The new journal Nature Health has an appalling blindspot

This almost instantly rejected letter to the brand new journal Nature Health was submitted on January 22, 2026. It is first posted here on Feb 24, 2026. My submitted letter originally followed the journal's requested format; here I have added the names of the cited articles.

After its rejection I learned that the jounal's inaugural editor (Dr Ben Johnson) has a PhD in virology and additional training as a journalist. It is unclear if he (or any of his co-editors, other than Dr Manonmani Soundararajan, who studied biotechnology at Tamil Nadu Agricultural University, India) have any "on the ground" experience in the Global South: a population whose well-being the journal will ostensibly focus on.

Dear Editor 

Health is indeed influenced by more than medicine; especially global population health. Of “many” challenges your inaugural editorial leads with misinformation and disinformation, though providing no examples. To this category I suggest the added dimension of selective information. An example of this in the domain of global health is the relationship between high fertility in low-income settings and other determinants of human well-being, including armed conflict and involuntary migration, each of which are factors that you do mention.

 

Rafael Salas, who served as the first executive director (1969-1987) of the United Nations Population Fund (UNFPA) is still described on the UNFPA website as “a pioneer in the field of population .. one of its first true international advocates, conveying to others the importance of understanding the crucial links between population and development and the need to take population factors into account in development planning”.¹The opinion that accelerating the demographic transition in low-income settings (especially using human rights-based means) will benefit population health and other aspects of human well-being in developing countries (now the Global South) was once widely accepted, but came under intense attack in the 1980s, such as by the US National Research Council, itself disproportionately influenced by the highly optimistic futurist Julian Simon.^2-3 

 

Within public health Salas’ view persisted for over a decade,^4-5 but with diminishing frequency and influence. The topic faded from curricula, including within schools of public health. Younger practitioners seemed to either ignore the topic or be uncomfortable when discussing it. Your editorial, by not mentioning fertility, reflects a view within health that is now overwhelmingly dominant.

 

Beyond health, the selective opinion that human fertility (at least if well above replacement) is not a major determinant of human well-being also dominates. Diana Coole, an emeritus professor of political and social theory, in 2021 described the population question as facing “powerful taboos”.⁷ However, periodically, older views still surface. For example, The World Scientists' Warning to Humanity (1992), signed by the majority of Nobel science laureates then alive, called for the adoption of effective, voluntary family planning in all nations, in order to live within limits.⁶

 

In 2020, two of the three 2024 Nobel economic laureates co-authored a study finding a “sizeable” effect between population increase, and social conflict, chiefly concerning access to natural resources⁸. They identified exacerbating co-factors, such as drought during the growing season and reviewed literature suggesting that scarcity of arable land could be a contributing cause. These authors even dared (and were permitted by reviewers and editors) to describe their model as “Malthusian, a term regarded as seemingly horrific by some other authors,⁹ apparently ignorant of, or choosing to ignore the fundamental influence of Malthus upon science, including for the theory of evolution.

 

The latest major report of the United Nations Environment Programme also breaks this silence, for example by pointing out that the importance of active promotion of “the multiple health and economic benefits of smaller family sizes” as necessary (if not sufficient) and that “universal access to modern contraception offers a potential win-win situation for women’s empowerment and the environment”.¹⁰

 

Nature Health aims for real-world impact. Encouraging research that explores the complexity of the relationship between human fertility and the determinants and consequences of development, including health, will powerfully contribute to achieving this noble aspiration.

 

References

 

1. https://www.unfpa.org/previous-executive-directors accessed 13 January, 2026.

2. Population Growth and Economic Development: Policy Questions (National Research Council, 1986);  National Research Council. National Academy of Sciences Press 1986.

3. Butler CD. Population, neoliberalism and "human carrying capacity" In: Butler CD, Higgs K, eds. Climate Change and Global Health: Primary, Secondary and Tertiary Effects. Second ed. CABI. 2024:113-124

4. King M. Health is a sustainable state Lancet 1990; 336: 664-667.

5. McMichael AJ. Contemplating a one child world BMJ 1995; 311: 1651-1652.

6. Coole D. The toxification of population discourse Journal of Development Studies 2021; 57: 1454-1469.

7. Acemoglu D, Fergusson L, Johnson, S. Population and conflict Review of Economic Studies, 2020;87,1565-1604.

8. Union of Concerned Scientists. World Scientists' Warning to Humanity Cambridge, Massachusetts: Union of Concerned Scientists http://www.ucsusa.org/about/1992-world-scientists.html, accessed 14 May, 2023, 1992.

9. Ojeda D, Sasser JS, Lunstrum E. Malthus’s specter and the Anthropocene Gender, Place & Culture A Journal of Feminist Geography 2019; 27: 316-332

10.  UNEP. Global Environment Outlook 7, 2025, page 40.

Planetary health and its fellow travellers: a struggle for justice and survival

Draft, for conference in Quito, Ecuador, September, 2026. (Keynote talk, 35 mins plus questions, to be given by Zoom, comments welcome).

Second International Symposium on ONE HEALTH Epigenomes and Microbiomes: From Soil to People" (OneHealthEPI2026)

 

Colin Butler

 

Humanity, Homo sapiens, is a bipedal primate that emerged in Africa, evolving through forces of both competition and co-operation, and has since spread to all continents, all oceans, and even into permanent orbit. Our species now rules over most other species, causing many extinctions. Technology has become increasingly powerful: fire, arrows, drones and inter-continental missiles. Messages once spread by drumming or by the lighting of pyres on hilltops have transformed to the internet. But these technological marvels have not been matched by a commensurate growth in wisdom. 

 

Humans are hierarchical, but our species’ tendency to extreme inequality has periodically been checked, such as by political assassinations, the imprisonment of kings, and successful anti-colonisation struggles. I reached adulthood in the 1970s, a decade that Halfdan Mahler, then director general of the World Health Organization, called the “warm decade of social justice”. It was also the decade of the first global environmental conference, held in Sweden 20 years ahead of Rio’s “Earth summit”, itself a mega-meeting once hoped by optimists to be a positive turning point for the Earth system. 

 

A near concurrence of events: growing human connectivity (e.g. the response to the “blue marble” photo of Earth), growing appreciation of the scale and longevity of environmental harm, and a sober understanding of global civilization’s vulnerability (following World War II and during the Cold War), inspired some writers to try to inform and to motivate the health community to add their voices to the movement for greater global environmental as well as social justice. Rachel Carson and René Dubos were followed by human ecologists, publishing in health journals from 1972. The term “planetary health” emerged, perhaps used for the first time by Jonas Salk in 1980, otherwise famous for his development of the first successful polio vaccine, which he refused to patent. 

 

This talk (given over the internet) will sketch the history of planetary health and its near relatives: ecohealth and One Health. The hope of “health for all”, once championed by Mahler, has vanished, replaced by naïve faith in market forces, colonialism, escapism and wishful thinking, illustrated for example by the hubris of the artificial intelligence promoter Sam Altman. Linking these issues is the colonization of the internet (especially social media) by entrepreneurs who abuse algorithms to deepen human divisions, to generate profits, to belittle and seek to undermine science, and to hide and suppress the poycrises’ underlying causes. Another is the compliance of big science and media, dependent on increasingly neoliberal funders for income and visibility.

 

As limits to growth become ever more stark – yet ever more hidden from public understanding because of self and imposed censorship (which also contaminate the dominant contemporary literature of planetary heath, ecohealth and One Health) I fear for the future. Somehow, we have to maintain sufficient morale to stay afloat, to “triage” the ecological resources that survive, and to join with others in the great struggle to reverse the trends that appear to be pushing civilization towards its demise.