UN Population Division, Department of Economic and Social Affairs,
with support from the UN Population Fund (UNFPA)
|
| UN Population Division, Department of Economic and Social Affairs, with support from the UN Population Fund (UNFPA) |
|
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The electronic preparation of this document has been done by the Population
Information Network(POPIN) of the United Nations Population Division in
collaboration with the United Nations Development Programme
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AS WRITTEN
SLOWING POPULATION GROWTH
AND ACCELERATING SUSTAINABLE DEVELOPMENT
A Call to Action
An Address
to the International Conference on Population and Development
Lewis T. Preston
President The World Bank Group
Cairo, Egypt
September 6, 1994
SLOWING POPULATION GROWTH
AND ACCELERATING SUSTAINABLE DEVELOPMENT
A Call to Action
Introduction: Difficult Questions
I think it is important to keep reminding ourselves why we are here.
Most of us have attended this kind of large conference before. We meet; we
highlight the issues; we reach a consensus; we make promises. Then we go home
-and, all too often, there is very little action.
We cannot afford to let that happen in Cairo. The stakes are too high. Putting
it bluntly: if we do not deal with rapid population growth, we will not reduce
poverty-and development will not be sustainable.
A billion people already struggle to survive on a dollar a day. Two billion
people are without clean water. Three million children die each year from
malnutrition. And yet, population in the developing countries will increase
more during this decade than ever before-by some 80 million people a year.
Within the next thirty-five years, global population will increase by about
half. South Asia's population will grow by two-thirds. Sub-Saharan Africa's
will more than double.
Who will feed and house the additional numbers? How will they be educated and
employed? And what will be done to relieve the inevitable stresses on the
environment?
These are difficult questions. But to a great extent, we know the answers. The
problem is that we are not doing enough-quickly enough-to implement the basic
actions that experience has shown to be effective.
Critical Actions
The Cairo Program of Action offers us the proper perspective on rapid
population growth: it is a symptom of poverty-and an obstacle to poverty
reduction.
We know that as incomes increase-and people lead longer, healthier lives-
fertility decreases. Rapid fertility declines in East Asia, for example, went
hand-in-hand with steady economic growth and improved living standards. In
Sub-Saharan Africa, by contrast, the population growth rate of more than 3
percent over the past decade has been running far ahead of the economic growth
rate of less than 2 percent. Africa's people have paid the price in terms of
declining incomes and increasing poverty.
Our approach to population policy, therefore, must be part of a broader
strategy to reduce poverty-through sustainable growth and investments in
people. Three types of investment are particularly important:
- First is basic health care, especially for women and children. In many of
the poorest nations, one in every ten children dies before its first birthday.
Reducing these appallingly high infant mortality rates-so that parents do not
have to worry so much about their children's survival-is essential to reducing
fertility rates.
- Second, we know that birth rates decline when women are given access to
education. An educated woman is more likely to delay marriage, space her
pregnancies, and have fewer and healthier children. She is also likely to earn
more if she works and to invest more in her children's education. Yet, nearly
100 million girls are currently denied education. The goal of universal
primary education is something that we can-and must-achieve within the next
generation.
- Access to family planning services is a third critical investment. Combined
with economic growth and social investment, access to family planning has
shown remarkable results in countries as diverse as Indonesia, Mexico, and
Zimbabwe. Even in very poor countries where income growth and investment in
people have lagged, family planning has made a big difference. Average
fertility rates in Bangladesh, for example, have declined from seven births
per woman in the mid-1970s to close to four in the 1990s.
Cost Effectiveness
These kinds of investments ate highly cost effective, but not high cost:
- The Bank estimates, for example, that a basic preventive health care
package-including maternal and child care-can be provided at an annual cost of
about $8 per person in the poorest countries.
- Raising girls' primary school enrollment rates to equal boys' would cost
just under $1 billion-or only 2 percent of annual education spending by the
developing world.
- Resources needed for family planning services are also relatively modest.
Around $ 5 billion per year is currently spent on family planning in the
developing countries-which is less than 5 percent of military expenditures.
Clearly, financing is not the main issue. Much of the money required can be
generated trough redirecting resources toward priorities-and making sure that
they are used efficiently. Nor need all the additional investment come from
government budgets. There is ample evidence that people are willing to pay for
family planning services, provided they have access to them.
The role of Donors and the Bank
Donors support, of course, remains important, particularly in the poorest
countries. But it must be better tailored to meet individual country needs-and
to offer people a range of appropriate choices. The proportion of couples
using some kind of fertility regulation has increased from 10 percent thirty
years ago to more than 50 percent today. Further and faster progress depends
on making those services even more responsive to people's needs. That means
listening even more to what people want-and we donors are not always very good
at listening.
The World Bank's support for poverty reduction focuses on the same investments
required for a broad approach to fertility reduction. About half of the
projects that we finance, for example, now include specific components aimed
at empowering women. Last year, we committed almost 2 $ billion for education
alone-much of it focused on keeping girls in school. Over the last five years,
the Bank has also become one of the largest financiers of family planning and
reproductive health services. Close to $ 200 million was committed last years-
and this is projected to increase by 50 percent over the next three years.
Quality, however, matters more than quantity. The Bank-and all of us-must do
more to ensure the effective implementation of the programs we support:
- by better targeting our resources, so that they reach the poor
- by strengthening partnerships among all those engaged in this effort to
enhance overall impact
- by keeping population issues at the forefront of the policy dialogue.
Conclusion: A Shared Responsibility
The world's rapid population growth rate affects us all. Addressing it is a
responsibility that we all share-which brings me back to why we are here.
The issue cannot be resolved around the conference table. It can only be
resolved when individuals decide that it is in their own best interest to have
smaller families, so that more resources can become available for education,
health, and poverty reduction. The international community must help to create
the conditions in which they can make that choice.
If this conference is to have any meaning beyond words and good intentions, we
must act-now.
Thank you.