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01 / 05
China’s Fertility Flip-Flop Shows the Folly of Legislating Family Sizes

Blog Post | Pregnancy & Birth

China’s Fertility Flip-Flop Shows the Folly of Legislating Family Sizes

Keep central planning out of family planning.

Summary: Recent attempts by the Chinese government to encourage higher birth rates have raised concerns about government interference in personal matters. These new measures continue the pattern of authoritarian regimes enforcing coercive family policies. State intervention in family planning has often resulted in human rights abuses. While some policymakers advocate for incentives to boost fertility rates, a cautious approach that prioritizes individual freedom offer a more effective and ethical solution to addressing declining birth rates.


After decades of the disastrous policy of limiting family growth by force, China, according to news reports, is now pestering its women through text messages and social media to have more babies. This meddling by the state, like past coercion, is counterproductive. China should stop telling couples how many children to have. Keep central planning out of family planning, and families will flourish.

Not content to regulate life outside the household, authoritarians have a long history of intervening in family affairs. The Chinese Communist Party’s recent family-policy flip-flop is unsurprising. Throughout history, communist countries have alternated between coercive measures aiming to produce larger families and ones intended to shrink the average family size. China’s one-child policy, for instance, was in force for 36 years (1979–2015).

Joseph Stalin’s Soviet Union financially penalized those without children, enacting a so-called “childless tax” that the country enforced from 1941 to 1990 in various degrees. The tax punished childless men between the ages of 20 and 50 and childless women between the ages of 20 and 45. A decree in 1944 expanded the childless tax to also penalize parents who had merely one or two children.

Communist Romania and Poland (post–World War II) implemented similar taxes modeled on the Soviet law. Those taxes, like their inspiration, lasted until the collapse of the USSR bloc in 1991. Nicolae Ceaușescu’s Romania went furthest of all, enacting strict prohibitions on birth control that resulted in a large number of abandoned children whose parents often could not afford to raise them.

The conditions in the communist nation’s overcrowded orphanages — nicknamed “child gulags” — were nightmarish. Yet signs at the inhumane institutions mockingly boasted, “The state can take better care of your child than you can.”

If communists are consistent on one point, it is that the state knows best. Always. Even when it comes to how many children each couple should bring into the world. Where communists have been inconsistent, though, is on whether that number ought to be higher or lower.

Starting in the 1960s and 1970s, it became fashionable among intellectuals around the world to worry about “overpopulation,” a concept that overwhelming evidence has since called into question. The resulting panic had its darkest manifestation in China’s one‐​child policy, which saw more than 300 million Chinese women fitted with intrauterine devices modified to be irremovable without surgery, over 100 million sterilizations, and over 300 million abortions, an unknown share of which were coerced.

China’s official Xinhua News Agency has boasted that the one-child policy prevented 400 million births. “Excess birth” fines could reach up to ten times a family’s annual disposable income.

Revenue-hungry local officials continued to fine families and enforce childbearing limits even after the country loosened its one-child policy to a two-child policy (2016–2021) and then loosened it further into a three-child policy. As China’s officials grew increasingly concerned about the population’s aging and shrinking, the three-child policy was, at last, rendered merely symbolic in 2023.

Yet China’s vast population-planning bureaucracy remains in place and could easily be reoriented toward attempts to coercively engineer the size of the country’s population upward. In a CCP-run paper, some Chinese academics have called for a tax on childlessness.

And China is not alone. Some Russian politicians also would like to reinstate a childless tax (Russia’s leaders have been toying with the idea for more than a decade).

Today, while unfounded overpopulation fears retain popularity in some circles, plummeting global birth rates have led the pendulum of policy-maker opinion to swing toward the idea that the world might benefit from more, rather than fewer, children. The number of countries with “raising fertility” as an explicit policy objective keeps rising.

Thankfully, in most cases such initiatives do not involve coercion. From South Korea to Estonia, various countries have tried offering government subsidies, expensive new state programs, cash bonuses, or similar incentives to encourage their citizens to have larger families. But an overview of past efforts to alter birth rates, whether upward or downward, shows that such efforts have had lackluster results at best and resulted in tragic human-rights abuses at worst.

Rather than pursuing new initiatives that are costly and questionably effective, and risk wading into the territory of social engineering or worse, policy-makers concerned about birth rates should take a “first do no harm” approach to fertility.

As my colleague Vanessa Calder and I outlined in a recent policy paper, removing government rules and regulations that disproportionately affect families would enhance families’ freedom of choice and may reduce the cost of child-rearing enough to boost fertility. In other words, policy-makers can make it easier for parents to form the families they desire by simply stepping back and removing government barriers to fertility and family life.

The state’s thumb shouldn’t be on the scale of intimate family decisions, one way or the other. Reforming policies that artificially make family life harder offers a better way forward. Hopefully, policy-makers in China and elsewhere will come to recognize that.

This article was published in National Review on 1/18/2024.

Fierce Biotech | Science & Technology

FDA Clears Minimally Invasive Brain-Computer Interface Implant

“Precision Neuroscience has obtained an FDA clearance for a crucial piece of its plans for a full brain-computer interface system, starting with its minimally invasive cortical electrode array. The company described it as the first regulatory green light for a developer of wireless mind-reading tech.

The agency cleared Precision’s Layer 7 interface as a temporary implant for use up to 30 days. Built on a thin, flexible film, the device and its 1,024 electrodes can be slotted through a sub-millimeter incision and placed nearly anywhere on the surface of the brain in a reversible procedure. It is capable of recording information as well as stimulating neural activity, and multiple implants have been used in a single patient.

The company said the go-ahead from the FDA will allow it to begin offering the device for medical applications such as brain mapping during open surgery, as it continues to develop its computer-controlling platform.”

From Fierce Biotech.

Reason | Poverty Rates

Javier Milei’s Free Market Reforms Are Starting To Pay Off

“Argentina’s poverty rate fell sharply in the second half of 2024, according to official data released this week, marking a major milestone for President Javier Milei’s sweeping economic reforms.

According to the country’s official statistics agency, the National Institute of Statistics and Census (INDEC), the poverty rate fell to 38.1 percent between July 2024 and December 2024—down nearly 15 percentage points from the first half of the year. Household poverty also declined by 13.9 percentage points, hitting 28.6 percent. And extreme poverty was cut by more than half, falling from 18.1 percent to 8.2 percent.

It’s a major turnaround from the beginning of Milei’s presidency. When he took office in December 2023, he inherited a poverty rate of 41.7 percent, which quickly surged to 53 percent as his administration launched a ‘shock therapy’ program to end Argentina’s economic misery.

One of the biggest drivers behind the poverty decline is the sharp drop in inflation. Annual inflation, which reached 276.2 percent a year ago—one of the highest in the world—dropped to 66.9 percent last month. Monthly inflation has also dropped, from 25.5 percent in December to just 2.4 percent in February.”

From Reason.

CIDRAP | Noncommunicable Disease

FDA Approves At-Home Test for Sexually Transmitted Infections

“The US Food and Drug Administration (FDA) today (3/28/25) approved the first at-home, over-the-counter test for chlamydia, gonorrhea, and trichomoniasis.

The Visby Medical Women’s Sexual Health Test is a single-use test intended for women with or without symptoms. The FDA granted marketing authorization to Visby Medical based on testing that showed the device correctly identified 98.8% of negative and 97.2% of positive Chlamydia trachomatis samples, 99.1% of negative and 100% of positive Neisseria gonorrhoeae samples, and 98.5% of negative and 97.8% of positive Trichomonas vaginalis samples.

The test, which includes a sample collection kit and a powered testing device that communicates testing results to an app, can be bought without a prescription and deliver results within 30 minutes.”

From CIDRAP.

Healio | Noncommunicable Disease

FDA Approves First New Antibiotic for Uncomplicated UTIs in Decades

“The FDA approved gepotidacin for the treatment of uncomplicated UTIs in women and adolescent girls aged 12 years or older, GSK announced.

It is the first new antibiotic for the treatment of uncomplicated UTIs (uUTIs) in nearly 30 years, according to GSK. 

The decision to approve gepotidacin, which will be marketed as Blujepa, was supported by positive phase 3 data from the EAGLE-2 and EAGLE-3 trials, which demonstrated the antibiotic’s noninferiority to standard-of-care treatment nitrofurantoin.

Data from the EAGLE-2 trial showed treatment success in 50.6% of participants vs. 47% in patients treated with nitrofurantoin, with an adjusted difference in success of 4.3 percentage points.”

From Healio.