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.
