"Urban transport systems based on a combination of rail lines, bus lines, bicycle pathways, and pedestrian walkways offer the best of all possible worlds in providing mobility, low-cost transportation, and a healthy urban environment." –Lester R. Brown, Plan B 4.0: Mobilizing to Save Civilization.
Chapter 7. Eradicating Poverty, Stabilizing Population: Stabilizing Population
Some 42 countries now have populations that are either essentially stable or declining slowly. In countries with the lowest fertility rates, including Japan, Russia, Germany, and Italy, populations will likely decline over the next half-century. 19
A larger group of countries has reduced fertility to the replacement level or just below. They are headed for population stability after large groups of young people move through their reproductive years. Included in this group are China, the world’s most populous country, and the United States, the third most populous one. A third group of countries is projected to more than double their populations by 2050, including Ethiopia, the Democratic Republic of the Congo, and the Sudan. 20
U.N. projections show world population growth under three different assumptions about fertility levels. The medium projection, the one most commonly used, has world population reaching 9.1 billion by 2050. The high one reaches 10.6 billion. The low projection, which assumes that the world will quickly move below replacement-level fertility to 1.6 children per couple, has population peaking at 7.8 billion in 2041 and then declining. If the goal is to eradicate poverty, hunger, and illiteracy, we have little choice but to strive for the lower projection. 21
Slowing world population growth means that all women who want to plan their families should have access to the family planning services they need. Unfortunately, at present 201 million couples cannot obtain the services they need to limit the size of their families. Filling the family planning gap may be the most urgent item on the global agenda. The benefits are enormous and the costs are minimal. 22
The good news is that countries that want to help couples to reduce the size of their families quickly can do so. My colleague Janet Larsen writes that in just one decade Iran dropped its population growth rate from one of the world’s fastest to one of the lowest in the developing world. When Ayatollah Khomeini assumed leadership in Iran in 1979, he immediately dismantled the family planning programs that the Shah had put in place in 1967 and instead advocated large families. At war with Iraq between 1980 and 1988, Khomeini wanted large families to increase soldiers for Islam. His goal was an army of 20 million. In response to his pleas, fertility levels climbed, pushing Iran’s population growth up to a peak of 4.2 percent in the early 1980s, a level approaching the biological maximum. As this enormous growth began to burden the economy and the environment, the country’s leaders realized that overcrowding, environmental degradation, and unemployment were undermining Iran’s future. 23
In 1989 the government did an about-face and Iran restored its family planning program. In May 1993, a national family planning law was passed. The resources of several government ministries, including education, culture, and health, were mobilized to encourage smaller families. Iran Broadcasting was given responsibility for raising awareness of population issues and of the availability of family planning services. Some 15,000 “health houses” or clinics were established to provide rural populations with health and family planning services. 24
Religious leaders were directly involved in what amounted to a crusade for smaller families. Iran introduced a full panoply of contraceptive measures, including male sterilization—a first among Muslim countries. All forms of birth control, including contraceptives such as the pill and sterilization, were free of charge. In fact, Iran became a pioneer—the only country to require couples to take a class on modern contraception before receiving a marriage license. 25
In addition to the direct health care interventions, a broad-based effort was launched to raise female literacy, boosting it from 25 percent in 1970 to more than 70 percent in 2000—an impressive achievement. Female school enrollment increased from 60 to 90 percent. Television was used to disseminate information on family planning throughout the country, taking advantage of the 70 percent of rural households with TV sets. As a result of the impressive effort launched in 1989, family size in Iran dropped from seven children to fewer than three. From 1987 to 1994, Iran cut its population growth rate by half. Its overall population growth rate of 1.2 percent in 2004 is only slightly higher than that of the United States. 26
If a country like Iran, with a strong tradition of Islamic fundamentalism, can move quickly toward population stability, other countries can too. Countries everywhere have little choice but to strive for an average of two children per couple. There is no feasible alternative. Any population that increases or decreases continually over the long term is not sustainable. The time has come for world leaders—including the Secretary-General of the United Nations, the President of the World Bank, and the President of the United States—to publicly recognize that the earth cannot easily support more than two children per family.
The costs of providing reproductive health and family planning services are not that high. At the International Conference on Population and Development held in 1994 in Cairo, it was estimated that a fully funded population and reproductive health program for the next 20 years would cost roughly $17 billion annually by 2000 and $22 billion by 2015. Developing countries agreed to cover two thirds of this, while industrial countries were to cover one third. Although we have passed the 10-year anniversary of the Cairo conference, developing countries have fallen short of their pledge by roughly 20 percent, while donor countries have fallen short by half, leaving a combined gap of roughly $6.6 billion per year. 27
The United Nations estimated that meeting the needs of the 201 million women who do not have access to effective contraception could each year prevent 52 million unwanted pregnancies, 22 million induced abortions, and 1.4 million infant deaths. Some 142,000 pregnancy-related deaths could also be prevented. The costs to society of not filling the family planning gap are unacceptably high. 28
Reinforcing these U.N. calculations are data from the grassroots showing how access to family planning services helps couples achieve their desired family size. Surveys in Honduras, for example, show poor women (often lacking family planning services) having twice as many children as they want, while women in high socioeconomic groups are quite successful at having the number of children they desire. 29
Shifting to smaller families brings generous economic dividends. For Bangladesh, analysts concluded that $62 spent by the government to prevent an unwanted birth saved $615 in expenditures on other social services. Investing in reproductive health and family planning leaves more fiscal resources per child for education and health care, thus accelerating the escape from poverty. For donor countries, filling the entire $6.6 billion gap needed to ensure that couples everywhere have access to the services they want and need would yield strong social returns in improved education and health care. 30
19. Population from United Nations, op. cit. note 4; Population Reference Bureau (PRB), 2004 World Population Data Sheet, wall chart (Washington, DC: August 2004).
20. United Nations, op. cit. note 4; PRB, 2005 World Population Data Sheet, wall chart (Washington, DC: August 2005).
21. United Nations, op. cit. note 4.
22. U.N. Population Fund (UNFPA), The State of World Population 2004 (New York: 2004), p. 39; the 201 million women who want to limit their family size but lack access to a choice of effective contraception consist of some 137 million women with an unmet need for contraception and another 64 million who are using less reliable traditional family planning methods.
23. Janet Larsen, “Iran’s Birth Rate Plummeting at Record Pace,” in Lester R. Brown, Janet Larsen, and Bernie Fischlowitz-Roberts, The Earth Policy Reader (New York: W.W. Norton & Company, 2002), pp. 190–94; see also Homa Hoodfar and Samad Assadpour, “The Politics of Population Policy in the Islamic Republic of Iran,” Studies in Family Planning, March 2000, pp. 19–34, and Farzaneh Roudi, “Iran’s Family Planning Program: Responding to a Nation’s Needs,” MENA Policy Brief, June 2002; Iran population growth rate from United Nations, op. cit. note 4.
24. Larsen, op. cit. note 23.
26. Ibid; population growth rates from PRB, op. cit. note 20; United Nations, op. cit. note 4.
27. Janet Larsen, “World Population Grew by 76 Million People in 2004—3 Million Added in the Industrial World and 73 Million in the Developing World,” Eco-Economy Indicator (Washington, DC: Earth Policy Institute, 21 December 2004); UNFPA, “Meeting the Goals of the ICPD: Consequences of Resource Shortfalls up to the Year 2000,” paper presented to the Executive Board of the U.N. Development Programme and the UNFPA, New York, 12–23 May 1997; UNFPA, Population Issues Briefing Kit (New York: Prographics, Inc., 2001), p. 23; UNFPA, op. cit. note 22, pp. 89–90.
28. UNFPA, op. cit. note 22, p. 39.
29. Honduran Ministry of Health, Encuesta Nacional de Epidemiología y Salud Familiar (National Survey of Epidemiology and Family Health) (Tegucigalpa: 1996), cited in George Martine and Jose Miguel
Guzman, “Population, Poverty, and Vulnerability: Mitigating the Effects of Natural Disasters,” in Environmental Change and Security Project Report (Washington, DC: Woodrow Wilson International
Center for Scholars, 2002), pp. 45–68.
30. “Bangladesh: National Family Planning Program,” Family Planning Programs: Diverse Solutions for a Global Challenge (Washington, DC: PRB, 1994).
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