Demographic Diversity and its Implications for the FutureJohn ClelandLondon School of Hygiene & Tropical Medicine

Life Expectancy Trends 1950-2005EuropeLatin AmericaAsiaWorldAfricaNorthern America

Fertility Trends 1950-2000AfricaAsiaLatin AmericaWorldEuropeNorthern America

Chart2

5.026.725.892.665.893.47

4.966.795.642.665.943.72

4.976.865.642.585.973.34

4.916.815.692.365.552.54

4.496.725.082.165.052.01

3.926.64.181.974.51.78

3.586.453.671.883.931.81

3.386.113.41.833.431.9

3.045.672.961.573.031.99

2.795.262.671.42.751.95

2.654.972.471.42.551.99

World

Africa

Asia

Europe

Latin America & the Caribbean

Northern America

Total Fertility Rate

Sheet4

Chart3

5.026.725.892.665.89

4.966.795.642.665.94

4.976.865.642.585.97

4.916.815.692.365.55

4.496.725.082.165.05

3.926.64.181.974.5

3.586.453.671.883.93

3.386.113.41.833.43

3.045.672.961.573.03

2.795.262.671.42.75

2.654.972.471.42.55

2.654.972.471.42.55

World

Africa

Asia

Europe

Latin America & the Caribbean

Total Fertility Rate

Sheet1

IndonesiaIndiaChinaBrazilUS/EU/Japan

6559524212.5

Sheet1

Sheet2

WorldAfricaAsiaEuropeLatin America & the CaribbeanNorthern America

19505.026.725.892.665.893.47

19554.966.795.642.665.943.72

19604.976.865.642.585.973.34

19654.916.815.692.365.552.54

19704.496.725.082.165.052.01

19753.926.64.181.974.51.78

19803.586.453.671.883.931.81

19853.386.113.41.833.431.9

19903.045.672.961.573.031.99

19952.795.262.671.42.751.95

20002.654.972.471.42.551.99

20052.654.972.471.42.551.99

2.47

Sheet2

World

Africa

Asia

Europe

Latin America & the Caribbean

Northern America

Sheet3

Sheet3

5.026.725.892.665.893.47

4.966.795.642.665.943.72

4.976.865.642.585.973.34

4.916.815.692.365.552.54

4.496.725.082.165.052.01

3.926.64.181.974.51.78

3.586.453.671.883.931.81

3.386.113.41.833.431.9

3.045.672.961.573.031.99

2.795.262.671.42.751.95

2.654.972.471.42.551.99

2.654.972.471.42.551.99

World

Africa

Asia

Europe

Latin America & the Caribbean

Northern America

Total Fertility Rate

Chart1

1530

1532

1934

2236

2236

2540

2642

2744

2845

2946

3252

3654

3756

3858

4060

8040

7545

77130

65150

20220

100420

90570

77680

60800

55880

50860

45855

40800

25690

25575

5450

MDCS

LDCS

Millions

Increase in Population by Decade, in Millions

Sheet1

MDCSLDCS

17501530

17601532

17701934

17802236

17902236

18002540

18102642

18202744

19302845

18402946

18503252

18603654

18703756

18803858

18904060

19008040

19107545

192077130

193065150

194020220

1950100420

196090570

197077680

198060800

199055880

200050860

201045855

202040800

203025690

204025575

20505450

20605360

20708320

208010230

209010190

210010120

2110890

2120885

2130670

2140660

2150545

35

Sheet1

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

MDCS

LDCS

Millions

Increase in Population by Decade, in Millions

Sheet2

Sheet3

Major Causes of Projected Population Growth: Developing Countries, 1995-2100Source: Bongaarts J. Science 263:771-776. 1994

Estimated Population, 2005 and Projected Population 2050, in millionsSource: UN Population Proj. 2004

20052050RatioSub-Saharan Africa75116922.25North Africa1913121.63Latin America5617831.39Asia390552171.34Northern America3314381.32Europe7286530.90World646590761.40

Population Ageing in Europe

Chart1

8.214.729.2

1.1310

1950

2000

2050

Sheet1

HighMeidumLow

20056.466.466.46

20106.96.846.78

20157.387.217.05

20207.877.587.28

20258.347.917.47

20308.788.27.62

20359.248.467.71

20409.718.77.75

204510.188.917.74

205010.659.087.68

Sheet1

000

000

000

000

000

000

000

000

000

000

High

Meidum

Low

Sheet2

% Aged 65+% Aged 80+

19508.21.1

200014.73

205029.210

Sheet2

000

000

000

1950

2000

2050

Sheet3

POTENTIAL SUPPORT RATIO (NUMBER AGED 15-64 /AGED 65+)Source: UN. World Population Ageing, 2002

Chart1

85.74.631.9

16.816.917.215.310.2

11.610.19.16.34.1

1950

1975

2000

2025

2050

Sheet1

EuropeLeast DevelopedWorld

1950816.811.6

19755.716.910.1

20004.617.29.1

2025315.36.3

20501.910.24.1

Sheet1

00000

00000

00000

00000

00000

1950

1975

2000

2025

2050

Sheet2

Sheet3

Chart1

731731731731

737730724729

743727711724

749722695716

752715678706

754707659694

757697639680

763687617664

770670592646

777664566626

High

Medium

Low

Constant

Projected Population of Europe under Different Fertility Assumptions

Sheet1

HighMediumLowConstant

2005731731731731

2010737730724729

2015743727711724

2020749722695716

2025752715678706

2030754707659694

2035757697639680

2040763687617664

2045770670592646

2050777664566626

Sheet1

0000

0000

0000

0000

0000

0000

0000

0000

0000

0000

High

Medium

Low

Constant

Projected Population of Europe under Different Fertility Assumptions

Sheet2

HighMediumLowConstant

2005769769769769

2010873867860877

20159909729521006

20201117108110441159

20251250119311361340

20301391130812261556

20351539142413111814

20401695154013882126

20451857165214582501

20502022176115182954

Sheet2

0000

0000

0000

0000

0000

0000

0000

0000

0000

0000

High

Medium

Low

Constant

Year

MIllions

Projected Population of sub-Saharan Africa under different fertility assumptions

Sheet3

IMMIGRATION SCENARIOS(EUROPE)(ALL FIGURES IN MILLIONS)(Source: UN Replacement Migration 2001)

Population Size (2000)730Projected Pop. Size assuming no net migration600Net Annual Migration (1990-98)0.95Net Annual Migration to Keep Constant Pop.1.82Net Annual Migration to Keep Constant Age Group 15-642.93Net Annual Migration to Keep Ratio 15-65/65+ Above 3.04.27Net Annual Migration to Keep Constant Ratio 15-64/65+25.20

African Fertility Trends (Past & Projected)

Chart1

6.986.256.486.89

7.036.375.846.97

7.046.495.587.03

6.956.65.157.04

6.856.644.727.01

6.636.594.046.86

6.256.513.526.59

5.896.363.16.2

5.586.252.95.83

5.246.12.715.35

4.825.832.544.84

4.385.422.394.35

3.964.992.273.91

3.64.532.173.54

3.284.062.083.24

3.013.6122.98

2.783.231.932.76

2.582.921.882.57

2050205020502050

East Africa

Middle Africa

Southern Africa

Western Africa

Sheet1

East AfricaMiddle AfricaSouthern AfricaWestern Africa

19606.986.256.486.89

19657.036.375.846.97

19707.046.495.587.03

19756.956.65.157.04

19806.856.644.727.01

19856.636.594.046.86

19906.256.513.526.59

19955.896.363.16.2

20005.586.252.95.83

20055.246.12.715.35

20104.825.832.544.84

20154.385.422.394.35

20203.964.992.273.91

20253.64.532.173.54

20303.284.062.083.24

20353.013.6122.98

20402.783.231.932.76

20452.582.921.882.57

2050

Sheet1

East Africa

Middle Africa

Southern Africa

Western Africa

Sheet2

Sheet3

Percentage of currently married women using a modern method of contraception: West Africa

Mean desired family sizes among all women (African surveys)

Niger

Population (2005)14 millionTotal Fertility Rate8 births per womanDesired number of children8% using modern contraception 4%Life expectancy45.4 yearsInfant mortality145Adult literacy16%% child stunted38%HIV prevalence1.2%Projected population in 2050 if(a) Fertility remains constant80 million(b) Fertility declines to 3.6 by 205050 million

Probable ConsequencesInability to feed population continued dependence on food aid and/or famineDestruction of local ecosystems due to overgrazing etcContinuation of mass poverty, underemploymentContinuation of dependence on international aid

Possible means of MitigationUranium miningMass migration to neighbouring coastal statesRemittances from migrants to Europe Attraction of global capital/skills for manufacturing with low cost labourAchieve sharper than expected fertility reductions

Kenya: Changes in Reproductive Indicators

1977-78198419891993Mean desired family size7.76.24.73.9% wanting no more children16%N/A49%52%% contracepting7%17%27%33%Fertility rate87.76.75.4

Trends in total fertility rate and contraceptive use in married Kenyan women

Chart1

8.10.07

7.70.17

6.70.215

5.40.26

4.70.3

4.80.3

Fertility Rate

Contraceptive Use

Year

Fertility rate per woman

Contraceptive Use (%)

Sheet1

yearFertility RateContraceptive Use

19778.17%line tfr year,xlabel(1977 1984 1989 1993 1998 2003) xscale(range(1997 2003)) yaxis(1) ytitle(TFR) lcolor(black) ||line var4 year, yaxis(2) yscale(axis(2) range(0 30)) ytitle(% change,axis(2)) yscale(axis(1) range(0 9)) ylabel(0(1)9,axis(1)) xtitle(Y

19847.717%

19896.722%

19935.426%

19984.730%

20034.830%

Sheet1

&A

Page &P

Fertility Rate

Contraceptive Use

Year

Fertility rate per woman

Contraceptive Use (%)

Sheet2

19778.17%

19847.717%

19896.722%

19935.426%

19984.730%

20034.830%

Sheet2

00

00

00

00

00

00

Sheet3

KENYA: CAUSES & CONSEQUENCES OF FERTILITY STALLCAUSE(?) Between 1995-2005 USAIDs Annual allocation for family planning fell from $12 million to $9 million while HIV/AIDS allocation rose from $2 to $74 millionCONSEQUENCES: % unwanted births rose from 11% (1998) to 21% (2003) and % contraceptive users relying on public sector supplies fell from 68% to 53%KENYAS PROJECTED POPULATION IN 2050 RAISED FROM 44 TO 83 MILLION

DISTRIBUTION OF 76 LOW AND LOWER-MIDDLE INCOME COUNTRIES BY RATE OF POPULATION GROWTH AND UNMET NEED FOR FP

Unmet NeedLow (

Conclusions High fertility and rapid population growth remains a severe barrier to progress in many but not all poor countriesMost poor countries already have appropriate population & FP policiesBUT they have received far too little encouragement and funding from donor agencies to implement them with commitment.Donors must take much of the blame Excessive political correctness? Fads and fashions?Renewed emphasis on population stabilisation and FP and respect for reproductive rights are compatibleInternational FP needs a champion

What needs to be done?Re-forge link between investment in FP and poverty-reduction that was broken in 1994 at Cairo.Stop cloaking FP in that obfuscating phrase sexual and reproductive healthRecognise that priorities in poor countries are increasingly divergent population/fertility is a bigger problem than AIDS in most of Africa but not in Southern Africa.

****************