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UN Population Fund Report

November 3, 2011

State of the World Population 2011

Introduction

JOANNE MYERS: Good afternoon. I'm Joanne Myers, and on behalf of the Carnegie Council I'd like to thank you all for joining us this afternoon.

With the birth of a Filipino infant just a few days ago, the United Nations symbolically declared that the world's population had reached the seven billion mark, having added a billion new lives to the planet in just 12 years. While this projection has at least a 1 percent margin of error—meaning the population can be reached six months before a target date or six months after—the facts are clear: The world's population is growing and will continue to do so, as so clearly stated in this year's State of the World Population Report.

We are delighted that Barbara Crossette, the author of this report, accepted our invitation to discuss these findings with us. The report was prepared under the auspices of the United Nations Population Fund, also known as UNFPA.

For those of you who are not familiar with UNFPA, just briefly let me tell you that it was established in 1969 and has been the lead agency at the United Nations for population and development issues. Working in partnership with government, civil society, and other agencies to promote the right of every woman, man, and child to enjoy a life of health and equal opportunity, its programs seek to ensure universal access to reproductive health, including family planning and sexual health for couples and individuals. UNFPA is guided by the Programme of Action adopted at the 1994 International Conference on Population Development and the Millennium Development Goals.

In enlisting Barbara to write this year's report, UNFPA made a very wise choice, and for many reasons. Even though for most of her journalism career Barbara was a reporter at The New York Times, serving as bureau chief at the United Nations and earlier as The Times' chief correspondent in Southeast Asia and South Asia, in recent years the core of her writings has been on UN-related issues, with a focus on stories that make a difference. With a strong moral compass informing all of her writings, it is not surprising that Barbara has been recognized, awarded many prizes, and celebrated, as a reading of her bio indicates.

She is known not only for articles which immediately engage the reader, but also for the particular way that her writings have helped us to understand the complexities of international issues. For example, she writes that while most of the world will be focusing on numbers, she chose to tell personal stories to shed light on real-life challenges and the trends that affect people in their everyday lives. With characteristic astuteness, this approach helps us to focus on what is needed to build better lives for ourselves, our families, communities, and countries.

The report begins with a sampling of young people, and in the chapters that follow she explores such issues as aging populations, migration, and reproductive health. With the UN predicting that there could be more than 10 billion people by the end of the century and that most of the births will be in the poorest countries, where resources are slim, Barbara tells us that the actions we take now will decide whether the future will be healthy, sustainable, and prosperous, or whether it will be marked by inequalities, environmental decline, and economic setbacks.

It is my great pleasure to introduce Barbara Crossette.

Remarks

BARBARA CROSSETTE: Thank you. It's a pleasure to be here with a well-informed audience to talk about this issue. In fact, the guest list is scary.

It's an issue littered with numbers, most of which I will spare you, in order to suggest instead some ideas about what they mean. I hope this is more interesting.

As everyone knows by now and as Joanne has just said, demographers at the United Nations Population Division, the keepers of global statistics, have been crunching and analyzing numbers for more than a year and concluded that three days ago the world had reached its population of 7 billion. The date is really an estimate. The U.S. Census Bureau has a rather later date, but within the margin of error. No one really knows who that seventh billion person is, although there has been a lot of attention to the Philippine baby and also possibly in north India. Again, statistical analysis.

But what the experts do know is that it took about 12 years to reach the milestone and that in the decades ahead population growth is likely to be faster than projected only two years ago. In the spring of this year, a revision of the 2010 population projections was published and it upped the numbers, with 9.3 billion people in 2050 and well over 10 billion by 2100. That is by cautious estimates. There are higher ones.

Demographers also know that almost all that growth, as Joanne again said, will be in the poorest countries, to the poorest women, in villages and urban neighborhoods where poverty and hunger are already relentlessly stalking their lives.

So it is with some frustration that all this week I have been listening to and watching the same predictable arguments by the same familiar pundits about whether or not the world has too many people, given the limits of natural resources.

There are also all the old and equally predictable and useless macro arguments about whether or not all the people on Earth can fit on a small island, or whether we have plenty of space to spare if we just take the total acreage of the world and divide it by the people. What is missing from this arid debate are the people themselves, the individuals with stories to tell, and where they live—very important—their own environment.

This year the United Nations Population Fund decided to leave the numbers to the Population Division, which is demography, and instead produce reports from the field. In countries around the world, especially some of the most stressed countries by population growth or decline, people do not talk about 7 billion. They have more pressing local concerns.

I was asked to report and write about what I saw and heard. I spent much of the first half of this year visiting eight countries to talk with people about how this world of 7 billion people looks from their local vantage points, where they live—close up, in other words, microcosmic if you will.

These were eight very different places with eight very different human conditions: China, India, Egypt, Ethiopia, Nigeria, Mexico, Macedonia, and Finland. The editor of the report then also traveled to Mozambique to add another African country. African nations are important. Africa, specifically sub-Saharan Africa, will be the one remaining region of the world where the population is set to double or triple in the next 40 years.

In the report I wrote, I quoted Joseph Chamie, a former director of the UN Population Division, who now directs research for the Center for Migration Studies here in New York, who said this: "If Africa's fertility rates were to remain unchanged over the coming decades, the population of the continent would grow extremely rapidly, reaching 3 billion by 2050 and an incredible 15 billion by 2100."

Nigeria, in particular, would see astronomical growth. Obviously, this trend in Africa, if it happens, would skew all current predictions of global growth. Nigeria alone, with 158 million people, Africa's largest population, is projected to grow to 730 million by the end of the century—and that's just the current figures, not the larger extrapolations. That would be larger than the population of all European countries combined.

"Ten other African countries are likely to have populations above 100 million by the century's end," Chamie says.

South Asia is another region where growth continues above what demographers call a replacement level, a fertility rate of 2.1 children for each woman to replace two parents. I always have to say that extra "point 1" in 2.1 is a kind of statistical correction to account for deaths and so on.

India's population has now topped 1.2 billion, and by 2025, possibly sooner, India will have overtaken China as the world's most populous nation. India could have 2 billion people by 2050, if current rates of growth continue. Its once-pioneering family-planning program is in disarray. It was a model in the early post-colonial years.

Bangladesh, as Ambassador Chowdhury knows, has in many ways taken the shine off of India and shown, with Sri Lanka, what can be done in that region of the world. Pakistan and Afghanistan are another problem.

But as I promised, there would be not too many numbers. So what are people talking about these days in Xi'an, in Mumbai, in Cairo, in Addis Ababa, in Lagos, in Toluca, in Helsinki, or in Rostushe.

Rostushe, in case you haven't been there, is a spectacularly scenic old town in the mountains of western Macedonia. A cloud of gloom hangs over its largely empty streets. "All the young people have left," a teacher in the local school told me. She has only three children in one of her classes. Rows of houses stand empty or are home to the grandparents who are left behind. Migration to Western Europe and North America has taken away the sounds of children and the hum of now-shuttered factories.

Macedonia is one of the countries in the world deeply concerned, not about population growth, but about its decline. Migration is part of the story. Macedonia was the least economically developed of the former republics of Yugoslavia, so it starts from a low level.

In Skopje, the Macedonian capital, officials are focused on the country's very low fertility rate, now estimated to stand at 1.4 children per woman. The Macedonian government, eager to join the European Union, knows it has to offer investors a large enough work force to spur economic growth. So it offers women money to have a third child. This is something the UNFPA considers unacceptable.

"No thanks," many of them say—these are the young women. "How many children, if any, I have will be a family decision, my decision, for my own reasons." Young Macedonian women I met in Skopje and in smaller cities, including in the Albanian Muslim communities, often talked about their travels and work abroad and why they came back. They want to be entrepreneurs. One ran a catering service. Another was a personal coach teaching yoga on the side. So you get the idea.

Other countries also worry a lot about shrinking populations. Russia, Italy, and Japan are most often mentioned. I went to Finland, where the fertility rate is now inching up a little, to 1.85 children per woman.

By the way, there are two tremendous tables at the back with every kind of figure you could possibly want. Those of you who know these reports know that journalists always start from the back to see what the lead is in the story.

I went to Finland, where the fertility rate has inched up, but where the attitude of young women was not very different from their counterparts in Macedonia. The Finnish women, with a very high standard of living, had careers and sometimes live-in partners. But children? Not yet, or maybe never—although government-supported child care is the world's gold standard.

Indeed, reproductive health specialists have begun to worry in Finland that women are delaying births too long, late into their 30s. A leading specialist in fertility told me that 20 years ago, 10 years ago, 15 years ago, if you asked Finnish women, "At what age do you finish your family?" they would have said—that is a pun not intended—"At what year should you end your child-bearing years?" they would say 37. Now many of them say they would start having children at 36 or 37. She said this creates problems with conception, with pregnancy, and to women's health generally. In-vitro fertilization is now very much in demand in Finland and largely free in government hospitals.

There is a story about a young woman, a Lutheran pastor, who waited until her 30s to have children, and how she went through the government service and how little it cost. And it was very successful. They aren't all successful.

In China there are also concerns about the shrinking youthful population, in large part because of the coercive one-child policy for most couples that has been in place for more than 30 years. The policy is now being reconsidered, Chinese demographers say freely. It has already been tempered by many exceptions to the one-child rule.

I met a man in a farming town who boasted of having five children, all girls. He did have to give up his local party chairmanship and undergo self-criticism and a vasectomy. But, as he told his story, he got applause from his neighbors—this was a well-lubricated lunch—who said he would be fine in old age because girls take better care of you than boys.

At the other end of the age spectrum, old age and the rapid growth of an elderly population is also a major focus of Chinese officials, as it was in Finland and to some extent in Mexico, where the federal government is giving grants to the elderly to supplement family incomes of sons and daughters so that their parents can continue to live in the family home, which is what most elderly people in a lot of countries—maybe every country—would prefer if it were possible.

Most countries have not gone as far as Singapore, with the "granny flat" concept, where you build apartment blocks that have a little flat to one side for the grandparents. But in China, they have built housing accommodations with extra rooms and a bath and so on so that the families' generational mix is workable.

India is one place where I should have said—in Mexico also I heard this—there have often been reports of elderly abuse, abuse of old people, when tensions rise in families and one partner or another says, "We need to spend the money on our children, on ourselves, on our house," and these old people are not bringing in any money. So the federal government in Mexico has started to give grants according to age—it goes up.

Around the world what stood out to me was the extent to which countries with very different political and economic systems were looking to the private sector to meet the needs of the elderly—building homes and producing aids, such as sophisticated wheelchairs or appropriate household appliances. In Xi'an, in China's Shaanxi province, the chair of the local commission on aging called old age a growth industry. That's kind of interesting.

Other countries rely on charities, religious bodies, and nongovernment organizations [NGOs] to care for the elderly, prompting fears that governments simply want to abandon their responsibilities for their oldest citizens. They have other priorities.

Moreover, those who care for the elderly are talking about asking retirees—and this was again in surprising countries—to take out what we would call reverse mortgages, or draw down their savings or their retirement funds and pensions, to pay for their own care. That was certainly true in Finland, where pensions are quite generous. The OECD [Organisation for Economic Co-operation and Development] figures are pretty astounding.

In the poorest countries—Ethiopia is the example I used in this book—there are no savings to draw on, no pensions, and certainly no banking system that would work for the elderly, among whom homelessness is growing, particularly in Addis Ababa.

Young people, the under-25's, are now half the global population, and they figure prominently in this report because they are a crucial link to the future of the world population, the younger and the older side of them as a keystone. With more sex education, schooling generally, skills training, and better jobs, they are likely to have fewer children and improve their economic status. Governments, of course, see them as contributors to old-age support. They are the hope financially.

Meanwhile, the global young are becoming more political and connected to trends in other countries. In Nigeria, I saw a poster put up by a youth group with a photo from Egypt's Tahrir Square and the slogan, "Don't Say It Can't Happen Here."

There is much more to report, but time runs short. I want to move on to the poor women, the mothers of this century's children, effectively. As I traveled, I became obsessed with them.

Over and over again, women in villages and slums said they knew their families were too big for them to handle. They thought two or three children were ideal, close to the replacement level, and many had five or six or more. And they knew their uneducated daughters were doomed to the same life of servitude and hardship.

Such women are often exhausted, anemic, or short-lived. Hundreds of thousands die of pregnancy-related causes in the developing world, most of them preventable, because they lack maternal health care and any access to contraception.

Somehow, in the Global North, or what we once called the West, the idea has taken hold that giving women contraceptives in the developing world smacks of population control—and, anyway, they like big families. From years of anecdotal evidence as a reporter, I would say those are false excuses for letting down the world's most desperate women and girls.

Teenage girls, many of them child brides, even where early marriage is against the law, are dying in botched or unsafe abortions or pregnancies that are simply ruining their bodies. Their bodies aren't big enough for this. For girls, pregnancy is the leading cause of death in sub-Saharan Africa. North Africa is an entirely different picture, which we can talk about later if you are interested.

Women are denied contraception most often, they say, because of family pressures for sons—in India, the rate of aborted female fetuses has risen to epidemic proportions, the last census in April showed—or because of cultural or traditional beliefs, some of them which are now beginning to be challenged in Africa and Asia.

Archbishop Desmond Tutu of South Africa said in September that he has made this issue his most urgent campaign. He said, "If we could end apartheid in a generation, we can deal with some of these abuses, like child brides." South Africa is not a country that has this problem. It is farther north in sub-Saharan Africa.

But most governments have not made family planning a necessary priority in economic development. Women are denied the same choices that those of us in the richer countries have enjoyed for decades. Even when women have access to family planning centers nearby, many say they cannot risk the beatings they would get from the men in their lives if they made use of the services.

Last year in Uganda—I was doing another report in Uganda on post-conflict areas—I heard of women, more than one, killed for taking the step of going to a family-planning clinic.

Domestic violence ran through the conversations I had with women. In a slum settlement called Bhimnagar, north of Mumbai—I've got a sidebar story about them. These peripheral slums, by the way, are changing Indian demographers' perceptions of rural-urban migration. The rural poor now often cannot afford to stay in traditional city centers, or they are pushed out by urban redevelopment.

The bad news for many around the world is that foreign aid for family planning has dropped or plateaued over the last 10 to 20 years. On page 104 there is a wonderful graphic that shows money for HIV, money for reproductive health generally, and money for family planning. Now the American Congress is busily moving again to cut off all money to the UN Population Fund.

In Cairo, an Islamic scholar of population at Al Azhar University, the great center of Islamic learning, calls this "a violation of poor women's human rights on a global scale."

Those who say that we have nothing to worry about in the newest population figures always cite the good news—and there is good news:

  • Average life expectancy has risen from 48 to 68 years in little more than half a century.
  • Infant mortality has dropped from 133 infant deaths in every 1,000 births in the 1950s to 46 in 1,000.
  • Fertility is down from 6 births per woman to 2.5 globally.

But now we come back to the penchant for looking at macro numbers or averages that do not display the disparities.

In some countries, mainly in Africa, the fertility rate remains well above five children per woman. This is the continent with the highest fertility rates. In Niger, the fertility rate is 6.9 children per woman; in Mali, 6.1; in Malawi, 6.0. Beyond Africa, Afghanistan tops the list at six births per woman.
 

Even in large countries with fertility rates moving down to a replacement level of 2.1, future projections rest on an ever-larger base of population and that very big youth bulge right now of young people just at the peak of their reproductive years. They may be producing another generation of children still without the means to take control of their reproductive lives.

I want to close with one very compelling story of a young woman named Amsalu Buke, who is pictured in this report. If I could, I would make a documentary about her.

In a remote area of Ethiopia, this 20-year-old woman with a secondary-school education and minimal health training runs a tiny health post in an area where there are no doctors or roads, no electricity either. UNICEF gave her a generator to keep her vaccinations cool.

With enormous commitment and enthusiasm, she walks miles every day from hamlet to hamlet to vaccinate children, to deliver babies, to cure intestinal upsets, and to provide a wide range of family-planning tools—more options than women, for example, have in rural India, where sterilization is usually the only service offered to the poor.

Amsalu Buke also proselytizes against child marriage, which she assures those of us who went to visit her that she thinks is finally in decline in parts of rural Ethiopia. And that is one of the leading countries for child marriages in the world.

On the day I spent with her and an even younger assistant, we twice saw women literally emerge from hedges near the health post to beg for an injectable contraceptive, the "no traces left" option for women who fear violence.

No one is pushing birth control on these poor illiterate women. They seek family planning at some personal risk. Then they tell others whom they can trust how contraception has given them breathing space.

Joseph Chamie, the former head of the UN Population Division that I quoted earlier, has a pithy phrase for this that he used to always use. He said, "Given the tools, women will talk fertility down."

Thanks.

Questions and Answers

QUESTION: Carol Spomer.

I just want to know what your take is on the AIDS epidemic in Africa and how that will impact the population growth, and also the Bill Gates initiatives for health improvements in those countries. How do they counteract each other?

BARBARA CROSSETTE: I'm not an expert on some of these programs.

HIV is a part—and I should have mentioned this probably—of the entire issue now of the failure to provide enough reproductive health care for women. As you know, AIDS has become a women's disease in large parts of Africa. It is affecting whole families.

Anecdotally, what I heard was that the idea that somehow they would lose so many people in Africa that this would have an effect on population growth doesn't seem to be a current theory right now. In this room, correct me if I'm wrong, because I'm not an expert on that.

The Bill and Melinda Gates Foundation is doing a lot of work, and in India they are trying to do a lot more work also on family planning. They have been involved in Ethiopia; so has, I think, the Packard Foundation been involved in Ethiopia, and have they have played a part in setting up or helping to fund some programs.

But the programs I saw were government or the equivalent of the Family Planning Association of Ethiopia, which everything there now is quasi-government. They were very defensive about the lack of training and so on.

When I was talking to them, I was trying to say—and because they didn't have money this was always the story—but trying to say that I thought it was very impressive, and they thought I was saying, "But she only has a high school education." But for the women in that area it was tremendous.

I don't know the figures and I was only in Ethiopia and Nigeria on this trip.

QUESTION: Philip Schnissel [phonetic].

It's interesting, with this great population boom, that one of the Republican candidates as part of his platform wants to outlaw contraception. If that should, God forbid, ever happen, it will spread all over the world.

BARBARA CROSSETTE: People in UNAIDS will say that a lot of damage was done by the war on condoms by a previous administration and that it takes a long time to recover.

This again is the invidious difference between our lives and the people's in these countries. If they were to outlaw contraception here it wouldn't change a whole lot. There are a lot of countries in Latin America where the church tried to do that, and women just went ahead. And the same thing—at the Cairo Population Conference there were Irish priests and Colombian priests who were there promoting family planning. You know, we have options.

But the problem is when the United States takes this step into the aid program of the USAID [United States Agency for International Development] and also into—it's a chilling effect worldwide, you're absolutely right.

I was in Ghana in 2004. Things were closing down, especially peer groups of young people. There was a thing called Young & Wise in Ghana. They had really been wiped out because the International Planned Parenthood Federation, which used to take any American money as long as it told them they couldn't do this or do that with it—it was quite a discussion, to say the least, within the International Planned Parenthood, IPPF.

So it does have a chilling effect. And it has a chilling effect on the people who are the most vulnerable, not on us. And that includes the people who are vulnerable in this country, poor women.

QUESTION: James Starkman.

How did the China one-child policy evolve? How do you view the pros and the cons of it? And what are the implications for extrapolating it to many of the African and other high-growth areas?

BARBARA CROSSETTE: How it evolved is that the government suddenly took note of what kind of—in those days we did use the word "explosion"—they were having, and they began to look at development figures and began to look at their programs for the country's development, and they began to see that this was going to be a very costly thing.

So, like so many things in whatever kind of government you want to call it—totalitarian—they just simply said, "Okay, well, we'll fix that. Everyone will have just one child." And it became a law.

From the beginning there were exceptions: if you were a farming family; sometimes if you had a daughter, you could have a son.

What I learned is that the local Communist Party authorities often had huge power, and so the population policy was enforced with levels of coercion—forced abortions, horrible things—in some places, not in others.

Now, how this farmer that I met got away with five children—he would say to people as a joke, "Ask my wife."

So these things were happening. I met people all over—and I wasn't all over China—but I met people in places I went who had come from families where there were two children.

It has become a hugely complicated policy now because it has been kind of—you know, it's like a Christmas tree, with all these different things on it that people can use to get around the policy.

But officially now—a very high-level official once said some months ago, I think in the spring, at the time of their new census—it was a very interesting year because China had a census, India has a census, the U.S. Census figures came out from last year, and so there is a lot of new information around.

Anyway, some woman said—in fact, it was put on the wires for 15 seconds—that the one-child policy was over. And then, as I said, according to a demographer I know, 15 minutes later somebody higher than her in the Party said, "No, no, no, that was premature."

But they are admitting that they are thinking about it. It's because they are having this problem of a hugely large population of elderly people. The same thing that we hear in European countries, and who is going to pay for this imbalance.

Now, I think—I have never worked in China or lived there; I've traveled there off and on for years—but I have lived in India twice and I have been back almost every year since. I think it's visible, the difference it has made. It's awful to say. But Chinese families live better, the children are healthier. If you look at the Human Development Index every year and look at the human development indicators, by every social standard the Chinese are better off than Indians. Poor Indians make up a huge, huge, huge part of the population. In China there are huge areas, too, that are very poor.

But it has made a difference, and it has made a difference in many ways. The children all go to school; the literacy rates are high. In India almost half the children are malnourished.

One of the things I didn't say in this speech, if I can just digress again—I told Joanne this is why I wrote a speech, because I digress too much—is the education system.

The head of the census in India told me this spring—when the census was coming out and I was in Delhi —that they are in love with the demographic dividend: "All these young people are going to make an industrial power. But," he said, "are we making them into assets? What are we training them for? What are we doing with them?" You hear this all over the developing world where there is a huge youth population. Yes, it is a demographic dividend. But there is a certain period of time when you have to use it or lose it in this case, because it's fleeting.

China has been past and through that. Now they are having difficulty finding people for industries and so on, and a lot of people are migrating to China, including well-educated engineers and others from the Western world and other places.

One of the interesting things about China's one-child policy is you now get Chinese demographers saying, "We could have done it without this because rising expectations, more affluence, better education, were already bringing down the population. If there hadn't been such a panic attack in government about this..."

And so, in the same period of time that China has been—you know, forced abortions and just harassing people, and causing people to do all these bizarre things, like run to Hong Kong to have babies. And by the way, China sort of allows that. Hong Kong has had to put a limit on the number of Chinese who can come every year. So you could have one child in Xi'an or somewhere and another child in Hong Kong. So all these things occur.

Taiwan—"Taiwan province of China," as the UN calls it—has a lower fertility rate than all of China except for Shanghai. Shanghai is lower. Without any coercion, over the same period of time the Taiwanese were able to do this—and South Korea—promoting family planning in a very positive way, promoting the value of girls so that there wouldn't be female feticide. There have been problems like this, I am told, in Korea. I wasn't there on this trip.

But that's the complexity of it.

JOANNE MYERS: But also in China isn't the lack of females one of the problems, too, because there are not enough to go around for the young men?

BARBARA CROSSETTE: Yes. I have a friend in Hanoi who used to be my interpreter when I worked in Southeast Asia and Vietnam. She tells me stories about raids over the border where Chinese traffickers come and just snatch Vietnamese young women out of villages and take them back. Some of them are actually offered jobs or something. Then when they get back there, they find out that they are basically married off or put into some sort of sex trade. Yes, this is a problem.

And in India I heard this too. In the last census of ten years ago, for every 1,000 boys born, 927 girls were born. This year it went from 1,000 boys to 914 girls, and in some places down into the 800s. So there are concerns there too.

And this creates some social tensions and other problems among a young male population without a job, without a wife, and what happens. Most other people in India thought this was overblown. India has ways of correcting itself when these things happen. But it is a concern.

In China, they have a square somewhere in Beijing where people go—I can't remember what they call it now; it's like "Leftover Women" or "Leftover Men" or "Leftover Square." It's like a dating mart.

QUESTION: Ron Berenbeim.

I looked at your report very quickly when I got here. I saw three major headings that got my attention: (1) that the world population is getting younger all the time; (2) that for the first time we seem to have turned the corner where a majority of people are living in cities, some of them extremely large; and (3) that work force participation of the young can be in some cases rather low, in some cases somewhat higher.

These three things in combination we have seen played out in the Middle East, but people haven't thought much about what their global implications might be—at least I haven't seen much comment on that. I wonder what your thoughts on it might be.

BARBARA CROSSETTE: I quoted some ILO figures, the International Labour Organization in Geneva. They feel that the unemployment rate in the Arab countries played a large role in the revolutions starting in Egypt, and that it also played a role—and this is not necessarily ILO, but other people—in the recruitment of militants.

It also played a a big role in migration. The saddest cases I met, as you would expect, were in Ethiopia, where there simply was not enough land left to farm for large families. So boys and young women are fleeing to Addis to escape child marriage. They have a couple of centers for them that are really very rudimentary. But the idea is to get them off the street before they get into prostitution or abject servant status and give them some education in things like handling money and everything. So, yes.

Your first point, the youthful population is the largest cohort of youth ever, which is pretty obvious if everything else is the largest—but that is extremely important. That is the "make or break," as I said people are talking about in India and elsewhere—the "make or break" of the future economies of some of these countries, depending on how these young people can be put to work.

Some people would suggest that, because these young people are technologically more savvy, they're in social networking everywhere. I saw this in Nigeria.

When I was writing the report and I had to ask questions, I could just email people. The young ones always answered right away. Some of the others, you could see them freezing, at the other end, when the email came in.

For example, in many developing countries, alternative energy sources would be very productive. There's lots of sun, wind, sea power, whatever. Lester Brown from Earth Policy Institute thinks that North Africa could be fueling Europe with solar energy.

So to train and bring these young people into new technologies and agricultural development is interesting. Africa needs a Green Revolution. Asia needs another one.

It's an extremely important and interesting case right now. And they are also going to be the parents of a lot more children.

QUESTION: Susan Gitelson.

Barbara, it's so wonderful to have you back with us, with all your insights and concern.

BARBARA CROSSETTE: She's a friend of mine. [Laughter]

QUESTIONER: You are presenting a Malthusian picture.

BARBARA CROSSETTE: Ooh, dirty word.

QUESTIONER: Barbara, please consider it, because for several hundred years the Malthusian kind of argument of overpopulation has raised fears of what is going to happen. The counter-argument has been what you started suggesting in China, where people work and maybe live in cities and don't have room, and there is less desire for so many children, and therefore more control. And also, what we want so much is economic development, sustainable development, in all these areas.

Are there are least some government leaders who are wising up to emphasize improving the economies and at the same time reducing the populations?

BARBARA CROSSETTE: Well, yes. Or turn it around the other way, to understand that family planning is part of economic development, that this is not an attack on women, this is not an accusation against women in Africa or anywhere else. Because as I said, if you talk to them, some of them were desperate for this kind of help.

It's interesting. I had to read up on Malthus because I knew he was going to come up in the course of my reporting. You know, he was writing about Europe at the end of the 18th century. He was not writing about global population. He didn't even know this was going to happen.

Jeffrey Sachs and I have had arguments about this. The last time I talked to him—it was some years ago now—about this Malthusian thing, he said, "Well, maybe Malthus was right in some places."

This is what I argue. Disaggregate world population. Some places, as I said, are crying out for more people. In other places, they know they have a problem; they don't have schools, they don't have food. In, of all places, the Horn of Africa, bigger developing countries—the South/South/South split—bigger developing countries are coming in and leasing or buying land to grow food for their own populations as a food bank. So it's even worse.

I think among demographers even, who are considered bad people by some of the women's rights groups, the Malthusian thing is something, just like one-child policies or forced sterilization or whatever, that you don't dare talk about because of the fear that it will come back. That is the Malthusian argument.

And Paul Ehrlich is on the other side. He is still out there writing. He has just written a book that even a lot of demographers have criticized, but on the other side of that argument.

But again, if you are going to talk about it in those terms, it is local where you have this kind of a problem. It's not a global problem. I think people figure the world can feed itself. But an awful lot of people, 1.6 billion, go hungry or don't have enough to eat. So there are an awful lot of people who don't fit the cheery "divide by 7" scenario.

QUESTION: C. Matthew Olson.

Let's continue on your disaggregation point a little bit further. With widely recognized demographic problems in Europe being the opposite of widely recognized demographic problems in Africa, that you correctly pointed out; or India versus Japan; or even if you believe what a lot of people are writing about China; does it make sense to start to talk about adopting different points of view about immigration, or do we just give up and say, "Well, people are always going to be racist and opposed to immigration for medieval reasons, and we shouldn't even try"?

BARBARA CROSSETTE Well, I ask myself over and over again why it is that the world doesn't see that if there are population problems they could be self-correcting if you just put out what people need. Okay, that's one point.

But the second thing is why there hasn't been—led by the ILO, which isn't doing it—some international debate on how you can identify migrants and bring them into countries that need labor and other things instead of putting up barriers.

Europe is the worst. Of 14 million people outside their country, at least 12 million are in the United States, legal or illegal. I don't know. People have different takes on this.

But managed immigration seems an obvious thing. I guess the guest worker programs and things like that were efforts to do that.

The international migration figures show that Europe is still the big problem, where they need people and they don't want people.

Finland is now giving asylum to Somalis and to other people. They have a hard life in Finland because it is really cold. I looked like the Michelin Man when I had a picture of me taken there. It was 35 degrees below zero Celsius when I was there last winter. So you can imagine coming from Africa. I mean they can't get a foothold.

Now, in Maine there are Somali women and in California there are Somali women who are doing—

JOANNE MYERS: And in Minnesota.

BARBARA CROSSETTE: —and in Minnesota, doing very well at farming and market gardening and selling in these new green markets.

The feeling in the United States, I think, is that immigration here, as you know, is a good thing and that it does bring in young people. There are lots of other problems that I can understand also.

But again, it is a failure of this country and every country to manage immigration. I think the countries who would like more out-migration in a managed way would be much more amenable to some sort of—maybe it's too big now—but some sort of international discussion.

Even the Chinese now are worried about immigration. And Russians are worried about too many Europeans.

QUESTION: Bob Frye [phonetic].

What I'm responding to as I go through this, and also listening to you, is there is one word that comes up all the time and also when you were speaking about the woman in Ethiopia—and that is empathy. The idea if we all in the world can be empathic to this situation, there are a lot of possibilities and solutions that are readily available. Is that a fair statement?

BARBARA CROSSETTE: Oh, yes. And a lot of it is at the community level.

In Bangladesh this has worked; I write about the Matlab experiment. In lots of places the community efforts can then spread to other communities. Or, as Joe Chamie says, "Women will talk fertility down." And women also have cell phones and things. They can keep in touch with each other.

In many of these communities, the part that is a problem for governments is that a lot of family planning is not very expensive. So you can't ask for huge amounts of money. And when they get money, it goes often into the health ministry and it is distributed.

Egypt, since the revolution, since Mubarak's overthrow, has downgraded the population council, or whatever they call it—population ministry, population commission—and put it back into the ministry of health. So it goes down the list.

The new head of the UNFPA, who is a Nigerian [Babatunde Osotimehin], was a minister of health. So he wants to go to ministers on these issues. He says also that countries should not accept family planning from outside, they shouldn't assume that this is a charity, that this is a government responsibility, and that it should be factored into the development policies of the country, and they should pay for it. He said it doesn't cost that much.

The other thing he is going to do is go to parliaments, where the purse strings are controlled in democratic or pseudo-democratic countries, and talk to parliamentarians about taking this up.

It has happened in India, where one parliamentarian I know has called the family-planning situation a national epidemic and we should treat it like a disease. But that's a radical view.

There are ways. But it has to be kicked up to cabinet level and it has to be made a part of development at a higher level.

We have some people here who have been working on these things. To start again with what you were saying, with Amsalu Buke, she does wonders in one area. They have 37,000 Amsalu Buke's around the country. They are now, as I said, defensive about the fact that they aren't trained very much. But they are going to have more, and they are going to give them basic paramedic training—in other words, so that they will be able to deal with cardiac arrest. I mean they move them up a little bit, even though they will never be doctors. When I asked her about whether she would want to be a doctor, she just laughed. It was outside her range of possibilities.

That's where I think the Packard people and Gates and others are watching in Ethiopia and in other places. Senegal is supposed to have something similar.

It's a little bit like the barefoot doctors of China, who can do basic diagnostics, very simple, if you have a stomachache, a headache, whatever, and relieve some of the low-level infections.

But the main thing is the vaccinations, which is letting people live longer and keeping children alive.

JOANNE MYERS: Ambassador Chowdhury?

QUESTION: Thank you very much, Barbara, for your presentation.

While introducing you, Joanne was saying that UNFPA has done the right thing by inviting you to pen the report. I should say or add to that that the Carnegie Council has done well by inviting you to speak about that report.

I believe that population is not a demographic problem, it is a human problem, and that is how it should be addressed. I value your report in that context. You have written a powerful human story.

Particularly, special thanks to you when you bring up the case of poor women around the world. I think that is the key to understand the population problem as well as the key to find the solution to the population problem.

If I can talk about Bangladesh, I should say that the empowerment of these women through simple things, like microcredit or girls' education, and then the involvement of civil society in spearheading the population program, particularly, as you mentioned in other countries, at the community level, have done wonders in one of the least-developed countries, one of the poorest countries of the world, with very low indicators in terms of many things. This country has done well in terms of population. So I would believe that that should be the focus of addressing the population question.

When I was, as a part of the UN, championing the cause of the least developed countries, this is what I found out. Particularly, 34 out of 50 least developed countries (LDCs) are in Africa, and that is how the solution should be reached.

Tell me, Barbara, why do you think after the 1994 Cairo Conference the assistance in the area of family planning, population planning, has gone down? I find that in many cases when the donors are not prioritizing population, somehow it has an effect at the country-level budget planning and budget allocation. Do the donor countries not understand that population has a value in the effective results of their assistance to these countries?

BARBARA CROSSETTE: That second part is very contentious.

Before I get to it, I should say Bangladesh is going to meet almost all the Millennium Development Goals. It has already met some. It's got parity of boys and girls in school.

The other thing about Bangladesh that interests me—it was part of my territory when I lived in India as a correspondent—is that this is the kind of example. It's a country that was ruled by the military when a lot of these family-planning programs started. It wasn't coercive. They gave NGOs a free hand. It's an Islamic-majority country. I guess it is an Islamic democracy, they call themselves. And it was an extremely poor country.

But Bangladesh is an interesting case study for these reasons. It proves that, in an Islamic country once ruled by the military, giving space to the NGOs and standing back and neither coercing nor stopping a family-planning program has made a huge difference.

Post-1994 is very controversial, because women's rights groups came out of Cairo saying, "Women's rights are the answer. You give women rights, you assert those rights." That was fine. I was at the Cairo Population Conference. Everybody came away euphoric.

And then, after a while, what was happening is that, as I said, for some people it was, "Okay, it's over." But you can't talk about women's rights in the village in Ethiopia; it's absolutely meaningless, even as a starting point.

Then a lot of money went into HIV-AIDS. Money that would go into reproductive kind of things, sex stuff, it went into HIV-AIDS. So that's another controversy, because obviously this is a very serious issue. So you can't argue, "We should be taking money from HIV-AIDS and putting it back."

A lot of people feel that there should have been more of a marriage of these two tracks because they aid women in many ways if you put the family planning and the AIDS and other things into a particular part of the health system.

The demographers are blamed. Demographers blame feminists and feminists blame demographers for talking about numbers. Family planning in many ways fell by the wayside.

Because of the tremendous success of Cairo, a lot of people didn't go back and look again.

Now, the Cairo Program of Action is quite clear about family planning. It really needs—this is my personal opinion—to be revisited and a critical mass has to come up around it.

There is a group of people now, including the former president of Brazil, Cardoso, Mary Robinson, and a couple of other people, who are trying to get together this critical mass to start a big movement for family planning in the countries that want it. No one's pushing it down their throats.

JOANNE MYERS: Barbara, before you began, I know many fans of yours were here to listen to you. Now that you have finished, you have many more fans that you will be leaving

BARBARA CROSSETTE: Thank you very much.

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