The UK All Party Parliamentary Group on Population, Development and Reproductive Health Parliamentary Hearings between May – July 2006

POPULATION GROWTH– IMPACT ON THE MILLENNIUM DEVELOPMENT GOALS

Submission by the Department for International Development

March 2006

Summary of key points

CONTENTS

Page number

Introduction and Summary 3

Recent Global Demographic Trends 4

Population Growth and:

Poverty - Social Exclusion and Social Protection 6

- Hunger and Nutrition6

- Poverty and Growth6

Universal Primary Education7

Gender Equality and Empowerment of Women7

Child and Maternal Health 7

HIV/AIDS, Malaria and other diseases7

Environmental Sustainability8

Migration8

MDGs in the Africa Region9

MDGs in the Asia Region9

MDGs in Europe, Middle East and Americas Region9

Introduction

DFID welcomes the opportunity to provide a submission to the APPG Hearing. This submission includes contributions from policy and geographic departments in DFID to respond to the themes to be covered by the Hearing, and draws on a range of external source material. Each section of this submission deals with a specific MDG and the final three sections consider population growth and the MDGs in the three DFID regions: “Africa”, “Asia” and “Europe, Middle East and Americas”.

A recent population conference in Paris hosted by DFID and AFD (March 1-3 2006) highlighted some of the links between demographic change and poverty reduction. It suggested areas for further research, where knowledge and evidence gaps remain, to support policy development. In resource poor settings, rapid population growth may put pressure on all areas of public provision as well as on the environment. In countries where resources exist to promote job opportunities, to provide access to health and education services and manage natural resources and energy, modest population growth can be useful. On an individual level, improving access to basic services means that women can choose if and when to have a child which has considerable health benefits for them and their families. DFID will share the report of this conference with the APPG when it is available.

Summary Messages

  • Rapid population growth due to high fertility is continuing in some of the poorest developing countries and amongst the poorest populations in those countries. Most future population growth will take place in poorer countries.
  • Rapid population growth may make it harder for some poor countries to reduce poverty and improve access to health, education and other services.
  • Rapid population growth in low resource settings may make it more difficult to reduce inequality and hunger.
  • High fertility in countries with continuing rapid population growth will make it harder to improve child and maternal health.
  • Rapid population growth has consequences for environmental sustainability as larger numbers of people put a strain on and perhaps compete for existing resources. This may contribute to conflict and instability.
  • Increasing levels of socially excluded populations is a major contributing factor to conflict, social violence, and extremism.
  • Gender equality suffers in poor countries with high population growth as women have little control in childbearing and are burdened with high fertility and poor health, and cannot participate in markets, politics and education. They may suffer increased personal insecurity.

Recent Global Demographic Trends

Population growth (and demographic composition) trends have diverged over the past two decades – with parts of sub-Saharan Africa, and other countries and regions of the developing world, now following quite different paths. Within much of Africa, improvements in health, mortality and life expectancy have stagnated, primarily – but not only – due to the impact of HIV and AIDS.

There are large regional differences in population growth and demographics. Africa is still experiencing high levels of fertility, but also high death rates due to AIDS and other illnesses, maternal and child deaths. Southern Africa has such high levels of AIDS that it is resulting in large decreases in the 20 – 49 years age range. These demographic situations are affecting countries’ ability to attain the MDGs.

Whilst some countries are seeing slow declines in fertility, many of Africa’s poorest countries – other than those in southern Africa bearing the brunt of the AIDS pandemic – will see a doubling or tripling in their populations over the next 40 to 50 years.

By contrast, in other regions of the developing world, there has been a more predictable continuation in prevailing demographic trends. Crude death rates have also fallen - reflecting the combined demographic and epidemiological transitions that most Asian and Latin American countries are now embarked on. Fertility rates continue to steadily decline or stabilise at low levels. Population growth rates have continued to slow in these regions and countries, and can be expected to carry on doing so.

Nevertheless, in spite of slowing population growth rates over the past half century, the total population of Asia continues to increase, and is predicted to rise from 3.9 billion in 2005 to 4.4 billion by 2015. Much of the growth in numbers will be in South-central Asia. Countries like China and India have benefited from demographic transition[1] and well educated work age populations. However countries like Bangladesh, Nepal and the Philippines are experiencing pressure on the environment and sustainable farming due to population growth.

Countries in the Europe, Middle East and Americas region tend to be middle income countries and are experiencing lower levels of fertility and population growth. However high inequality in access to services in Latin America has meant that fertility remains high amongst the poor and excluded groups including indigenous and afro-Latin groups.

A recent workshop on population and development co-hosted by DFID and AFD (March 1-3 2006) illustrated the scarcity of evidence showing the impact of population growth and identified priority areas for more research. It recommended the utility of research focused on examining how and in what way demographic trends may affect development prospects, and the kind of policy responses needed. A report of this meeting will be shared with the APPG.

Recent Trends in Reducing Poverty

Other, perhaps not dissimilar, divergences can be seen in global trends in poverty reduction. These have been dominated by the rapid economic growth in China and the East Asia and Pacific region. Poverty has also fallen in South Asia over the past 20 years, and while the decline was not as rapid, almost 45 million fewer people were living in extreme poverty by 2001.

In Sub-Saharan Africa, where GDP per capita shrank 14 percent, poverty rose from 41 percent in 1981 to 46 percent in 2001. Thus, whilst the total population in Sub-Saharan Africa increased by 280 million since the beginning of the 1980s, the numbers of people living in extreme poverty rose by 150 million.

Poverty

Social Exclusion and Social Protection

  • High rates of population growth can place pressure on the resources and ability of states to deliver adequate and quality health, education and other social services to the general population.
  • Socially excluded groups are worst affected by this, since they are more disadvantaged over others in their society because of discrimination on the basis of their social identity or where they live..

Hunger and nutrition

  • The UN predicts that by 2025 the global population will be approximately 8 billion people. Feeding this population will require an increase in cereal production from 2.2 billion tonnes now to 3 billion tonnes. The rate of increase in food production appears to be slowing down
  • Currently around 10% of the world’s population face chronic freshwater shortages. Over the next 2 decades, this may grow to up to one third, with Ethiopia, India, Kenya and Peru – along with parts of China – all running short of water.
  • People lack access to food largely because of poverty, political disadvantage and war and conflicts. The rate of population increase tends to be highest amongst the poor. Access to food by the most vulnerable populations in the most marginalised areas is likely to be exacerbated by population growth.
  • Increasing populations in poor rural areas result in decreases in farm size and therefore the potential household production. In some – but not all – cases increasing pressure on land results in degradation as households attempt to increase yields through unsustainable practices (e.g. reduced fallow) and by bringing into production land unsuitable for farming.

Poverty and Growth

  • Population growth and poverty are related, but the nature of the relationship is complex. Simplistic causal inferences should be avoided.
  • Efforts to slow population growth and to reduce poverty are mutually reinforcing. Population growth affects other MDGs which in turn affect ability to reduce poverty.
  • Because population growth tends to occur in poorer populations, the longer we take to lower poverty, the greater the number of people that have to be lifted out of poverty.
  • It is not clear if links between demographic change and economic growth in one region may necessarily be repeated in the same way elsewhere.

Universal Primary Education

  • High population growth is making the provision of Universal Primary Education (UPE) by 2015 more difficult and is of particular significance in sub Saharan Africa. This is despite the growing number of AIDS related deaths amongst school age children.
  • Rapid population growth and increased enrolments are placing considerable strains on education systems. Education quality is at risk as class sizes and pupil:teacher ratios rise.
  • Understanding the interrelationship between gender, education and population growth is significant for effective policy interventions for poverty reduction.

Gender Equality and Empowerment of Women

  • The ability of women to control their own fertility is absolutely fundamental to women’s empowerment and equality.
  • Where women’s status is low, family size tends to be large, which increases the likelihood of maternal mortality and morbidity and infant mortality and decreases women’s ability to participate in markets, education and politics.
  • When women are empowered, whole families benefit, and these benefits often have ripple effects to future generations.

Effect of population growth on Child and Maternal health

  • High fertility rates are associated with increased risks of infant and child deaths, and strongly increases a woman’s lifetime risk of dying from pregnancy related causes.
  • The risk of neonatal and infant mortality decreases with increasing birth intervals. And, when women become pregnant again within 6 months of giving birth, there are higher risks of maternal deaths.
  • Accessible and effective family planning services have the potential to reduce maternal deaths by 35%9 .Unfortunately about 130 million women in the developing countries have no access to contraception, especially in sub Saharan Africa.
  • Sustained high fertility rates and rapid population growth could for some countries pose obstacles to poverty reduction as serious as that from HIV and AIDS.

AIDS, Malaria and other diseases

  • The AIDS pandemic has profound consequences on the ability of the worst affected countries to complete the transition from high to low mortality as infectious disease becomes less prevalent and is no longer the main cause of mortality.
  • The impact of AIDS on population size is most striking in Botswana, Lesotho and Zimbabwe, where populationsize is expected to go into decline. But in most African countries, rapid population growth will still continue and lead, in many, to a tripling in population sizes.
  • Measures that improve the educational attainment and reproductive health of women, enabling them to pursue productive activities, are central to addressing the spread of HIV. Where women have less power to protect themselves – either against disease, or to prevent an unwanted pregnancy – they and their families suffer.

Environmental Sustainability

The interplay between population growth and environmental sustainability has implications in three critical ways for the attainment of the MDGs.

1. Direct impact on MDG 7 Environmental Sustainability per se.Primary relationship (MDG 7). The relationship between environmental sustainability and population growth can be expressed in terms of;

  • The carrying capacity of natural resources and their ability to support an increased population.
  • The footprint that an increased population will have on the ability of natural resources to sustain that growth.

2. Indirect impact on the prospects for all MDGs to be attained.

Secondary/ Indirect relationship (MDG 7 underwrites all the MDGs): The attainment of all the MDGs is dependent upon the maintenance of wide ranging environmental sustainability

3. Impact on other prerequisites for the attainment of the MDGs.

Tertiary/ Indirect relationship (Other development goals are interdependent with MDG 7): Other development needs, such as access to energy services, are not reflected as an MDG goal.

Migration

Well managed migration has the potential to help achieve the economic development Millennium Development Goals. This can be done if:

  • there are opportunities for legal migration, including low skilled migration where these meet the labour market needs of receiving countries, and the transaction costs of remittances are reduced;
  • there is circulation of highly skilled migrants, with receiving countries maximising the opportunities for high skilled migrants to repatriate their skills and earnings ;
  • migrant men and particularly women have access to their human rights and their entitlements under national law.
  • the positive contributions of diasporas to their countries of origin and destination is recognised and supported, for example tapping into skilled health worker nationals on a temporary or longer term basis;

What effect is population growth having on MDGs in Africa?

  • High mortality rates in Africa, lower investment in human capital and impact on productivity and thus economic growth.
  • Fertility rate in Africa (although decreasing in some countries) is still high (average of 4 children per female, though many of the poorest countries with more than 6) – requires policy focus on, for example, provision of education for growing number of children.
  • The impact of HIV and AIDS through women on population growth directly affects most of the MDGs.
  • Without the projected changes in future paths and trends in population growth, attainment of the maternal and child health MDGs in Sub-Saharan Africa will be highly unlikely.

What effect is population growth having on MDGs in Asia?

In spite of slowing population growth rates over the past half century, the total population of Asia continues to increase, and is predicted to rise from 3.9 billion in 2005 to 4.4 billion by 2015. Much of the growth in numbers will be in South-central Asia.

  • Different demographic situations require different policy responses for meeting the MDGs. For example higher fertility countries, such as those in South Asia, will need to expand primary education provision in order to provide for the growing number of children.
  • Population growth increases pressure on the environment and natural resources. Managing these issues is likely to be a key challenge for Asian countries as they attempt to continue economic growth and poverty reduction.
  • The rising proportion of the population who are of working age has been helpful for the newly industrializing Asian countries such as India and China in aiding economic growth, and therefore poverty reduction.

Europe, Middle East and Americas

  • In the Europe, Middle East and Americas Division (EMAD), many countries have already gone through the transition towards lower fertility. The major exceptions are West Bank and Gaza, and Yemen. In both, rapid population growth contributes towards significant difficulties in the provision of essential services and urbanisation. Early and frequent pregnancies also contribute to high levels of maternal morbidity and, in Yemen particularly, mortality.
  • In other EMAD countries, where the fertility transition has only recently taken place, dependency ratios are high, and local authorities struggle to provide high quality basic services. A large proportion of the population (those under 15 years and the elderly) are dependent upon a smaller proportion of those employed or otherwise economically active, with a negative impact on economic development.
  • It is important that appropriate reproductive health services are made more widely available, along with education for youth (in and out of school) to encourage later marriage and use of family planning to space and limit the number of pregnancies. Youth-friendly services are still relatively rare in EMAD countries and access to safe abortion is restricted in many states. High quality reproductive health services, including education, will also have an impact in reducing transmission of HIV and other sexually transmitted infections.

[1] Demographic transition happens when birth rates fall and a population has fewer dependents and a larger proportion of working age population. This supposedly can give a boost to economic growth if there are employment opportunities for those who can work.