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Contemplating A One Child World - Fundamental re-thinking is needed. (Published British Medical Journal, 1996;312:907) by Colin Butler A one child world (1) may just be possible in China, a country of coercion, abortion and neglect of orphans; it may also be soon achievable in Catholic Italy and Ireland. For most countries though the switch from demographic transition (average families of 2.1 children) to ecological transition (a one child world) is at least a generation away, and in countries threatened by or already experiencing demographic entrapment this will take much longer. The resurgence of nationalism also complicates this objective, as many ethnic groups will insist that a one child family should not apply to them. If human survival on a global level is possible families urgently need to adopt not only a one child world but one in which the destructive ecological effect of each person is as small as possible (2-3). The issues of demographic and ecological entrapment must become central to scientific and public health policy debate; the taboos which hamper this must fall from our eyes, lest they be forcibly torn. Fundamental rethinking is needed. This is especially true in the industrialised countries - the so called North, where the ecological effect of one person easily outweighs that of fifty in the non-industrialised South. Improved surveillance of, and response to, the catastrophic public health threats that the North now face do not represent an adequate solution (4). The explosion of the consumption bomb threatens populations in both North and South (5). To defuse it fundamental rethinking is needed; along with the nuclear and population bombs this is the greatest threat to public health we currently face. REFERENCES (1) McMichael AJ. Contemplating a one child world. Falling grain stocks and rising population spell disaster and demand debate. BMJ 1995;311:1651-2. [RETURN TO TEXT] 2. Smith R. Overpopulation and overconsumption: Combating the two main drivers of global destruction. BMJ 1993;306: 1285-6. 3. Butler C. Overpopulation, overconsumption, and economics. Lancet 1994;343:582-4. [RETURN TO TEXT] 4. Patz JA, Epstein PR, Burke TA, Balbus JM. Global climate change and emerging infectious diseases. JAMA 1996;275:217- 223. [RETURN TO TEXT] 5. Butler CD. Defusing the consumption bomb. Med J Aust 1995;163:112.[RETURN TO TEXT]