Peter Singer and Frances Kissling recount how Emmanuel Macron answered a question posed by a journalist from the Ivory Coast as to "why the world’s rich countries have not developed a plan to assist Africa in overcoming its problems, as the United States’ Marshall Plan had aided Europe after World War II?"

In his "lengthy" response, Macron explained that Africa - unlike Europe - doesn't need to be rebuilt. Africa needs "sophisticated responses" to the many problems it faces. Apart from structural problems that impede development and the lack of good governance, many countries are stuck in their "difficult transitions to democracy." He also pointed out that some African countries are making good progress, and have achieved high rates of economic growth."

However the second half of Macron's response to Africa's problems "caused outrage .... and led to accusations of racism." The authors admonish Macron's "unfortunate choice" of the word "civilizational", saying it smacks of condescending righteousness, when France and other imperial powers patronised Africa and elsewhere in their quest for colonies during 19th century. Yet they defend Macron, insisting "the Ivory Coast journalist framed his question in a manner that invited this kind of broad and undifferentiated approach."

Macron's comment on Africa's "rapid population growth" alienated many at best and offended some at worst. "Even if you spend billions of euros, Macron said, you will not be able to stabilize anything 'when countries still have seven to eight children per woman.'” While this figure is somewhat overblown - 2.5 children per woman globally, 4.7 children per woman in Africa - it isn't the "inaccuracy" that sparked outrage but the "taboo" Macron broke around population growth. While this slows in the rest of the world, it continues to rise in Africa.

In 1994 the UN-led International Conference on Population and Development in Cairo "adopted a Programme of Action that rejected a demographically driven approach to population policies, and instead focused on meeting the reproductive-health needs of individuals, especially women. Population targets were out; rights were in." The Sustainable Development Goals that focus on family planning and reproductive rights, in the context of women’s health and gender equality were "portrayed as colonialist and patriarchal, if not racist," sending a warning that "white men should not be telling black women not to have babies."

The authors say, even if "India’s mass sterilization programs and China’s one-child policy" were controversial due to their "coercive population policies," it makes little sense to "question the wisdom of the taboo on discussing population." There are reasons for concerns, because populations in some parts of Africa will "increase fivefold by 2100."

In Niger, where GDP per capita is less than $1 per day, and the average number of children a woman is likely to have in her life is more than seven, the population is expected to rise from 21 million today to "192 million by the end of the century." Niger and countries with similar rapid population growth face the daunting task of eradicating poverty and malnutrition.

Crippled by poverty Africa is a long way from reaching the UN's anti-poverty goals. The Arab Spring in the Middle East should serve as an example that youth bulge, high unemployment, rampant corruption and abject poverty make a toxic mix. Girls and women growing up in domineering paternalistic cultures or religioous prohibition are deprived of an education and knowledge to overcome social barriers to contraceptive use.

Even if we don't know whether "new technologies or social institutions" would help "the least-developed countries" fare better in 2100, "Macron was not being unreasonable when he suggested that the prospect of such rapid population increase is relevant to questions about the efficacy of a concerted effort to overcome poverty in Africa." Earlier this year, Germany's Development Minister Gerd Müller had presented a plan to help create a future for Africa's youth. But it isn't enough if population continues to surge.

