A policy backgrounder from the Population Research Institute

February 25, 1999

Executive Summary

The purpose of this Population Research Institute (PRI) policy backgrounder is to support a U.S. ban on funding of the United Nations Population Fund (UNFPA).

The Population Research Institute has three primary objections to United States funding of the UNFPA, as follows:

• If the purpose of funding the UNFPA is to save the lives of women and children, then this is a very inefficient use of taxpayer dollars. If the money previously used to fund the UNFPA had instead been used to support basic health care and authentic economic development, ten times as many women and children would be saved.
• The indiscriminate distribution of contraceptives to women in the developing world, who are often malnourished and in poor health, is dangerous to their health. Moreover, contraceptive failure rates are high, especially in the developing world, which leads to increased reliance on abortion as a back-up.
• The UNFPA—and all population control programs—have outlived their usefulness. The population of the world is rapidly leveling off and will soon begin to decline, leading to potentially catastrophic economic and social disruptions. We can preview the impending global depopulation by examining the present demographic situation in dying Europe. Why should the United States spend hundreds of millions of dollars a year to further reduce fertility in countries whose populations will all too soon be in decline? Population control spending should be immediately curtailed, lest further harm be done.

Steven W. Mosher, President
Population Research Institute

Background:

In October 1998 the U.S. Congress, with strong bi-partisan support, refused any further funding to the United Nations Population Fund (confusingly known as the UNFPA). The immediate cause of this action was the UNFPA's decision to collaborate with China's one-child-per-family policy. Representative David Obey (D-Michigan), who actually zeroed out UNFPA's $25 million dollar annual grant in the Omnibus Budget Act, explained that "in my view they have a coercive abortion program in China."1

Indeed they do. China's program of forced abortions and sterilizations is a population control scandal of the first order. Under the terms of Beijing's one-child-per-family policy, women who have one child must have IUD's inserted. Women who have two children must be sterilized, or their spouses must be sterilized. Women who are pregnant with an over-quota child must be given "remedial measures"; namely, an abortion.

There can be no justification for the UNFPA to collaborate in any way with a country that inflicts such a policy on its people.

Adding to congressional concerns were long-standing questions about the UNFPA's promotion of abortion, even in countries where abortion is illegal. Also, congressional concerns included use of methods such as "menstrual regulation," which are abortifacient in character. The UNFPA's inability to extricate itself from coercive population control programs—it provided critical assistance to China's one-child-per-family policy from 1979 to 1995—was another source of concern.

We assert that there are other reasons, perhaps even more compelling, to oppose U.S. funding of UNFPA activities. Our research indicates that UNFPA programs are an inefficient, even wasteful, way of reducing maternal mortality, and that UNFPA programs endanger the health of poor and malnourished women in the developing world by their indiscriminant reliance on contraceptives. More generally, we believe that, in a world of rapidly falling fertility rates, the UNFPA and its population control programs have outlived their usefulness.

I. UNFPA Programs are an Inefficient and Wasteful Way of Reducing Maternal Mortality

UNFPA advocates have introduced legislation that would allocate $25 million to the UNFPA in 2000 and $35 million in 2001. In pledging to "do whatever it takes to restore funding for UNFPA," they claim that the cut off of U.S. funding "has deprived 870,000 women in developing countries of modern contraception, leading to half a million unintended pregnancies, 200,000 abortions and "thousands of maternal and child deaths."2

The Problem is Poverty:

Women in developing countries die in childbirth not because they do not have access to contraceptives and safe abortion, but mostly because they are poor and/or in ill health.

Contraception is a grossly inefficient method of reducing maternal mortality. Dumping tons of condoms, pills and IUDs on Third World women is a short-sighted, "quick fix" approach that will not save many lives. What will save many more lives—and enable them to be lived at a level of well-being they do not now enjoy—is a comprehensive attack on the underlying causes of poverty and ill health.

This is a complex problem, because there are many causes of poverty and ill health. But the effect of poverty on maternal mortality is aptly illustrated in Sub-Saharan Africa, which has the highest maternal mortality ratio in the world: 1,030 maternal deaths per 100,000 live births. Within this region, the country that suffers the greatest number of maternal deaths is Nigeria. In 1990 Africa's most populous country recorded 44,000 deaths, or one out of every thirteen maternal deaths in the world.3

Kelsey A. Harrison, professor of Obstetrics and Gynecology at the University of Port Harcourt in Nigeria, observed that:

instances abound where women are dying in the hands of good doctors just because they do not have the money to pay. . . High maternal mortality in Nigeria, estimated to be 1,000 per 100,000 births, will not go away as long as three fundamental issues prevail: mass poverty with gross inequalities, unbooked emergencies, and illiteracy, which bestrides and underlies both. . . . High maternal mortality is a manifestation of gross underdevelopment. Hence its permanent reduction requires societal transformation.4

Unbooked emergencies—pregnant women with medical emergencies—account for 70 percent of all maternal deaths in Nigeria. Many poor women do not receive any form of prenatal care and deliver their children far from the nearest medical facility. Others are seen by a health professional for the first time when they arrive at a hospital in severe distress. Many of these are suffering acutely from difficult labor, pregnancy complications in an advanced state (obstructed labor, uterine rupture, obstetric fistula, or retained placenta), or other disease (malaria, anemia and bacterial infections such as active pulmonary tuberculosis). Poor women fortunate enough to experience a relatively uncomplicated delivery often suffer from postpartum neglect leading to life-threatening problems such as severe blood loss and infection.5

How to Solve the Problem of Maternal Mortality:

In the long term, the best way to reduce maternal mortality in a developing country is to improve its economy, reduce poverty and eliminate illiteracy. Hillary Clinton acknowledged as much at the UNFPA's Hague Forum when she said that "No nation can move forward when a large share of its women are illiterate and impoverished."6

It is a truism that "economic development is the best contraceptive." The principal factors leading to reduced fertility are urbanization, industrialization, and female participation in the work force. As a nation's economy develops, young people tend to marry later and to postpone childbirth. Even for those who remain in the countryside, the advent of modern agricultural technology, basic health care, and pension programs cause a marked drop in the birth rate. Farmers who enjoy these benefits don't feel the need to have as many children to work the fields, to ensure that some children survive, or to take care of them when they are old and infirm.

Construction of basic infrastructure in developing countries would not only reduce the birth rate, it would dramatically improve the quality of life of the people. United Nations studies show that there are direct mathematical correlations between maternal, child and infant health and the provision of certain basic services.

Maternal, child and infant health improves as:

• Access to safe water improves.
• Access to sanitation facilities improves.
• Trained health workers attend more births.
• Proper child nutrition programs are instituted.
• Illiteracy decreases.
• Commercial energy use increases.
• Immunizations against disease increase. Of particular interest are acute respiratory virus (ARV), diphtheria, dengue fever, hemophilus influenza Type B, hepatitis B, Japanese encephalitis, measles, meningococcal, mumps, pertussis, poliomyelitis, rotavirus, pneumococcal disease, shigella, tuberculosis, typhoid fever, varicella (chickenpox), vitamin A deficiency, and yellow fever. 7
  

Saving Lives in the Short Run:

The only way to ensure that every pregnant woman is healthy and at minimum risk is to provide her with comprehensive maternal health care during her pregnancy. However, this essential long-term solution will probably require some years, if not decades, to implement in most developing countries. How can we best help the millions of poor women at risk in the meantime?

The best short-term solution for the vast majority of cases of maternal mortality and morbidity among poor women in developing nations is to broaden the availability of emergency obstetrical care and encourage all births to be attended. This approach has been endorsed by the UNFPA itself:

Obstructed labor, hemorrhage and postpartum infection (maternal sepsis) are among the major causes of maternal mortality. . . . Reducing maternal mortality to reach the goals accepted by the international community (reduce the 1990 level by half by year 2000 and by half again by 2015) calls for broad availability of emergency obstetrical care to handle complications of birth and delivery. It also calls for attended birth to be the norm rather than the exception.8

To address the underlying health problems, which later give rise to maternal morbidity and mortality, we must first solve the problem of malnutrition in developing countries. The UNFPA itself identified malnutrition as a key factor contributing to many maternal deaths:

Malnutrition contributes more than any other factor to disease and injury worldwide. It contributed to 5.9 million deaths in 1990 and played a role in fully 15.9 % of all morbidity (illness). Most of the people who died were in Africa and south Asia, and many were in the first years of life when children are especially vulnerable. Poverty was the main underlying cause, but a disproportionate number were female. . . . Malnutrition and associated health problems among young girls are far more common than they need to be even in poor families. Malnutrition for girls in early life contributes to health problems later on. It contributes to anaemia, a risk that intensifies after the start of menstruation. In developing countries, iron-deficiency anemia is the third leading cause of disease for women between ages 15 and 44 . . . . Malnutrition and anemia contribute to many of the problems found in pregnancy and delivery and play a part in many maternal deaths.9

Saving the Lives of Mothers, Babies: a Demonstration:

• Let us assume for a moment that the numbers quoted by UNFPA partisans are correct, and that for $25 million the UNFPA can prevent 500,000 pregnancies in developing countries.
• Let us also specify that all this money will be spent in Sub-Saharan Africa which, at 1,030 deaths per 100,000 live births, has the highest maternal mortality rate of any area in the world.
• Under these optimum conditions, this means that $25 million in spending on contraceptives would save 5 X 1,030 =5,150 women's lives.
• This translates into an average cost of $4,854 per life saved.

But if our goal is, as it should be, to save as many mothers and babies as possible, then we must find the most efficient use of taxpayer dollars to accomplish this end. We could save far more mothers by:

• Maternal tetanus immunizations: Studies show that, depending on the area, an average expenditure of $27 to $225 on maternal tetanus immunizations will protect and save the life of the baby—an average of $126 per life saved.10 This means that the lives of 198,400 African babies could be saved by maternal tetanus immunizations—nearly forty times as many lives saved than if $25 million were spent on contraceptives.
• Breastfeeding promotion: The same $25 million spent on breastfeeding promotion among AIDS-free mothers would save the lives of more than 50,000 African infants, more than nine times as many as would be saved if the money were spent on contraceptives.11
• Attending births: United Nations statistics prove that maternal and infant mortality decreases dramatically if deliveries are attended by skilled personnel. In those nine African countries where an average of only 15% of all births are attended, the maternal mortality ratio averages 1,340 per 100,000 births. In those nine countries where an average of 83% of all births are attended, the maternal mortality ratio averages 320 per 100,000 births, a tremendous decrease.12 Attended births also significantly reduce infant mortality. As the percentage of attended births increases from an average of 15% to an average of 83% in the countries mentioned above, infant mortality is halved, from 11,600 per 100,000 to 5,800 per 100,000.13 This means that maternal mortality decreases by 15 deaths per 100,000 and infant mortality decreases by 85 deaths per 100,000 for every percentage point improvement in attended births. At $50 per attended birth, $25 million would allow an additional 500,000 births to be attended, saving the lives of 7,500 mothers and 42,500 infants—a total of 50,000 lives saved, more than nine times as many lives saved than is claimed would be saved if the money were spent on contraceptives.
  

The cost of giving $25 million to UNFPA will be intolerably high in terms of women's lives:

• If $25 million is given to UNFPA to spend on contraceptives instead of allocating it to maternal tetanus immunizations, more than 193,000 mothers and babies will die as a result.
• If the money is given to UNFPA instead of spending it on breastfeeding promotion, more than 50,000 African infants will die.
• If $25 million is given to UNFPA instead of paying health care workers to attend births, 7,500 women and 42,500 infants will die.

The UNFPA's Misguided Strategy:

Instead of attacking the problems of maternal, infant and child mortality at their roots, the UNFPA focuses almost exclusively on the provision of contraceptives. Take, for example, its programs in Nigeria. The UNFPA's 1996 Inventory of Population Projects in Developing Countries Around the World [the last such report available] outlines the agency's overall country strategy for Nigeria:

The Governing Council approved $35 million for a five-year program starting in 1992. The program will: decrease maternal and infant mortality; achieve a lower population growth rate through the reduction of fertility by voluntary fertility regulation compatible with the social and cultural conditions of the country and the economic and social goals of the nation; enhance the status and condition of women and encourage their full participation as equal partners in the development process of the country; continue the population education programme for secondary schools and organized labor; and promote (IEC) [information, education and communication] campaigns for special target groups, with special emphasis on the promotion of Safe Motherhood; promote community and NGO [non-governmental organization] involvement in program development, implementation, monitoring and evaluation.

This country strategy, which is typical of the strategies for all of the developing countries in which the UNFPA operates, suggests a broad-based program in which efforts to reduce maternal and infant mortality are given priority over the wholesale distribution of contraceptives for population control purposes. But closer examination of UNFPA projects reveals that this is not the case.

The Inventory provides details on UNFPA's 22 projects in Nigeria during the 1993-1997 time period. These include:

• Three community reproductive health service projects (with a strong emphasis on providing contraceptives, in particular condoms)—at a total cost of $840,482;
• Three contraceptive supply projects—total cost $6,151,000;
• Seven Maternal and Child Health/Family Planning projects, which consist of increasing the availability and accessibility of contraceptives—total cost $4,839,000;
• One "Safe Motherhood" project, which seeks to improve cooperation between traditional birth attendants and the medical staff in the communities—total cost $373,000;
• "Family Health Soap Opera Television Series"—total cost $658,000; and
• Seven projects designed to perform research and data analysis on population policies. These projects primarily include the collection and analysis of demographic data, cartography and census work, planning, and coordination, monitoring and evaluating various population programs—total cost $3,367,552.
  Of the 22 Nigerian population projects, 14 are "grassroots" efforts, comprising the first four categories above. Of the total of $12,203,482 in expenditures on these four categories only three percent—the "Safe Motherhood" project—will have any lasting impact on maternal health.

The Safe Motherhood Initiative was launched at the first international safe motherhood conference in Nairobi in 1987. Unfortunately, as the Nigerian example suggests, the response of the UNFPA and other international agencies to this crisis has been anemic. The chief reason for this failure, according to Dr. Robert Walley, the founder of Matercare International and an obstetrician-gynecologist of many years of experience in Africa, is:

The promotion by governments, their funding agencies and international health organizations of what is now known as "reproductive health," which is simply a euphemism for abortion and contraception. It is estimated that billions of dollars are spent by our governments and private agencies on birth control programs, but only a small fraction is spent on emergency obstetric care which would help mothers survive their pregnancies. . . [T]o be a maternal death, a mother must be pregnant. The question is how do birth control pills or condoms help a mother with obstructed labor or a postpartum hemorrhage. In my experience the women who die want to be mothers but are poor, young and have no influential voice to speak on their behalf. [They] are denied emergency care which is readily available and inexpensive. This is culpable neglect by our world which has no concern for what a UNICEF report on maternal mortality calls the "unimaginable suffering" of mothers due to a "conspiracy of silence." There is not the will or compassion to do what is necessary.14

The UNFPA effort in Nigeria, as in the developing world as a whole, is heavily weighted toward preventing pregnancy in order to, as its own country strategy suggests, "lower [the] population growth rate." However loudly the UNFPA trumpets the slight reduction in maternal mortality that follows from their massive campaigns to prevent pregnancy, it is clear that this is merely a secondary effect of its primary goal: to reduce the number of babies born.

The UNFPA's claim to "reduce maternal mortality" is fundamentally dishonest. By its undue emphasis on contracepting and sterilizing the women of developing countries, the UNFPA seems to be arguing that the best way to eliminate maternal mortality is to eliminate pregnancy altogether. But this is absurd. It is like arguing that the best way to avoid traffic deaths is to eliminate cars or prohibit individuals from driving. Reasonable people would agree that the proper way to reduce traffic deaths is to educate drivers and to make motor vehicles and roads safer. Similarly, reasonable people should be able to agree that the best way to reduce maternal and infant mortality is to provide proper prenatal and infant care, and have all births attended.

Development that Respects Human Dignity:

What the countries of sub-Saharan Africa and other developing regions need is authentic economic development that would provide new opportunities for all people. The developed nations of the world, led by the United States, Canada, Sweden, Denmark and Japan, have spent more than $100 billion on population control programs over the past thirty years. If this money had instead been allocated towards infrastructure construction in developing countries, it would have completely changed the lives of more than 25 million of the world's poorest people. It might have been used to:

• Build half a million miles of hard-surface roads and bridges connecting 50,000 remote towns and villages with a population of more than 25 million to national road systems, allowing them to ship their goods to markets and have access to the national highway systems; and
• Build 50,000 well-equipped basic health care clinics for these towns and villages that could care for the health of their 25 million country people, and cut maternal and infant mortality in those villages in half (saving thousands of lives a year); and
• Build grain storage facilities for these 50,000 remote towns and villages, so their rice and other harvests were not partly or mostly consumed by insects and rodents; and
• Bring electricity and clean drinking water to these 50,000 towns and villages, thereby cutting down the source of most disease and increasing production towards self-sufficiency; and
• Build and staff enough modern schools to properly educate the five million children of these towns and villages, who would otherwise receive little or no education and would therefore fall into lives of poverty.

It is too late now, of course, to "take back" the more than 100 billion dollars that have been spent on population control and reallocate it to authentic economic development. However, it is not too late to refuse to fund the United Nations Population Fund and instead allocate the funds to purposes that will strengthen and empower the women and families of entire nations and continents.

Poor people—and especially poor women—in developing nations often perceive the developed nations as fundamentally hostile to their way of life. We reinforce this impression when we inundate them with contraceptive devices and chemicals, or attempt to impose on them our laws governing sterilization and abortion. Typifying this overbearing attitude is George Foulkes of the United Kingdom, who said at the recent UNFPA-sponsored Hague Forum that "We need to make contraceptives and condoms as easy to get hold of in the developing countries as a can of Coca-Cola."15 This same kind of cultural imperialism is evident in Hillary Clinton's comment, offered at an 18 October 1997 meeting on the role of women in Buenos Aires, that "the only road to improve the life of women is the massive promotion of contraceptive methods."16 The poor women of developing countries rightly translate this message to mean: "We of the developed world want you to have fewer children, or none at all, and we will not help you care for the children you already have."

Conclusion:

We should stop funding UNFPA programs which, in effect, tell people in Africa, Asia, and Latin America that we want fewer of them. The U.S. and other developed nations must be partners in economic development, not neocolonial masters. Our aid programs should respect human dignity, not denigrate the worth of human beings. The massive, monomaniacal bias toward population control in our current "aid" programs is unjust, discriminatory and frankly racist.

II. Contraceptive Use in Developing Countries

Contraceptives can be detrimental to the health of women in developing countries who are malnourished or in poor health.

Most so-called "modern" contraceptives have been tested in field trials on healthy women of the developed world. Their indiscriminate use on women in the developing world who are malnourished, anemic, or suffer from other health problems can be extremely detrimental.

The Case of Norplant:

Many women in Bangladesh who were given Norplant, for instance, suffered serious side effects. According to Farida Ahktar, an activist concerned with the plight of poor women, Bangladeshi women who received Norplant suffered much more serious side-effects than those admitted by Norplant's proponents: continuous bleeding far heavier than a normal menses, weakness in the limbs, severe pain, and blurred or double vision, among other ailments.

Akhter reported that women who took Norplant "fainted quite often, you know, which was not the case before." Other women complained that "[the family planners] were telling us we were supposed to be very happy after taking this Norplant, but why is our life like hell now?" Not only were these adverse side-effects not noted, desperate cries from the women to have the implants removed were simply ignored.17

Women who experience difficulties find it almost impossible to get medical attention. This, too, is a consequence of the single-minded focus on reducing the fertility rate. The emphasis on manufacturing, manufacturing and distributing contraceptive devices in Africa, Asia and Latin America leads to a neglect of basic health care services. As Dr. Margaret Ogola, a Kenyan physician, says, "Practically the only kind of health care you get in this country centers on reproductive health and family planning."18

High Contraceptive Failure Rates Lead to Increased Reliance on Abortion as a Back-up:

All population control organizations make the unwarranted assumption that increased contraception means less abortion. For example, UNFPA claims that "Where abortion is safe and widely available, and other reproductive health services are in place, rates of abortion tend to be low. The simple conclusion is: better contraceptive services for all people will reduce abortion."19

We need look no further than our own back yard to recognize how questionable this claim is. In the United States, virtually anyone can get any contraceptive they want from any drug store or supermarket. There are condom machines in restrooms, schools and restaurants. Thousands of Planned Parenthood Federation of America (PPFA) and other family planning clinics work assiduously to ensure that our sons and daughters have access to a complete range of contraceptives and abortifacient devices.

In the United States, fully 94.8% of sexually active women are now either sterile or use some form of contraception—yet the abortion rate has not changed significantly since 1975.20

The reason for this is simple: As the Alan Guttmacher Institute, the research arm of PPFA, acknowledges, there are two million contraceptive failures in the United States each year. Nearly 60 percent of all abortions in the USA—more than 870,000 annually—are performed on women who, at the time they became pregnant, were using contraception.21 Dr. Louise Tyrer, Medical Director of the Planned Parenthood Federation of America, confirmed that "More than three million unplanned pregnancies occur each year to American women; two-thirds of these are due to contraceptive failure."22

On a worldwide level, contraceptive use in developing countries has increased from about 8% of all couples in 1960 to about 60% of all couples in 1998. Yet the number of legal and illegal abortions worldwide continues to increase, to an estimated 55 million per year, according to the International Planned Parenthood Federation.23 If contraceptives were really the answer to reducing "unwanted pregnancies," we should have seen a drop or a leveling out in the number of abortions worldwide. Instead, the upward trend continues.

Contraceptive Failure:

One reason for this apparent paradox is the fundamental dishonesty of birth control propaganda. Population control groups routinely make exaggerated claims about the efficacy of contraceptives. They claim that contraception is the "answer to the problem of unwanted pregnancies" and that it will "cut down on unsafe abortions." The contraceptives themselves are presented to illiterate or semi-literate Third World women as "magic pills" or devices that have "no medical side effects." Such claims are intended to make contraceptive use widespread, but they have the unintended consequence of giving people a false sense of security. As contraceptive use becomes widespread, and traditional methods such as abstinence fall into disuse, these methods begin to fail in hundreds of thousands of cases. The population controllers must then agitate for unrestricted abortion as a back-up lest their fertility reduction programs fail.

Even within the ranks of the abortion movement the reality that more contraception leads to more abortion has been recognized. Dr. Malcolm Potts, the former Medical Director for the International Planned Parenthood Federation, is on record as saying that "As people turn to contraception, there will be a rise, not a fall, in the abortion rate."24 Dr. Christopher Tietze, perhaps the world's most experienced abortion statistician, concurs with this view:

A high correlation between abortion experience and contraceptive experience can be expected in populations to which both contraception and abortion are available . . . women who have practiced contraception are more likely to have had abortions than those who have not practiced contraception, and women who have had abortions are more likely to have been contraceptors than women without a history of abortion.25

Even more damaging to the "contraception reduces abortion" myth is Tietze's calculation that the abortion rate in a country with moderately effective contraception programs will be 1,000 per 1,000 women over their reproductive lifetimes.26 According to Tietze, many contracepting women will have repeat—second or third—abortions: "Within 10 years, 20 to 50 percent of pill users and a substantial majority of users of other methods may be expected to experience at least one repeat abortion (italics added)."27

Control-minded demographers are also concerned that contraception alone will not sufficiently depress fertility. They advocate the legalization of abortion to correct "contraceptive failures" and reduce the birth rate to below replacement. Population statistician Emily C. Moore reflected on this consensus and remarked:

Since contraception alone seems insufficient to reduce fertility to the point of no-growth, and since population experts tell us that eliminating unwanted fertility [is necessary], we should permit all voluntary means of birth control (including abortion) so as to avert the necessity for coercive measures.28

Conclusion:

The U.S. should stop funding UNFPA population control programs that harm the health of women in the developing world, and almost certainly contribute to an increase in the abortion rates in the developing world.

III. The UNFPA (and Population Control in General) Has Outlived Its Usefulness.

The Tragedy of Hunger:

For more than three decades, population alarmists have been predicting that lean times will soon befall the human race. They have predicted, time and time again, that man's capacity to reproduce would soon outstrip his ability to produce additional food. Mass starvation would then ensue. Population Bomber Paul Ehrlich issued such a Jeremiad in 1968, warning that 100 million people would die of starvation during the 1970's.29 Also in 1972, Planned Parenthood-World Population circulated an article with the apocalyptic title, "The Human Race has Thirty-Five Years Left: After that, People will Start Eating Plankton. Or People." Others told us that by 1990, we would need to build huge artificial islands in the middle of the ocean to handle the earth's population, and that the primary objective of all wars would be to seize other nations' food stocks.30 These predictions would merely be laughable had they not been used to justify harmful population control programs.

Great advances in agricultural and food storage and processing technology have long since rendered such Neo-Malthusian hand-wringing obsolete. For the past century, increases in food production have more than kept pace with population growth, thanks to technological and scientific innovations too numerous to mention here. We have set new records in food production 16 out of the past 30 years. Per capita food consumption continues to increase.

Preying on a gullible public, population control groups continue to generate income and support by claiming that hunger-related causes kill 60,000 people every day. According to the World Bank, however, deaths due to hunger rank no higher than twelfth among all causes of mortality in developing countries. This works out to an average of 1,644 deaths from malnutrition each day, or only about one-fortieth of the number of deaths claimed by the population fear-mongers.31 These deaths, it turns out, are mostly a consequence of civil war: Opposing armies have taken to targeting the civilian populations of their enemy for extinction, destroying their crops and interdicting relief columns. Eradicating war is the solution to this heinous practice, not cutting birth rates.

The Overall Justification:

Population control ideology asserts that, in order for a nation to advance economically or socially, it must reduce the fertilility rate of its people to replacement or below. This contention ignores basic economic and demographic realities, namely, (1) that nations with relatively large populations have more weight on the world scene and, (2) as shown by the late Julian Simon, moderate population growth is positively correlated with economic growth. 

What are the real motivations of the population controllers? In large part, it is to maintain the existing balance of power. Among themselves, they speak ominously of what they call "the threat of differential fertility." This is a reference to the fact that, while the populations of some developing countries are still increasing (although at an ever-slowing rate), the populations of most developed countries have peaked or are falling. There are more babies being born in Africa, Asia, and Latin America than in North America, Japan, and Europe. Their answer to this imagined "threat" is to induce the rest of the world to limit its fertility. As Dr. Charles Ravenholt, former Director of the Population Office of USAID, candidly explained:

Population control is needed to maintain the normal operation of United States commercial interests around the world. Without our trying to help those countries with their economic and social development, the world could rebel against the strong United States commercial presence. The self-interest thing is a compelling element. If the population explosion proceeds unchecked, it will cause such terrible economic conditions abroad that revolutions will ensue. And revolutions are scarcely ever beneficial to the interests of the United States.32

This was not merely Dr. Ravenholt's personal opinion. It was enshrined in an official document of the U.S. government entitled "Implications of Worldwide Population Growth for U.S. Security and Overseas Interests." Drafted by the National Security Council under the direction of Henry Kissinger, and secretly published as National Security Study Memorandum 200 (NSSM 200) on 10 December 1974, it took a very uncharitable view of population growth in the developing world.33 Among other things, NSSM 200 declared that:

The U.S. economy will require large and increasing amounts of minerals from abroad, especially from less developed countries. That fact gives the U.S. enhanced interest in the political, economic, and social stability of the supplying countries. Wherever a lessening of population pressures through reduced birth rates can increase the prospects for such stability, population policy becomes relevant to resource supplies and to the economic interests of the United States.

In other words it is in the national interest of the U.S. that the populations of developing countries are "stabilized" through "lessening of population pressures through reduced birth rates" in order to maintain the flow of raw materials from those countries to the United States. The authors of NSSM 200 go on to say:

The conclusion of this view is that mandatory [population control] programs may be needed and that we should be considering these possibilities now . . . 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?... [W]e should recognize that those who argue along ideological lines have made a great deal of the fact that the U.S. contribution to development programs and health programs has steadily shrunk, whereas funding for population programs has steadily increased.

These statements imply a deliberate policy of keeping the developing world down, by mandatory population control programs if necessary. In fact, USAID went on to insist that governments desirous of U.S. foreign assistance adopt a population policy, which then became a Trojan Horse for a wide array of U.S.-funded programs to reduce fertility rates. Many desperately poor developing countries felt they had no choice but to accept this Faustian bargain.

The authors of the report were well aware of the criticism that publication of the report would generate, both domestically and abroad. The extraordinary secrecy in which the report was shrouded (it was only released 25 years after its publication) is proof of this:

It is vital that the effort to develop and strengthen a commitment on the part of the LDC [less developed countries] 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 . . .

What NSSM 200 delicately calls a "perception" was actually the reality: The United States was in fact deliberately setting out to "keep th[e developing countries] strength down [and] reserve resources for use by the Ârich' countries." But it would never do for this imperialistic policy to become generally known.

To disguise U.S. involvement in population control programs a policy of using surrogate organizations was advocated by NSSM 200 and later adopted. For the past quarter century American population control aid has been funneled through the UNFPA and non-governmental organizations (NGOs) such as the International Planned Parenthood Federation (IPPF) and Pathfinder International. The appearance of a vast international consensus on the need for population control has been created to disguise the shabby reality of narrow U.S. self-interest.

The Future Dies in Europe:

The population controllers' fears regarding shifting demographic power are not entirely unfounded. Few in the United States realize that the depopulation of Europe is already underway, and is causing massive economic and social disruption.

This year, according to the United Nations, the population of Europe will peak and begin to decline. The population projections point to a demographic debacle of the first order in the decades to come. Consider the following grim facts:

• Europe has the nine lowest total fertility rates (TFRs) in the world and 23 of the lowest 30. The lowest TFRs in the world belong to Bulgaria and the Czech Republic, which share the dubious distinction of having an anemic 1.05 children per woman.
• From Ireland to the Russian Republic not a single European country is having enough children to replace itself. The demographic rule of thumb is that 2.1 children per woman are required to stave off depopulation. The highest TFR in all of Europe is Macedonia's 1.94 children per woman.34 (see Table 1).
• The populations of seventeen European countries have already begun to crash. The nations whose populations fill more coffins than cradles each year are Belgium, Bulgaria, Croatia, the Czech Republic, Denmark, Estonia, Germany, Hungary, Italy, Latvia, Lithuania, Portugal, Romania, Slovakia, Slovenia, Spain and Russia.35
• The average total fertility rate for Europe (including Russia) is currently about 1.35 children per woman, and it is expected to fall further in years to come. If current fertility rates continue, the current European population of 727 million will crash to 550 million by the year 2050—a drop of nearly one-fourth.36 The last time Europe's population showed a decline of this magnitude was during the Black Plague from 1347-1352. Should these low fertility rates continue, the population of Europe will decline to only 207 million—less than 30 percent of the present population—by the end of the twenty-first century.37
• The average age of Europeans will increase from the current 37.8 years to 52.6 years by the year 2050 and to more than 60 by the year 2100. Seven nations (Austria, Bulgaria, the Czech Republic, Greece, Italy, Romania and Spain) will have populations with an average age of over 55 in the year 2050.
• This aging will create an unbearable strain on social security and health care systems. At the current time, 1.6 workers support one young or retired dependent. By the middle of the next century, each worker will have to support one dependent. This will place an increasingly heavy tax burden on a work force that is declining in number. By contrast, the average age of people in Africa is now only 18.6 years, and will be only 34.6 by 2050.38 Needless to say, the economic vitality of a nation is derived from its workers; fewer workers, barring stellar increases in productivity, mean a weaker economy.
• Europe currently possesses 12 percent of the world's population. In just fifty years, it will have just 7.5 percent of the world's people, and by the year 2100, just 5 percent.
  Europe is already beginning to suffer from the economic and social dislocations caused by a huge birth dearth, a rapidly-aging population, and massive immigration. As it spirals into a demographic free-fall in the years to come, these problems may become well-nigh insuperable. It is safe to say that the problems caused by a declining population will be much more severe than those caused by a rapidly growing population. After all, children become progressively less dependent over time; the elderly become progressively more dependent.

Consider what is happening. The elderly population is exploding, while the number of babies being born is plummeting. The consequences of this demographic shift are mind-boggling. Economies will stagnate for lack of workers and consumers. Pension plans will go belly up. The elderly will have to work longer, and retire on less. Even so, the relatively small number of people in their productive years will have to shoulder a huge and growing tax burden to keep social security and other government programs afloat. And this tax burden will drive down birth rates even further, as young couples are forced to work longer hours for less take-home pay—and postpone, perhaps indefinitely, having children.

Can the Birth Dearth be Overcome?:

Many European countries have begun enacting policies that encourage family formation and childbearing. The alternative—an inexorably aging population draining away the resources of the few remaining young—is a recipe for extinction.

Can European nations reverse their population decline through a combination of pro-natal and pro-family public policy measures and tax incentives? Several countries and regions are attempting precisely this, but with little success to date. The popular attitude towards children is that they are inconvenient, expensive and, as a group, a threat to the environment. Birth rates remain well below replacement.

The German state of Brandenburg became alarmed when total births fell from 38,000 in 1984 to only 12,000 in 1993. (In four other adjacent German states, births fell by at least half during the same period.) In order to encourage childbearing, the state offered to pay its citizens a child bonus of $650. The birth rate in Brandenburg has hardly budged.

Propaganda campaigns have had even less effect. A two-year-old French national ad campaign trumpets La France a besoin des enfants! [France needs babies!]. The French are not listening, however. Birth rates remain low, except among the Muslim immigrant population. The Czech Republic has erected billboards extolling the virtues of larger families. Czech birth rates remain the lowest in Europe.

It is unclear what level of incentives will be required to convince the Europeans that babies are a blessing and not a burden. The current level of benefits for those who have children, which range from a few hundred to a couple thousand dollars, is obviously insufficient. Serious pronatalist initiatives will undoubtedly prove very expensive, and will find themselves in competition for scarce government funds with organized and highly vocal groups representing the elderly and their interests in generous pension and medical benefits.

World Totals:

According to the latest United Nations' projections, the population of the world will never double again. Instead, it will peak at about 7.46 billion in the year 2038, after which it will begin an increasingly steep decline. By the year 2082 it will have declined to six billion, and be slightly under 5 billion by the end of the twenty-first century.

The current world total fertility rate or TFR is, at 2.48 children per woman, not far above replacement. Given still high infant mortality rates in many parts of the world, the replacement fertility rate is about 2.2 children per woman, a figure that will be reached by the year 2005. For all practical purposes, then, the world is currently at zero population growth, although because of lengthening life spans in many parts of the world, population will continue to expand for several more decades. The world TFR will drop to 1.54 children per woman by the year 2050.39 Should current trends continue, the TFR will fall to only one children per women by the end of the next century.

The current population of the developed world, Europe plus North America and several Asian countries, is about 1.18 billion. This population will peak over the next few years. Only about five million more people will be added to the developed world by the year 2010, then a steep decline will begin. Its population will decrease to 990 million by 2050 and to about 600 million by 2100 (see Table 2 and Table 2A).

The current population of the developing regions of the world is about 4.84 billion. It will level off at about 6.4 billion in the year 2040 and will then begin a slow but accelerating decline to about 4.3 billion in the year 2100. The developing world will soon enough be experiencing the same demographic decline that Europe is now, with this difference: The developed world grew rich before it grew old. The developing world will grow old before it grows rich.

Conclusion:

The total fertility rate of the world will reach replacement level in just six years—and all indications are that it will continue falling. Despite all the talk about zero population growth, there is nothing magical about replacement rate fertility. If we take the European case as exemplary of the fertility rates of post-modern societies, we can expect that fertility rates for the world as a whole will fall to somewhere between 1.1 and 1.8 children per family in the years to come. We will see not zero population growth, but negative population growth, with all the economic and societal problems this implies.

Humanity's long-term problem will not be too many children, but too few children. Too few children to fill the schools and universities, too few couples buying homes and second cars. Too few consumers and producers to drive the economy forward, and too few workers to provide support, through their tax dollars, for the ballooning population of elderly.

Recommendation:

Given the looming crisis of depopulation, the United Nations Population Fund should not receive U.S. funding for its programs. The UNFPA, as well as population control programs in general, have outlived whatever usefulness they may once have possessed. Why should the United States spend hundreds of millions of dollars a year to further reduce fertility in countries whose populations will all too soon be in decline? Population control programs should be abolished, lest they do further harm.