Women's Unmet Needs Spur Grim Forecasts

(WOMENSENEWS)–By the year 2050, the world as we know it will no longer exist.

Almost 9 billion people will crowd the planet.

People the world over will be younger, poorer, at greater risk for health problems, and in greater need of help from governments that are already cutting back on social support services.

Such are the predictions of two new reports: “The State of the World Population 2004,” published yesterday by the United Nations Population Fund and “The 2004 World Population Data Sheet,” released in August by the Population Reference Bureau, a demographic clearinghouse based in Washington, D.C.

The trends are based, in great measure, on the bleak state of women’s reproductive health care today. While the overwhelming majority of women in developed countries have access to modern contraception, as few as 14 percent of women in developing countries do.

If this doesn’t change, population growth is likely to explode in the poorest and least developed nations.

“Unless international assistance rises, the number of people who need family planning, maternal health care and HIV/AIDS prevention treatment will continue to grow,” says Thoraya Ahmed Obaid, executive director of UNFPA, the international agency based in New York City that supports population programs. “So far, the response of the international community to this need has been woefully inadequate.”

Poland and Niger

Take the example of Poland and Niger. While women in Poland (where contraceptives are readily available) have an average of 1.2 children each, women in Niger (where they are not) have an average 8 children each. By 2050, Poland is expected to be one of the slowest-growing countries, while Niger is expected to be the fastest-growing, swelling in population from 12 to 53 million.

At present, 44 percent of the population in sub-Saharan Africa is under the age of 15 while only 3 percent of the population is over 65.

In contrast, 17 percent of Europe is under 15 and 15 percent is over 65. As the older population dies off in developed countries and the younger population begins having children in developing nations, this will also contribute to higher populations in the poorest regions–and to economic shortfalls across the globe, these reports indicate.

“In the future, the industrialized world may not have enough workers to fulfill its job needs and the developing world may not have enough jobs for workers to fill,” says Robert Engleman, vice president of research at Population Action International, a public policy organization based in Washington, D.C. “This could result in massive migration from developing countries to developed ones–even though there will likely not be enough jobs for migrants to fill.”

Some Good News

The reports do contain some good news.

One third of African countries, for instance, have declining HIV/AIDS rates, and three-fourths of all countries have implemented national strategies on HIV/AIDS.

Since 1994, 131 countries have changed national policies, laws or institutions to recognize reproductive rights. Nearly all developing countries have integrated reproductive services into primary health care and the use of modern contraception has risen from 55 to 61 percent of couples.

Since 1994, more than half of all countries have adopted legislation on women’s rights, ratified U.N. conventions or established national commissions for women. Topics that were previously ignored in policy discussions–such as gender-based violence, unsafe abortion and post-abortion care–are now being addressed.

But these bright spots are overshadowed by disturbing trends.

In some areas of sub-Saharan Africa, 25 percent of the workforce is HIV-positive. The global incidence of HIV/AIDS (now at 1.1 percent of adults ages 14 to 49) is likely to continue rising–especially among women and in Africa.

The number of people living in cities is spiking twice as fast as total population growth. By 2007, half the world’s population will be urban and by 2030, all regions will have urban majorities.

Obstetric complications are the leading cause of death among women of reproductive age in developing countries.

By 2025, demand for family planning services will surge by 40 percent.

Preventive Measure

So what’s the preventive global medicine?

Though funding for population-control measures has fallen short of goals set in 1994 at the International Conference on Population and Development in Cairo, policy analysts see room to hope.

“These projections aren’t necessarily destiny,” says Robert Engleman of Population Action International. “What happens in the future is going to depend on what individuals do in terms of their own reproduction and on what governments do to support them in making responsible choices.”

Cairo Meeting in 1994

Aware that recent demographic trends could spell disaster, delegates from 179 United Nations member states met in Cairo, Egypt, in 1994 and set a 20-year goal for curbing population growth, easing poverty and improving women’s access to reproductive health care. Yesterday’s UNFPA report represents the half-way mark of their work.

In Cairo, participating countries pledged to devote $18.5 billion per year to population efforts by the year 2005, with developed countries providing one-third of the total investment and developing countries making up the rest. To date, however, developed nations have fulfilled only half of their promise and developing nations have fulfilled only 80 percent of theirs.

“Our biggest challenge in addressing these population changes is funding,” says Carl Haub, a senior demographer at PRB and the author of its 2004 World Population Data Sheet. “In 2001, there was only $9.6 billion spent on reproductive health; less than half the amount pledged for that effort 10 years ago.”

Across the globe today, more than 200 million women have no access to contraception. The UNFPA estimates that meeting their needs would cost $3.9 billion per year–funding that would prevent 23 million unplanned births, 22 million induced abortions, 1.4 million infant deaths, and 142,000 pregnancy-related deaths.

“It’s inexcusable that 1 in 16 women in Africa will die in childbirth while only 1 in 2,800 women in developed countries will do so,” says Karen Hardee, director of research for the policy project at the Futures Group, an international developmental organization based in Washington, D.C. “We know how to prevent maternal mortality, and obstetric care isn’t necessarily expensive. This is just a matter of government priorities.”

Molly M. Ginty is a freelance writer based in New York City.