 10.1136/bmj.319.7215.998
- Abbasi K. King in a maverick style. BMJ 1999;319, 942: doi: 10.1136/bmj.319.7215.942 pmid: 10514154
- Hardin, G. 1974. Living on a life boat. Bioscience, 24, 561–568, doi: 10.2307/1296629
- King, M. & Elliott, C. 1996. UNICEF's call to greatness--An open letter to Ms Carol Bellamy, Executive Director, United Nations Children's Fund. National Medical Journal of India, 9, 130-133, PMID: 8664826
- King, M. & Elliott, C. 1997. To the point of farce: a Martian view of the Hardinian taboo - the silence that surrounds population control. BMJ, 315, 1441-1443, doi: 10.1136/bmj.315.7120.1441
- Brown, L. 1987. Analyzing the demographic trap. In: Brown, L. (ed.) State of the World 1987. New York: Norton. pp. 20-37.
- Leibenstein, H. 1954. A Theory of Economic Development, Princeton, NJ, Princeton University Press.
- Nelson, R.R. 1956. A theory of the low-level equilibrium trap in underdeveloped economies. American Economic Review, 46, 894-908, Available at: https://www.depfe.unam.mx/actividades/12/curso-crecimientoydesarrollo/02_nelson_1956.pdf
- André, C. & Platteau, J.-P. 1998. Land relations under unbearable stress: Rwanda caught in the Malthusian trap. Journal of Economic Behavior and Organization, 34, 1–47, doi: 10.1016/S0167-2681(97)00045-0
- Hatzfeld, J. 2006. Machete Season. The Killers in Rwanda Speak, New York, New York, Farrar, Straus and Giroux, MacMillan, p 60-61 (first published 2003)
- Gasana, J. 2002. Remember Rwanda? Worldwatch Magazine, The Worldwatch Institute, 24-33. Available at https://www.researchgate.net/publication/292667977_Remember_Rwanda
- Acemoglu, D., Fergusson, L. and Johnson, S. 2020. Population and conflict. The Review of Economic Studies, 87, 1565-1604, doi: 10.1093/restud/rdz042
- Arrow, K., Bolin, B., Costanza, R., Dasgupta, P., Folke, C., Holling, C.S., Janssong, B.-O., Levin, S., Mäler, K.-G., Perrings, C., et al. 1995. Economic growth, carrying capacity, and the environment. Science, 268, 520-521, doi: 10.1126/science.268.5210.520
- Kendall, H.W., Arrow, K.J., Borlaug, N.E., Ehrlich, P.R., Lederberg, J., Vargas, J.I., Watson, R.T. & Wilson, E.O. 1995. Meeting the challenges of population, environment, and resources. The cost of inaction. Third Annual World Bank conference on Environmentally Sustainable Development. Washington DC: Union of Concerned Scientists and the World Bank.
- King, M. 2003. The population demons. In: King, M., Mola, G., Thornton, J., Breen, M., Bullough, C., Guillebaud, J. & Addo, F. (eds.) Primary Mother Care (Definitive Edition). Stamford, UK: Spiegl Press. pp. Ch 29 (17 pp).
- Butler, C.D. 2024. Grand (meta-) challenges in planetary health: environmental, social and cognitive. Frontiers in Public Health, 12, 137378, doi: 10.3389/fpubh.2024.1373787
- Monbiot, G. 2020. Population panic lets rich people off the hook for the climate crisis they are fuelling The Guardian, https://www.theguardian.com/commentisfree/2020/aug/26/panic-overpopulation-climate-crisis-consumption-environment
- Bryant, L., Carver, L., Butler, C.D. and Anage, A. 2009. Climate change and family planning: least developed countries define the agenda. Bulletin World Health Organization, 87, 852-857, doi: 10.2471/BLT.08.0625
- Butler, C.D. 2024. Population, neoliberalism and "human carrying capacity". In: Butler, C.D. & Higgs, K. (eds.) Climate Change and Global Health: Primary, Secondary and Tertiary Effects. Second ed. Wallingford, UK., Boston USA: CABI. pp. 113-124. https://www.cabidigitallibrary.org/doi/10.1079/9781800620025.0009www.cabidigitallibrary.org/doi/10.1079/9781800620025.0009
- Robinson, J. 1966. Preface. Essay on Marxian Economics. 2nd ed. London: MacMillan Press. pp. 6-21.
- Daly, H. 1971. A Marxian-Malthusian view of poverty and development. Population Studies, 24, 25-37, doi: 10.1080/00324728.1971.10405780
- Butler, C.D. 1991. Global warming, ecological destruction and human health. Medical Journal of Australia, 155, 351, see: https://colindbutler.weebly.com/1990s.html
- McMichael, A.J. 1993. Planetary Overload. Global Environmental Change and the Health of the Human Species, Cambridge, UK, Cambridge University Press.
- Butler, C.D. 2000. Entrapment: global ecological and/or local demographic? Reflections upon reading the BMJ's "six billion day" special issue. Ecosystem Health, 6, 171-180, doi: 10.1046/j.1526-0992.2000.006003171.x
- Kelley, A.C. 2001. The population debate in historical perspective: revisionism revised. In: Birdsall, N., Kelley, A.C. & Sinding, S.W. (eds.) Population Matters: Demographic Change, Economic Growth, and Poverty in the Developing World. Oxford; New York: Oxford University Press. pp. 24-54.
- Butler, C.D. & Higgs, K. (eds.) 2024. Climate Change and Global Health. Primary, Secondary and Tertiary Effects, Wallingford, UK: CABI. https://www.cabidigitallibrary.org/doi/book/10.1079/9781800620025.0000www.cabidigitallibrary.org/doi/book/10.1079/9781800620025.0000
- Gupta, S. 2012. Profile of Anthony J. McMichael. Proceedings of the National Academy of Sciences, 109, 6787-6789, doi: 10.1073/pnas.1205294109
- Folke, C., Rockström, J. & Richardson, K. 2023. Obituary – Will Steffen, the father of Earth System science. Global Sustainability, 6, 1-2, doi: 10.1017/sus.2023.16
- Jørgensen, P.S., Jansen, R.E.V., Ortega, D.I.A., Wang-Erlandsson, L., Donges, J.F., Österblom, H., Per Olsson, Nyström, M., Lade, S.J., Thomas Hahn, et al. 2024. Evolution of the polycrisis: Anthropocene traps that challenge global sustainability. Philosophical Transactions B, 379, 20220261, doi: 10.1098/rstb.2022.0261
- Lawrence, M., Homer-Dixon, T., Janzwood, S., Rockstöm, J., Renn, O. & Donges, J.F. 2024. Global polycrisis: the causal mechanisms of crisis entanglement. Global Sustainability, 7, 1–16 doi: 10.1017/sus.2024.1
- Butler, C.D. & Rao, M. 2025. What “dose” of anxiety is needed to awaken transformative action on climate change? BMJ, 388, q2584, doi: 10.1136/bmj.q2584
Image: photo of Maurice King and Colin Butler, London, probably early 1997 (photographer uncertain). On a stack of relevant books, some co-edited by Maurice (more are visible in this image than the one at the start). Photographer: Colin Butler