The Environment,
Population and
Reproductive Health

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Estimated Number of Births & Deaths  Resultant Population Increase, Mid-2003
 Total Pop., Mid-2003  6.3 billion (G.R. 1.3%)
                                   Population
                             Births           Deaths      Increase

	No. per year    139,000,000   57,000,000   82,000,000
	No. per week       2,673,000     1,096,000    1,577,000
	No. per day             381,857        156,571      225,286
	No. per minute             265               109             156

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Population Growth Rates

	Growth Rate (%) Doubling Time (yrs)
			4.0 17
			3.0 23
			2.0 35
			1.0 69
			0.002       35,000

Estimates of Birth, Death
 and Growth Rates, Mid-2003

	Pop.   Births/    Deaths/  Growth      D.T.
	1000         1000        rate (%)        (yrs)
	WORLD      6,314M      22            9          1.3         53
	Africa             861M      38          14         2.4         29
	Asia            3,830M       20            7         1.3         53
	L. America     540M      23            6         1.7         41
	Europe           727M      10          12        -0.2             -
	N. America     323M      14            8         0.5         138

Estimate of Birth, Death & Growth Rates
Mid-2003, Selected Countries

	Pop.    Births/  Deaths/  Growth  D.T.
	1000        1000       rate (%)   (yrs)
	China 1,289M       13          6            0.6      115
	India   1,069M       25          8            1.7        41
	Russia   145M       10        16           -0.7         -
	U.S.        291M       14          9            0.6      115

World Population, 1950-2020 (millions)

	Less                  More
	World           Developed         Developed
	(x1,000,000)    (x1,000,000)      (x1,000,000)
	1950     2,501         1,644  (68%)          857   (34%)
	1970     3,610         2,526  (70%)       1,084   (30%)
	1985     4,845         3,671  (76%)       1,174   (24%)
	2003     6,314         5,112  (81%)       1,202   (19%)
	2010*    6,903         5,687  (82%)       1,217   (18%)
	2025*    8,082         6,842  (84%)       1,240   (16%)
	*United Nations Medium Projection

Population Projections
(Millions)

	1994   2003     2010    2025
	World              5,607   6,314   6,903    8,082
	Africa                 700      861      979    1,288
	Asia                 3,392    3,830   4,235   4,965
	Latin America    470     540       591     697
	Europe               728      727       731     715
	North America   290      323      333      376

Population Projections,
Selected Countries
(Millions)

	1994       2003      2010      2025   2050
	China      1,192      1,289     1,394     1,561  1,394
	India           912      1,067     1,197     1,441  1,628
	U.S.            261        292        298       335       422
	Indonesia   200        221        239       275       316
	Russia       148        146         142       135       119
	Nigeria         98        134         150       203       307
	Mexico         92        104         118       140       153

Momentum of World Population Growth

	Eventual point
	at which
	Year in which the     World population    population
	world attains           at replacement         stabilizes
	replacement fertility                 (x1,000,000)
	2000-2005              5.9                8.4
	2020-2025              8.4              11.2
	2040-2045            12.0              15.1

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Urban Populations (Millions)

	1970           2001           2015
	Sao Paolo         8              18             21
	Mexico City       9             18             20
	Shanghai         11             13             14
	Mumbai             6              17             23
	Calcutta             7             13             17
	Jakarta              4              11             17
	Beijing               7              11             12

Urban Areas Larger Than
5 Million People

	Developing     Developed
	countries         countries
	1970           11                      9
	2000            37                    11

Contraceptive Prevalence:
Developing Countries
(Approximate %)

	1960              2001
	<5%   57% (all methods)
	51% (modern)

1974 Population Conference,
Bucharest

	North-South Debates
	Western Nation Imperialism

1984 Population Conference, Mexico City

	U.S. Stance: Free Market Systems;
	Population Growth Not An Issue;
	Abortion (With Catholic Church)
	Developing Country Concerns Re:
	Population

International Conference on Population and Development (ICPD)
(Cairo, September, 1994)

	Major Issues:
	Population
	Environment
	Human Rights
	Empowerment of Women
	Women’s Sexual & Reproductive Health & Rights

Cairo - The Setting

	15,000 Attendees
	3,700 Delegates from 179 Countries and
	8 Observer Delegations
	4 Presidents, 7 Prime Ministers, 5 Vice Presidents, Many Parliamentarians
	1,200 Nongovernmental Organizations (NGOs)
	4,200 Journalists

Brundtland of Norway

	“Morality becomes hypocrisy if it means accepting mothers suffering or dying in connection with unwanted pregnancies and illegal abortions, and unwanted children living in misery .. “

Environmental Issues

	Conflicts Between Developed and Less Developed Countries
	Developed Countries
	Consumption Patterns
	Industrialization
	Pollution

Environmental Issues (cont.)
Less Developed Countries

	Population
	Deforestation
	Loss of Top Soil
	Early Industrialization - Pollution
	Urbanization

Water Issues

	Projections for the future are daunting
	Again, impact heaviest on the poorest countries
	Increases in population numbers play a major role

ICPD Programme of Action

	Overall emphasis on sustainable development, humanitarian goals, and status of women rather than on demographic targets

Empowerment of Women

	“The empowerment and autonomy of women and the improvement of their political, social, economic and health status is a highly important end in itself …”

Empowerment of Women

	Economic Equity:
	Access To Jobs, Equal Pay
	Health Equity:
	Right to Reproductive and Sexual Health
	Political, Legal, Educational and Social Equity

Abortion in Cairo

	“In no case should abortion be promoted as a method of family planning …
	All governments …are urged …to deal with the health impact of unsafe abortion as a major public health concern…
	In circumstances in which abortion is not against the law, such abortion should be safe.”

Human Rights

	“These [human] rights rest on the recognition of the basic rights of all couples and individuals to decide freely and responsibly the number, spacing and timing and to have the information and means to do so and the right to attain the highest standard of sexual and reproductive health … free of discrimination, coercion and violence ..”

Reproductive Health Issues

	Family Planning Services
	Prevention, Diagnosis and Treatment of
	STDs and HIV/AIDS
	Adolescent Sexuality and Pregnancy
	Maternal Mortality
	Abortion

Family Planning Services

	Make Available All Effective and Safe Methods of Contraception On A Voluntary Basis With Full Informed Consent

Family Planning Methods

	Oral Contraceptives
	IUDs
	Injectables & Implants
	Barrier Methods
	Periodic Abstinence
	Sterilization Procedures

STDs and HIV/AIDS

	Gonorrhea and Syphilis
	Chlamydia
	Herpes
	Trichomonas
	Monila
	HPV
	HIV/AIDS

STDs and HIV/AIDS (cont.)

	Prevention Education
	Condom Use
	Women-Controlled Methods
	Diagnosis and Testing Issues
	Treatment Issues

Adolescent Sexuality and Pregnancy

	The Issue Worldwide, Particularly in Urban Areas
	The Controversies
	“The Rights, Duties and Responsibilities of Parents”

Maternal Mortality

	500,000 Deaths Annually, 98% in LDCs
	MM Ratios 10-100 Times Those in Developed Countries
	LDCs: 100-1000/100,000 Livebirths
	US:  8/100,000 Livebirths

Maternal Mortality (cont.)

	High Incidence of Home Deliveries, Particularly in Rural Communities, with TBA, Relative or No-One in Attendance

Maternal Mortality: Causes

	Obstructed Labor/Ruptured Uterus
	Postpartum Hemorrhage
	Toxemia/Eclampsia
	Postpartum Sepsis
	Abortion Complications
	Role of Age and Parity

Maternity Care Interventions:
Emergency Obstetrical Care

	Transfusions
	Parenteral Antibiotics
	Cesarean Section
	Treatment of Abortion

Abortion

	Incidence Worldwide:
	40-50 Million
	Estimated Deaths Annually From Unsafe Abortions: 60,000-110,000
	Single Most Controversial Issue in Society Today

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 Global summary of the HIV/AIDS epidemic,
December 2002

Adults and children estimated to be living
with HIV/AIDS as of end 2002

Estimated number of adults and children
newly infected with HIV during 2002

Estimated adult and child deaths
from HIV/AIDS during 2002

About 14 000 new HIV infections a day in 2002

	More than 95% are in developing countries
	2000 are in children under 15 years of age
	About 12 000 are in persons aged 15 to 49 years, of whom:
		almost 50% are women
		about 50% are 15–24 year olds

Women and AIDS

	“…It is only when women can speak up, and have a full say in decisions affecting their lives, that they will be able to truly protect themselves -- and their children -- against HIV.”*
	*UN Secretary-General Kofi Annan

Women and AIDS

	The vulnerability of women
		12-13 African women infected per 10 men
	The threat to sex workers
	The threat to spouses
	Relationship with F.P. programs
	The role of prevention
		Safe sexual practices
		Microbicides & condoms (male & female)
		Vaccines

The AIDS Orphan Tragedy

	An estimated 12-14 million children have lost one or both parents
	Loss of the mother is particularly devastating
	Educational, food, housing and nurture needs are grossly neglected

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