Chapter One - INTRODUCTION
When the Marshall Plan began after World War II, the
economically prostrated countries of Western Europe had 14 percent of the
world's population. Today these countries have grown rich and, with their trade
and mutual cooperation in many areas, provide a bulwark to American prosperity.
But they are also a smaller part of the world than they used to be, with only
half their previous share of the world's population. While the industrial
countries were rebuilding their economies and achieving previously unattainable
levels of prosperity, the rest of the world was setting its own records, with
population growth rates exceeding 1.9 percent annually over the entire period.
Population outside the advanced industrial countries has almost tripled in the
past 50 years.1
1Unless otherwise indicated, historical
demographic statistics are from United Nations (1996), and population
projections use the World Bank (1997a) model.
This rapid population growth is not over, despite recent reports
of lower fertility2 around the world. The first part of this report
will argue that population growth persists and that family planning programs
continue to be needed to moderate future growth. This argument involves several
steps, to show (a) that the "population explosion" is not a "one-shot wonder"
but is likely to be a nagging concern into the next century, (b) that rapid
population growth because of high fertility robs countries of valuable
opportunities for economic development, and (c) that high fertility is actually
contrary to the preferences of many people, who would prefer smaller families
but, because of ignorance and sometimes unfounded fears about health effects, do
nothing to restrict births.
2For the purposes of this discussion, we
follow the usage of demographers who define fertility as actual
childbearing and fecundity as the potential to have children (the
opposite of sterility). French demographers reverse these terms.
To show how family planning programs have made and could
continue to make a difference, the middle part of this report will discuss their
record. These programs are an unusual social invention, blending frank talk
about previously taboo topics, large cadres of trained health workers,
attractive advertising, and a strong concern with enhancing voluntary decisions
and expanding women's options. Their value, if they are run properly, is
demonstrated in studies ranging from the experimental to the cross-national.
This contribution does not depend on a favorable socioeconomic and cultural
environment, which is neither indispensable for success nor a guarantee of it.
Rather, the contribution depends on how effectively a program exploits the
opportunities in its environment and how it attends to the basics of service
Since no intervention is without cost, the last part of the
report examines this issue. What programs cost is "pennies a day," as one report
has been titled.3 Given their wide benefits for the population, even
beyond those the clients themselves receive, these programs deserve government
support. Donor support, provided in the past on humanitarian grounds and to
promote global prosperity, is crucial and needs to be maintained.
3Family Health International