From population control to policy by numbers

Zohran Mamdani has recently been in the news—young, articulate, politically sharp, and controversial in equal measure. But whenever I read his name, my mind returns to another time and another figure: his father, Mahmood Mamdani. Today, as Bangladesh once again hears bold announcements about family cards, health cards, social protection, and Universal Health Coverage (UHC), I find myself wondering: are we standing before an old question in a new form?

I first encountered Mahmood Mamdani’s work as a student at the London School of Economics (LSE) in the late 1970s. The world was then gripped by anxiety over what was called the “population explosion.” Paul Ehrlich’s The Population Bomb had injected a tone of urgency, even alarm, into development thinking. In the geopolitical climate of the Cold War, high fertility rates in the Global South were viewed not just as an economic problem but as a political risk as well. In policy circles in Washington and elsewhere, rapid population growth was increasingly framed as a driver of poverty, instability, and even extremism. Family planning became more than a public health initiative; it became a geopolitical priority. In classrooms, we were shown graphs: population curves rising steeply, food production lagging. The prescription appeared straightforward: reduce fertility. Set targets, increase “acceptors.”

The numbers were clear. The logic was simple. It was at this moment that I read Mahmood Mamdani’s The Myth of Population Control. The book unsettled me.

At the heart of Mamdani’s analysis was Khanna, a district in India’s Punjab, where, in the 1960s, a long-term family planning study led by Harvard University was conducted. The objective was direct: if modern contraceptives were made available and incentives provided, would rural couples adopt them?

Researchers visited the village regularly, provided counselling, distributed pills and injections, and collected survey data. The results showed rising “acceptance.” The study was celebrated internationally. Khanna became evidence that even rural India was embracing family planning. But Mamdani, an anthropologist, went back to the field and found a more complex reality. Many of those recorded as “acceptors” were not consistent users. Some took the pills but did not consume them. Others received injections once, but did not return. More importantly, Mamdani examined the power dynamics at play. The foreign researchers were educated, authoritative, and backed by state and international institutions. Villagers perceived them as sahibs. Refusal was not socially easy. In that context, what surveys recorded as “acceptance” often reflected deference rather than conviction.

In statistical terms, uptake had increased. In social terms, compliance masked constraints. Mamdani posed an even deeper question: why should these families reduce fertility in the first place? In agrarian settings marked by economic insecurity, absence of social protection, and reliance on children for old age support, children are not merely mouths to feed but also labour, insurance, and dignity. Without altering these structural conditions, how sustainable could a purely technical fertility intervention be?

I still remember sitting in the LSE library, winter light filtering through the windows, reading Mamdani’s arguments. I was studying demography—rates, regressions, projections. Yet, Mamdani reminded me that numbers do not float above society; they are produced within it. I may not have grasped the full implications at the time, but a seed of doubt was planted: does development thinking fall too easily in love with measurable success?

Later, during my doctoral studies at the London School of Hygiene & Tropical Medicine, I became close friends with Mahmood Mamdani’s sister, Masuma Mamdani. We spoke often about Africa, colonial legacies, and the politics of development. I visited her in Dar es Salaam. We walked by the Indian Ocean and debated whether development was fundamentally a technical matter or a question of power. Years later, Masuma visited us in Dhaka. In 2023, when our book 50 Years of Bangladesh: Advances in Health was launched in London, jointly by LSE and the Bangladesh High Commission, she was present. Time seemed to complete a circle. The intellectual challenge that once unsettled me had become part of my own professional journey.

When I returned to BRAC to help build its Research and Evaluation Division (RED), Mamdani’s lesson was quietly at work in my thinking. We did not want to produce numbers for their own sake. We did not want to celebrate coverage rates without understanding context. We asked why people change, why they don’t, and how power relations shape behaviour.

The family planning revolution in Bangladesh did not stem from contraceptive supply alone. It was the result of the work of female community health workers, expansion of girls’ education, women’s economic participation, and reductions in child mortality. Smaller families become a rational choice when women earn, when girls stay in school, and when children survive. Mamdani taught me that “acceptance” is not the same as empowerment.

Years later, working on global health systems and UHC, I saw the same pattern recur: elegant policy frameworks, sophisticated financial models, coverage statistics. But the fundamental questions remained: is inequality narrowing? Are households protected from catastrophic health expenditures? Are women and marginalised communities genuinely empowered?

Today, in Bangladesh, we are discussing health cards, family cards, and expanded social protection schemes. Millions of cards distributed may indeed be impressive. But the essential question lies elsewhere: who is actually receiving services, and of what quality? Who is being excluded? Is a card equivalent to an entitlement? Numbers can write press releases. Justice writes history.

For me, The Myth of Population Control was never just a book about fertility. It was a warning against the arrogance of technocratic development. It taught me that evidence is never neutral, numbers never tell the whole story, and policies fail when power structures remain untouched.

As Zohran Mamdani’s name circulates in political debate today, I am reminded that intellectual legacies travel across generations. His father once taught me to question the comfort of numbers. That question remains relevant not only in population debates of the 1960s but in contemporary discussions of UHC, social protection, and reform. Are we turning people into statistics, or are we putting statistics to work for people? Numbers tell stories. But when people cease to be at the centre of the story, the narrative collapses, and so does development.

Dr Ahmed Mushtaque Raza Chowdhury is convener of Bangladesh Health Watch and founding dean of the James P Grant School of Public Health at BRAC University.

Views expressed in this article are the author's own. 

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