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STATE OF WORLD POPULATION 2002 USEFUL FACTS Population Since 1960: In developing regions, fertility has been cut in half, from 6 children
per woman to 2.9. Contraceptive prevalence has increased from 10 to 62 per cent
of women, and life expectancy has increased from 48 to 64 years. In the least-developed countries, fertility has declined only from 6.6
children to 5.2, and life expectancy increased to just over 50 years from
roughly 39. (Though countries with high
levels of HIV/AIDS have lost their earlier gains.) Global population today it is 6.2 billion, twice what it was in 1960. By 2050: Global population will reach 9.3 billion by 2050. The less-developed regions will add 3.2 billion (going from 4.9 to 8.1
billion) – the same number as were added between 1950 and 2000. Family planning programmes and population assistance encourage lower fertility, accounting
for almost one third of the global decline in fertility between 1972 and
1994. Long-term demographic and economic data from 45
developing countries show that high fertility increases poverty by slowing
economic growth and by skewing the distribution of consumption against the poor. Slower population growth has encouraged overall economic growth in
developing countries. Since 1970, developing countries with lower fertility
and slower population growth have seen higher productivity, more savings and
more productive investment. The effects of programmes on fertility were particularly strong in
Asia, accounting for more than two thirds of the decline. They were
intermediate in Latin America and the Arab States and weak in Africa. Declining fertility in Brazil in the last 50 years
contributed an additional 0.4 to 0.5 per cent in the annual growth of per
capita income, which grew on average by nearly 3 per cent per year. The
demographic transition had a direct impact on poverty, accounting for an
estimated 15 per cent of the impact of economic growth. Mexico and other
countries in Latin America have registered similar effects. Demographic Window
Half of the improvement in economic growth
attributable to population factors has come from fertility decline and half
from mortality declines. A fall of 4 per thousand in the net birth rate
would translate into a 2.4 per cent decline in those living in absolute poverty
in the next decade. Asia
The effects of the demographic window could
be seen in the “Asian tigers” of the 1980s and 1990s: While the
proportion of their working-age populations (15-60) started to increase
as late as the mid-1970s, the pace of change was extremely rapid up
to the early 1990s. The relative growth of working-age populations in these
countries will continue for another decade. These countries made the
supporting investments in health and education early in the development
process, and created a framework for more open markets and social
participation. South
Asia is approaching the window’s peak. It will
reach its peak
ratio of working-age to
dependent-ages between
2015 and 2025. Latin America In Latin
America and the Caribbean, the
relative increase in the working-age population started at least five years
earlier than East Asia, but the proportional change has been less marked.
Change has been slower, especially among the poor; their progress in health and education
has not been shared at all income levels. In Brazil, 25 per cent of those born in 1970 are
poor. If fertility levels had stayed as high they were early in the century,
this would have been 37 per cent. The reduction in poverty
is equivalent to what would be gained from a 0.7 per cent annual
increase in per capita GDP. Arab States and Central Asia
The countries of North
Africa, and Western Asia and Central Asia are at a variety of stages in the
demographic transition. Countries well into the transition must act soon to
take advantage of their opportunity; others must quicken their transition
to increase their opportunity. Sub-Saharan Africa
Sub-Saharan Africa lags
most. Half the population of sub-Saharan Africa is less than 17.6 years old.
The working-age
proportion of the population between 15 and 60 (50.9 per cent) is lower than it
was in 1950 (52.5 per cent). Only six of the 46 sub-Saharan African countries
have populations with median ages as high as 20 years
(the median age in more-developed regions is now around 36). By 2050, the
regional median age will reach 26.4, lower than more-developed regions a
century earlier. The working-age population will increase to 62.2 per cent by
2050. Only 11 countries are projected to reach their maximum working-age proportion
prior to 2050. Poverty
Three billion people live on $2 a day or less.
This number is the same as additions to world population since 1960. Most
growth is now in the poorest countries. In the 1990s, the per capita GDP of developing countries grew by 1.6
per cent a year. But
these slow gains were unevenly distributed. The per capita GDP growth of the
poorest countries in the 1990s was slower than in the 1980s. Lower-middle-income countries had poorer economic performance in the
1990s than the 1980s.
Transitional and developing economies in Europe and Central Asia actually
declined in the 1990s. In 1999-2000 GDP growth per capita in low-income
countries in this region was 2.2 per cent per year. Similar rates held
regionally in Latin America and the Caribbean, South Asia, and the Middle East
and North Africa. Sub-Saharan African per capita economic performance grew by
only 0.6 per cent. While extreme income poverty declined in the 1990s, much
of that was due to progress in a few countries in Asia. The proportion of the population in developing
countries living on less than $1 a day decreased from 28.3 per cent in 1987 to
23.4 per cent in 1998. The percentages reflect
population growth; absolute numbers have remained relatively stable at about
1.2 billion. The reduction in the number of people living on
less than a dollar a day has been uneven across regions. The most dramatic reductions have taken place in East Asia, mainly
China. The most dramatic increase has been in Eastern Europe and Central Asia. There
were net additions to the number of poor in both south Asia and Africa.
Modest gains in poverty reduction were made in Middle East and Latin America. The gap between rich and poor, globally and within countries, has been
growing. The difference
in per capita income between the world’s wealthiest 20 per cent and the poorest
20 per cent was 30 to 1 in 1960; this ratio jumped to 78 to 1 in 1994, and
decreased slightly to 74 to 1 in 1999. An analysis of data for 53 countries between 1965 and 1990 found
that higher adult survival rates were responsible for about 8 per
cent of total growth. (A number reflected above as half the fifteen per
cent due to population.) Population
living on less than dollar a day
(at 1993
purchasing power parity)
Note: In South Asia the relative decline in proportions poor was
associated with an absolute increase of 50 million, in sub-Saharan Africa a
modest relative increase resulted in 84 million more extremely poor
people. These increases were largely
due to population growth. Women More women than men live in poverty.
This disparity has increased over the past decade, particularly in developing
countries. The gender-poverty ratio is the number of women per
100 men in the poorest fifth of the population or living below the poverty
line. Data from the early 1990s show this ratio ranging widely, from 93 in
Nepal to 130 in Bangladesh and as high as 190 in Botswana. There is greater gender inequality in social and
economic rights than in legal and political rights, especially in South Asia
and sub-Saharan Africa. Women in Eastern Europe and Central Asia experience
the greatest relative equality and women in South Asia, sub-Saharan Africa and
the Middle East and North Africa the least. At least half of women’s total work time is spent
on unpaid work. Education Women tend to be less educated than their husbands,
the difference being greatest in South Asia and the smallest in Latin America.
Women marry younger in South Asia and at older ages in Latin America. If
other regions had closed the education gender gap as fast as East Asia did from
1960 to 1992, per capita income could have grown by an additional 0.5 to 0.9
percentage points per year in sub-Saharan Africa, 1.7 per cent in South Asia
and 2.2 per cent in West Asia. In countries where girls are only half as likely to
go to school as boys, there are on average 21.1 more infant deaths per 1,000
live births than in countries with no gender gap. In sub-Saharan Africa, between 8 and 25 per cent of
girls’ school dropout rates are the result of pregnancy. Gender dimensions in development and programmes Studies in Bangladesh found that participation in programmes that
combine maternal and child health and family planning with poverty alleviation produce greater
reductions in child mortality, particularly among girls, in the poorest groups
compared to the richest groups. Combining the two programmes improved
their effectiveness. Reducing gender inequality can accelerate economic growth and have a
powerful impact on poverty.
Comparing East Asia and South Asia between 1960 and 1992, South Asia
started with wider gender gaps in health and education and closed them more
slowly. If gender gaps had closed at the same rate in the two sub-regions, South
Asia would have increased its real per capita annual growth in GDP by 0.7 to
1.0 per cent. A study of 44 developing countries showed that fertility is highest
among the poorest and lower in wealthier groups. The better-off have fewer
children than the poor, and they also are more likely to have only the children
they want. Risks Early marriage does not protect young women’s health: pregnancy before
the age of 18 is several times more risky than for a woman over 20. Women in the poorest countries, and the poorest
women within these countries, face a risk of death as a result of pregnancy up
to 600 times higher than their better-off counterparts.
A study in Zambia revealed that only 11 per cent of
the women interviewed believed that a married woman could ask her husband to
use a condom, even if she knew that he had been visiting prostitutes and was
possibly suffered from a sexually transmitted infection. The poorest women start their childbearing earliest. In many
developing countries, poor women marry and start bearing children between ages
15 and 19. In some of the 22 countries reviewed in sub-Saharan Africa, adolescent
fertility decreases with higher wealth; but where fertility is highest, fewer
differences are seen. Gender violence in the industrial countries alone, is estimated to
cost one in five healthy years of life of women age. Health Poor people in
a 41-country survey cited illness most frequently as the cause of
destitution and the reason for a slide into poverty. More than one fifth of the burden of disease among women of
reproductive age is connected with sex and reproduction. In sub-Saharan Africa, the figure
is 40 per cent. High prevalence of disease goes hand in hand with poor economic
performance. Productivity
losses from ill health could amount to roughly $360 billion per year in
developing countries within two decades. In countries where a high proportion of the
population is at risk of severe malaria, average income is less than one fifth
that of non-malarial countries. In the least-developed countries, life expectancy is just 49 years; it
is 77 in high-income countries. In the least-developed countries, one in ten children do not reach their first
birthday. Infant mortality is 92 per 1,000 live births; it is 6 in high-income
countries. Unwanted children are more prone to respiratory and diarrhoeal
infections than wanted children. Wanted or not, each additional sibling reduces
the chance of a child receiving treatment by 2 to 8 per cent. A woman’s lifetime risk of dying due to maternal
causes (pregnancy, delivery and related complication) is:
Women in the slums have limited access to reproductive health
information and care
because health centres are not conveniently located. Combined with social norms
this contributes to the fact that: ·
93 per
cent of married teenagers have begun childbearing; ·
22 per
cent of girls give birth before age 15; ·
63 per
cent of women have never used a modern method of family planning; ·
40 per
cent became pregnant unwillingly due to lack of knowledge of services. Health gaps between rich and poor are generally wider in poorer
countries than richer ones. Gaps have harmful effects everywhere.
In the United States, the country that spends the most on health care per
capita in the world, inequalities in access to health care are higher than in
other industrialized states. These disparities mean that overall health
performance is worse; for example, infant and child mortality in the United
States is higher than in most European Union countries. Child mortality levels
in some poor communities in the US rival those of Panama. RH gaps
Approximately 500,000 women die each year from maternal
causes, and many times that number suffer illnesses and
injuries associated with pregnancy and childbirth. Ninety-nine per cent of
these deaths occur in developing countries. Complications of pregnancy and childbirth are a leading cause of death
and disability for women aged 15-49 in most developing countries. Only 53 per cent of births are attended by trained practitioners, and
access to emergency obstetric care is extremely low, particularly among poor
and rural women. To
save women’s lives, there must be a large increase in essential equipment
and medications for safe delivery. Family planning gaps There is little difference in fertility between income groups in
countries with fertility rates above six children per woman. The higher the overall level of women’s
contraceptive use, the lower the differential between women in the richest and
poorest groups. The largest differentials are observed during the
transition. Once family planning use exceeds 40-45 per cent overall, the
differences between wealth groups narrows considerably, and family planning
becomes accepted as the norm. The use of family planning services depends less on cost than on
personal motivation, spousal, family and community support and institutional
commitment and resources for providing the services. Resources for health The poorest countries lack the financing or give
higher priority to debt servicing and repayment, defence or industrial
development. Low-income countries are spending only $21 per
capita per year for all forms of health care, much of it directed to expensive
curative services to the detriment of basic health prevention and care.
The WHO/World Bank Commission on Macro-economics and Health estimated that
an additional $30 billion per year is needed. In a majority of the countries, the richest 40 per cent receive a
larger share of the total health outlays than the poorest 40 per cent. In Viet Nam,
for example, the poorest receive nearly their proportional share of
reproductive health expenditures. Policies
can reduce inequality. Projected needs Demand for modern contraceptives will increase by over 40 per cent
during the next 15 years as the result of unmet need, increased demand and
growing populations of reproductive ages. HIV/AIDS HIV/AIDS is the
deadliest and fastest spreading of the diseases of sex and reproduction. It poses
a greater threat to development prospects in poor countries than almost any
other disease. On average, 14,000 men, women and children are
infected daily. HIV/AIDS is the leading cause of death in sub-Saharan Africa
and the world’s fourth-biggest killer. More than 60 million people have been infected with
HIV, and AIDS has already killed more than 20 million people. An estimated 40 million people are living with the
virus, over 28 million in Africa and almost 95 per cent in developing
countries. HIV/AIDS is the major cause of death in Africa.
All but 1.5 million of the 40 million currently infected people live in
developing countries. It is spreading fastest in Eastern Europe and Central
Asia, and is daily becoming a more serious threat in India and China. In 2001
three million people died of AIDS, out of 22 million the disease has killed.
AIDS deaths have left 13.4 million children without one or both parents, a
third of all orphans. In the 1990s, AIDS reduced Africa’s per capita annual growth by an
estimated 0.8 per cent.
In two decades, economies of the worst-affected countries may
be 20 to 40 per cent smaller than they would have been without AIDS. Surveys in 17 African countries indicated that over half of the girls
did not know any way of protecting themselves from HIV.
Cultural support for adolescent sex and poverty-driven interactions with
older men put young women at greater risk. More than 4 million children under the age of 15
have been infected with HIV. Over 90 per cent were infants
born to HIV-positive mothers and acquired the virus before or during birth or
through breastfeeding. Of the 580,000 children under the age of 15 who
died of AIDS in 2001, 500,000—nearly nine out of ten—were African. Young women know less than young men, though young women are more
vulnerable to infection. Half of all new HIV infections are among young people
aged 15-24, and young women are more likely to be infected than young men their
own age. By 2010, about 40 million children worldwide will
have been orphaned by the pandemic. The death of young working adults and
the increase in widows, widowers and orphans will increase dependency as well
as poverty. Sub-Saharan Africa will have 71 million fewer
people by 2010 than it would have had without AIDS. The result is to threaten
the economies, social structures and political stability of entire societies. Family farms in Zimbabwe see a 40-60 per cent fall
in the production of maize, peanuts and cotton after an AIDS death. Only about one in five people at risk for HIV have
access to prevention information and services. Fewer
than 5 per cent of people who need them get anti-retroviral drugs. By 2020 African economies could be 20-40 per cent
smaller than expected because of the pandemic. By 1997, worldwide, 41 per cent of all
HIV-positive adults were women. In 2001, the figure was over 47
per cent and in Sub-Saharan Africa, 55 per cent. About a third of infected mothers pass the disease to their children
in utero. Educated mothers have healthier children.
They know more about good nutrition, and there is less competition for food in
smaller families. The combination accounts for 43 per cent of the reduction
in child malnutrition between 1970 and 1995. Education Declining fertility in some countries is reducing
the pressure on public school systems, providing an opportunity to increase
quality without necessarily increasing expenditures. When opportunities are available for educated workers, earnings can
increase on average by 10 per cent for each additional year of schooling. Globally, about 31 per cent of women were without any formal education
in 2000, compared to 18 per cent of men. Women in South Asia have only half as many years of education as men,
and female enrolment rates at the secondary level are only two thirds of male
rates. In sub-Saharan Africa, girls’ school attendance at age 12-13 is 80 per
cent that of boys but by age 18-19, only half as many girls as boys are attending
school. Pregnancies contribute to as much as a quarter of school dropouts
among girls who continue into their reproductive years in Sub-Saharan Africa. Increases in women’s education makes the greatest
contribution to reducing the rate of child malnutrition, accounting for 43 per
cent of the total reduction. Improvements in food
availability came in a distant second, contributing 26 per cent. Educated women are more likely to have adequate prenatal care, to have
skilled assistance at the delivery of their babies, and to use contraception to
avoid unwanted and mistimed births. Studies
have found that an additional year of female education reduces fertility by
between 0.2 and 0.3 births per woman. In South Asia and in West and Central Africa, a large minority of
children from poor households never enrol in school. In Latin America, in contrast,
virtually all children complete the first grade, but subsequent dropout rates
are high. A recent study of 35 countries in West and Central Africa and in
South Asia showed that, in 10 countries, half or more of 15-19 year olds
from poor households never completed grade one. A larger percentage of public spending on education goes to government
actions that benefit the wealthy (e.g., higher levels of schooling rather than basic
education). Resources
In 2000, total expenditure towards the goal of
universal access to reproductive health by 2015 was $10.9 billion. Donor
assistance totalled $2.6 billion. This is less than a quarter (24 per cent) of
total expenditure, and less than half (46 per cent) of their commitment at the
ICPD. Developing countries contributed $8.3 billion, 76
per cent of the total spent and about 73 per cent of their commitment. A few
large countries account for much of this expenditure. Africa is the region with
the largest share (70 per cent) of allocations coming from international
sources. UNFPA estimates that contraceptive requirements for family planning
and prevention of STIs and HIV/AIDS call for total donor support in 2015 of
$739 million, an increase of $405 million over 2000. These are a fraction of overall
programme needs (commodities costs are only about a fifth of total service
costs) and represent 40 per cent of total commodity costs. Global indicators:
Indicators related to various launch sites:
As compared to:
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