A U.S. Global Population
Strategy
There is no simple single approach to the population problem
which will provide a "technological fix". As the previous analysis
makes clear the problem of population growth has social, economic
and technological aspects all of which must be understood and dealt
with for a world population policy to succeed. With this in mind,
the following broad recommended strategy provides a framework for
the development of specific individual programs which must be
tailored to the needs and particularities of each country and of
different sectors of the population within a country. Essentially
all its recommendations made below are supported by the World
Population Plan of action drafted at the World Population
Conference.
A. Basic Global Strategy
The following basic elements are necessary parts of a
comprehensive approach to the population problem which must include
both bilateral and multilateral components to achieve success. Thus,
USG population assistance programs will need to be coordinated with
those of the major multilateral institutions, voluntary
organizations, and other bilateral donors.
The common strategy for dealing with rapid population growth
should encourage constructive actions to lower fertility since
population growth over the years will seriously negate reasonable
prospects for the sound social and economic development of the
peoples involved.
While the time horizon in this NSSM is the year 2000 we must
recognize that in most countries, especially the LDCs, population
stability cannot be achieved until the next century. There are too
many powerful socio-economic factors operating on family size
decisions and too much momentum built into the dynamics of
population growth to permit a quick and dramatic reversal of current
trends. There is also even less cause for optimism on the rapidity
of socio-economic progress that would generate rapid fertility
reduction in the poor LDCs than on the feasibility of extending
family planning services to those in their populations who may wish
to take advantage of them. Thus, at this point we cannot know with
certainty when world population can feasibly be stabilized, nor can
we state with assurance the limits of the world's ecological
"carrying capability". But we can be certain of the desirable
direction of change and can state as a plausible objective the
target of achieving replacement fertility rates by the year
2000.
Over the past few years, U.S. government-funded population
programs have played a major role in arousing interest in family
planning in many countries, and in launching and accelerating the
growth of national family planning programs. In most countries,
there has been an initial rapid growth in contraceptive "acceptors"
up to perhaps 10% of fertile couples in a few LDCs. The acceleration
of previous trends of fertility decline is attributable, at least in
part, to family planning programs.
However, there is growing appreciation that the problem is more
long term and complex than first appeared and that a short term
burst of activity or moral fervor will not solve it. The danger in
this realization is that the U.S. might abandon its commitment to
assisting in the world's population problem, rather than facing up
to it for the long-run difficult problem that it is.
From year to year we are learning more about what kind of
fertility reduction is feasible in differing LDC situations. Given
the laws of compound growth, even comparatively small reductions in
fertility over the next decade will make a significant difference in
total numbers by the year 2000, and a far more significant one by
the year 2050.
The proposed strategy calls for a coordinated approach to respond
to the important U.S. foreign policy interest in the influence of
population growth on the world's political, economic and ecological
systems. What is unusual about population is that this foreign
policy interest must have a time horizon far beyond that of most
other objectives. While there are strong short-run reasons for
population programs, because of such factors as food supply,
pressures on social service budgets, urban migration and social and
political instability, the major impact of the benefits - or
avoidance of catastrophe - that could be accomplished by a
strengthened U.S. commitment in the population area will be felt
less by those of us in the U.S. and other countries today than by
our children and grandchildren.
B. Key Country priorities in U.S. and
Multilateral Population Assistance
One issue in any global population strategy is the degree of
emphasis in allocation of program resources among countries. The
options available range from heavy concentration on a few vital
large countries to a geographically diverse program essentially
involving all countries willing to accept such assistance. All
agencies believe the following policy provides the proper overall
balance.
In order to assist the development of major countries and to
maximize progress toward population stability, primary emphasis
would be placed on the largest and fastest growing developing
countries where the imbalance between growing numbers and
development potential most seriously risks instability, unrest, and
international tensions. These countries are: India, Bangladesh,
Pakistan, Nigeria, Mexico, Indonesia, Brazil, The Philippines,
Thailand, Egypt, Turkey, Ethiopia, and Colombia. Out of a total 73.3
million worldwide average increase in population from 1970-75 these
countries contributed 34.3 million or 47%. This group of priority
countries includes some with virtually no government interest in
family planning and others with active government family planning
programs which require and would welcome enlarged technical and
financial assistance. These countries should be given the highest
priority within AID's population program in terms of resource
allocations and/or leadership efforts to encourage action by other
donors and organizations.
However, other countries would not be ignored. AID would provide
population assistance and/ or undertake leadership efforts with
respect to other, lower priority countries to the extent that the
availability of funds and staff permits, taking into account of such
factors as: long run U.S. political interests; impact of rapid
population growth on its development potential; the country's
relative contribution to world population growth; its financial
capacity to cope with the problem; potential impact on domestic
unrest and international frictions (which can apply to small as well
as large countries); its significance as a test or demonstration
case; and opportunities for expenditures that appear particularly
cost-effective (e.g. it has been suggested that there may be
particularly cost-effective opportunities for supporting family
planning to reduce the lag between mortality and fertility declines
in countries where death rates are still declining rapidly);
national commitment to an effective program.
For both the high priority countries and the lower priority ones
to which funds and staff permit aid, the form and content of our
assistance or leadership efforts would vary from country to country,
depending on each nation's particular interests, needs, and
receptivity to various forms of assistance. For example, if these
countries are receptive to U.S. assistance through bilateral or
central AID funding, we should provide such assistance at levels
commensurate with the recipient's capability to finance needed
actions with its own funds, the contributions of other donors and
organizations, and the effectiveness with which funds can be
used.
In countries where U.S. assistance is limited either by the
nature of political or diplomatic relations with those countries or
by lack of strong government desire. In population reduction
programs, external technical and financial assistance (if desired by
the countries) would have to come from other donors and/or from
private and international organizations, many of which receive
contributions from AID. The USG would, however, maintain an interest
(e.g. through Embassies) in such countries' population problems and
programs (if any) to reduce population growth rates. Moreover,
particularly in the case of high priority countries, we should be
alert to opportunities for expanding our assistance efforts and for
demonstrating to their leaders the consequences of rapid population
growth and the benefits of actions to reduce fertility.
In countries to which other forms of U.S. assistance are provided
but not population assistance, AID will monitor progress toward
achievement of development objectives, taking into account the
extent to which these are hindered by rapid population growth, and
will look for opportunities to encourage initiation of or
improvement in population policies and programs.
In addition, the U.S. strategy should support in these LDC
countries general activities (e.g. big-medical research or fertility
control methods) capable of achieving major breakthroughs in key
problems which hinder reductions in population growth.
C. Instruments and Modalities for Population
Assistance
Bilateral population assistance is the largest and most
invisible "instrument" for carrying out U.S. policy in this area.
Other instruments include: support for and coordination with
population programs of multilateral organizations and voluntary
agencies; encouragement of multilateral country consortia and
consultative groups to emphasize family planning in reviews of
overall recipient progress and aid requests; and formal and informal
presentation of views at international gatherings, such as food and
population conferences. Specific country strategies must be worked
out for each of the highest priority countries, and for the lower
priority ones. These strategies will take account of such factors
as: national attitudes and sensitivities on family planning; which
"instruments" will be most acceptable, opportunities for effective
use of assistance; and need of external capital or operating
assistance.
For example, in Mexico our strategy would focus on working
primarily through private agencies and multilateral organizations to
encourage more government attention to the need for control of
population growth; in Bangladesh we might provide large-scale
technical and financial assistance, depending on the soundness of
specific program requests; in Indonesia we would respond to
assistance requests but would seek to have Indonesia meet as much of
program costs from its own resources (i.e. surplus oil earnings) as
possible. In general we would not provide large-scale bilateral
assistance in the more developed LDCs, such as Brazil or Mexico.
Although these countries are in the top priority list our approach
must take account of the fact that their problems relate often to
government policies and decisions and not to larger scale need for
concessional assistance.
Within the overall array of U.S. foreign assistance programs,
preferential treatment in allocation of funds and manpower should be
given to cost- effective programs to reduce population growth;
including both family planning activities and supportive activities
in other sectors.
While some have argued for use of explicit "leverage" to "force"
better population programs on LDC governments, there are several
practical constraints on our efforts to achieve program
improvements. Attempts to use "leverage" for far less sensitive
issues have generally caused political frictions and often
backfired. Successful family planning requires strong local
dedication and commitment that cannot over the long run be enforced
from the outside. [** There is also the danger that some LDC leaders
will see developed country pressures for family planning as a form
of economic or racial imperialism; this could well create a serious
backlash.**]
Short of "leverage", there are many opportunities, bilaterally
and multilaterally, for U.S. representations to discuss and urge the
need for stronger family planning programs. There is also some
established precedent for taking account of family planning
performance in appraisal of assistance requirements by AID and
consultative groups. Since population growth is a major determinant
of increases in food demand, allocation of scarce PL 480 resources
should take account of what steps a country is taking in population
control as well as food production. In these sensitive
relationships, however, it is important in style as well as
substance to avoid the appearance of coercion.
D. Provision and Development of Family Planning
Services, Information and Technology
Past experience suggests that easily available family planning
services are a vital and effective element in reducing fertility
rates in the LDCs.
Two main advances are required for providing safe and effective
fertility control techniques in the developing countries:
1. Expansion and further development of efficient low-cost
systems to assure the full availability of existing family planning
services, materials and information to the 85% of LDC populations
not now effectively reached. In developing countries willing to
create special delivery systems for family planning services this
may be the most effective method. In others the most efficient and
acceptable method is to combine family planning with health or
nutrition in multi-purpose delivery systems.
2. Improving the effectiveness of present means of fertility
control, and developing new technologies which are simple, low cost,
effective, safe, long- lasting and acceptable to potential users.
This involves both basic developmental research and operations
research to judge the utility of new or modified approaches under
LDC conditions.
Both of these goals should be given very high priority with
necessary additional funding consistent with current or adjusted
divisions of labor among other donors and organizations involved in
these areas of population assistance.
E. Creating Conditions Conducive to Fertility
Decline
It is clear that the availability of contraceptive services and
information is not a complete answer to the population problem. In
view of the importance of socio-economic factors in determining
desired family size, overall assistance strategy should increasingly
concentrate on selective policies which will contribute to
population decline as well as other goals. This strategy reflects
the complementarity between population control and other U.S.
development objectives, particularly those relating to AID's
Congressional mandate to focus on problems of the "poor majority" in
LDC's.
We know that certain kinds of development policies e.g., those
which provide the poor with a major share in development benefits
both promote fertility reductions and accomplish other major
development objectives. There are other policies which appear to
also promote fertility reduction but which may conflict with
non-population objectives (e.g., consider the effect of bringing a
large number of women into the labor force in countries and
occupations where unemployment is already high and rising).
However, AID knows only approximately the relative priorities
among the factors that affect fertility and is even further away
from knowing what specific cost-effective steps governments can take
to affect these factors.
Nevertheless, with what limited information we have, the urgency
of moving forward toward lower fertility rates, even without
complete knowledge of the socio-economic forces involved, suggests a
three-pronged strategy:
1. High priority to large-scale implementation of programs
affecting the determinants of fertility in those cases where there
is probable cost- effectiveness, taking account of potential impact
on population growth rates; other development benefits to be gained;
ethical considerations; feasibility in light of LDC bureaucratic and
political concerns and problems; and time-frame for accomplishing
objectives.
2. High priority to experimentation and pilot projects in areas
where there is evidence of a close relationship to fertility
reduction but where there are serious questions about
cost-effectiveness relating either to other development impact
(e.g., the female employment example cited above) or to program
design (e.g., what cost-effective steps can be taken to promote
female employment or literacy).
3. High priority to comparative research and evaluation on the
relative impact on desired family size of the socio-economic
determinants of fertility in general and on what policy scope exists
for affecting these determinants.
In all three cases emphasis should be given to moving action as
much as possible to LDC institutions and individuals rather than to
involving U.S. researchers on a large scale.
Activities in all three categories would receive very high
priority in allocation of AID funds. The largest amounts required
should be in the first category and would generally not come from
population funds. However, since such activities (e.g., in rural
development and basic education) coincide with other AID sectoral
priorities, sound project requests from LDC's will be placed close
to the top in AlD's funding priorities (assuming that they do not
conflict with other major development and other foreign policy
objectives).
The following areas appear to contain significant promise in
effecting fertility declines, and are discussed in subsequent
sections.
- providing minimal levels of education especially for women;
- reducing infant and child mortality;
- expanding opportunities for wage employment especially for
women;
- developing alternatives to "social security" support provided
by children to aging parents;
- pursuing development strategies that skew income growth toward
the poor, especially rural development focusing on rural poverty;
- [** concentrating on the education and indoctrination of the
rising generation of children regarding the desirability of
smaller family size.**]
The World Population Plan of Action includes a provision
(paragraph 31) that countries trying for effective fertility levels
should give priority to development programs and health and
education strategies which have a decisive effect upon demographic
trends, including fertility. It calls for international information
to give priority to assisting such national efforts. Programs
suggested (paragraph 32) are essentially the same as those listed
above.
Food is another of special concern in any population strategy.
Adequate food stocks need to be created to provide for periods of
severe shortages and LDC food production efforts must be reinforced
to meet increased demand resulting from population and income
growth. U.S. agricultural production goals should take account of
the normal import requirements of LDC's (as well as developed
countries) and of likely occasional crop failures in major parts of
the LDC world. Without improved food security, there will be
pressure leading to possible conflict and the desire for large
families for "insurance" purposes, thus undermining other
development and population control efforts.
F. Development of World-Wide Political and
Popular Commitment to Population Stabilization and Its Associated
Improvement of Individual Quality of Life.
A fundamental element in any overall strategy to deal with the
population problem is obtaining the support and commitment of key
leaders in the developing countries. This is only possible if they
can clearly see the negative impact of unrestricted population
growth in their countries and the benefits of reducing birth rates
and if they believe it is possible to cope with the population
problem through instruments of public policy. Since most high
officials are in office for relatively short periods, they have to
see early benefits or the value of longer term statesmanship. In
each specific case, individual leaders will have to approach their
population problems within the context of their country's values,
resources, and existing priorities.
Therefore, it is vital that leaders of major LDCs themselves take
the lead in advancing family planning and population stabilization,
not only within the U.N. and other international organizations but
also through bilateral contacts with leaders of other LDCs. Reducing
population growth in LDCs should not be advocated exclusively by the
developed countries. The U.S. should encourage such a role as
opportunities appear in its high level contact with LDC leaders.
The most recent forum for such an effort was the August 1974 U.N.
World Population Conference. It was an ideal context to focus
concerted world attention on the problem. The debate views and
highlights of the World Population Plan of action are reviewed in
Chapter VI.
The U.S. strengthened its credibility as an advocate of lower
population growth rates by explaining that, while it did not have a
single written action population policy, it did have legislation,
Executive Branch policies and court decisions that amounted to a
national policy and that our national fertility level was already
below replacement and seemed likely to attain a stable population by
2000.
The U.S. also proposed to join with other developed countries in
an international collaborative effort of research in human
reproduction and fertility control covering big-medical and
socio-economic factors.
The U.S. further offered to collaborate with other interested
donor countries and organizations (e.g., WHO, UNFPA, World Bank,
UNICEF) to encourage further action by LDC governments and other
institutions to provide low-cost, basic preventive health services,
including maternal and child health and family planning services,
reaching out into the remote rural areas.
The U.S. delegation also said the U.S. would request from the
Congress increased U.S. bilateral assistance to population-family
planning programs, and additional amounts for essential functional
activities and our contribution to the UNFPA if countries showed an
interest in such assistance.
Each of these commitments is important and should be pursued by
the U.S. Government.
[** It is vital that the effort to develop and strengthen a
commitment on the part of the LDC leaders not be seen by them as an
industrialized country policy to keep their strength down or to
reserve resources for use by the "rich" countries. Development of
such a perception could create a serious backlash adverse to the
cause of population stability.**] Thus the U.S. and other "rich"
countries should take care that policies they advocate for the LDC's
would be acceptable within their own countries. (This may require
public debate and affirmation of our intended policies.) The
"political" leadership role in developing countries should, of
course, be taken whenever possible by their own leaders.
[** The U.S. can help to minimize charges of an imperialist
motivation behind its support of population activities by repeatedly
asserting that such support derives from a concern with:
(a) the right of the individual couple to determine freely and
responsibly their number and spacing of children and to have
information, education, and means to do so; and
(b) the fundamental social and economic development of poor
countries in which rapid population growth is both a contributing
cause and a consequence of widespread poverty. **]
Furthermore, the U.S. should also take steps to convey the
message that the control of world population growth is in the mutual
interest of the developed and developing countries alike.
Family planning programs should be supported by multilateral
organizations wherever they can provide the most efficient and
acceptable means. Where U.S. bilateral assistance is necessary or
preferred, it should be provided in collaboration with host country
institutions as is the case now. Credit should go to local leaders
for the success of projects. The success and acceptability of family
planning assistance will depend in large measure on the degree to
which it contributes to the ability of the host government to serve
and obtain the support of its people.
In many countries today, decision-makers are wary of instituting
population programs, not because they are unconcerned about rapid
population growth, but because they lack confidence that such
programs will succeed. By actively working to demonstrate to such
leaders that national population and family planning programs have
achieved progress in a wide variety of poor countries, the U.S.
could help persuade the leaders of many countries that the
investment of funds in national family planning programs is likely
to yield high returns even in the short and medium term. Several
examples of success exist already, although regrettably they tend to
come from LDCs that are untypically well off in terms of income
growth and/or social services or are islands or city states.
We should also appeal to potential leaders among the younger
generations in developing countries, focusing on the implications of
continued rapid population growth for their countries in the next
10-20 years, when they may assume national leadership roles.
Beyond seeking to reach and influence national leaders, improved
world-wide support for population-related efforts should be sought
through increased emphasis on mass media and other population
education and motivation programs by the U.N., USIA, and USAID. We
should give higher priorities in our information programs world-wide
for this area and consider expansion of collaborative arrangements
with multilateral institutions in population education programs.
Another challenge will be in obtaining the further understanding
and support of the U.S. public and Congress for the necessary added
funds for such an effort, given the competing demands for resources.
If an effective program is to be mounted by the U.S., we will need
to contribute significant new amounts of funds. Thus there is need
to reinforce the positive attitudes of those in Congress who
presently support U.S. activity in the population field and to
enlist their support in persuading others. Public debate is needed
now.
Personal approaches by the President, the Secretary of State,
other members of the Cabinet, and their principal deputies would be
helpful in this effort. Congress and the public must be clearly
informed that the Executive Branch is seriously worried about the
problem and that it deserves their further attention. Congressional
representatives at the World Population Conference can help.
An Alternative View
The above basic strategy assumes that the current forms of
assistance programs in both population and economic and social
development areas will be able to solve the problem. There is
however, another view, which is shared by a growing number of
experts. It believes that the outlook is much harsher and far less
tractable than commonly perceived. This holds that the severity of
the population problem in this century which is already claiming the
lives of more than 10 million people yearly, is such as to make
likely continued widespread food shortage and other demographic
catastrophes, and, in the words of C.P. Snow, we shall be watching
people starve on television.
[** The conclusion of this view is that mandatory programs may be
needed and that we should be considering these possibilities
now.**]
This school of thought believes the following types of questions
need to be addressed:
- Should the U.S. make an all out commitment to major limitation
of world population with all the financial and international as
well as domestic political costs that would entail?
- Should the U.S. set even higher agricultural production goals
which would enable it to provide additional major food resources
to other countries? Should they be nationally or internationally
controlled?
- [** On what basis should such food resources then be provided?
- Would food be considered an instrument of national power?
- Will we be forced to make choices as to whom we can reasonably
assist, and if so, should population efforts be a criterion for
such assistance?**]
- Is the U.S. prepared to accept food rationing to help people
who can't/won't control their population growth?
- Should the U.S. seek to change its own food consumption
patterns toward more efficient uses of protein?
- Are mandatory population control measures appropriate for the
U.S. and/or for others?
- Should the U.S. initiate a major research effort to address
the growing problems of fresh water supply, ecological damage, and
adverse climate?
While definitive answers to those questions are not possible in
this study given its time limitations and its implications for
domestic policy, nevertheless they are needed if one accepts the
drastic and persistent character of the population growth problem.
Should the choice be made that the recommendations and the options
given below are not adequate to meet this problem, consideration
should be given to a further study and additional action in this
field as outlined above.
Conclusion
The overall strategy above provides a general approach through
which the difficulties and dangers of population growth and related
problems can be approached in a balanced and comprehensive basis. No
single effort will do the job. Only a concerted and major effort in
a number of carefully selected directions can provide the hope of
success in reducing population growth and its unwanted dangers to
world economic will-being and political stability. There are no
"quick-fixes" in this field.
Below are specific program recommendations which are designed to
implement this strategy. Some will require few new resources; many
call for major efforts and significant new resources. We cannot
simply buy population growth moderation for nearly 4 billion people
"on the cheap". |