Population growth could be bigger threat to reducing poverty in Africa than AIDS


EMBARGO: 00:01H (London time) Thursday October 27, 2005. In North America the embargo lifts at 6:30pm ET Wednesday October 26, 2005.

High fertility rates and rapid population growth could prove to be more serious obstacles to poverty reduction than AIDS in most African countries, states a viewpoint published online today (Tuesday October 25, 2005) by The Lancet.

Much has been written about how AIDS is undermining development in sub-Saharan Africa. The UK Prime Minister Tony Blair stated that the disease is the biggest barrier to tackling poverty. However, not enough is being said about the threat to African development posed by continued and rapid population growth, state John Cleland (London School of Hygiene and Tropical Medicine, London, UK) and Steven Sinding (International Planned Parenthood Federation, London, UK). In Asia and Latin America promotion of family planning has been successful in reducing birth rates, and hence, population growth. However, in Africa the population size is expected to double in the next 45 years to 1.69 billion by 2050. The United Nations (UN) expects sub-Saharan Africa to follow the pattern seen in other poor regions of the world and see a pervasive decline in birth rates. But Cleland and Siding state four reasons to doubt that this will happen. First, desired family sizes in Africa remain high. Second, uptake of modern contraceptive methods by married women remains very low in western and middle Africa. Third, international funding and commitment to family-planning programmes in Africa have decreased. Fourth, the dissemination of contraceptive information and service seems unlikely in countries with fragile governments. For these reasons population size in 2050 may well exceed the expectations of the UN. The authors detail the approach that they think is now needed, which combines a focus on fertility with an intensified effort to prevent the spread of HIV.

Professor Cleland states: "In the face of the uncertain future trends in African HIV/AIDS epidemics, HIV prevention should remain a major public-health priority throughout the region. But we believe that AIDS is not yet, as is so often claimed, the main threat to development in most countries. Continued high fertility rates and rapid population growth could prove to be more serious obstacles to poverty reduction than AIDS in most, although not all, African countries. Population growth also threatens food security in already malnourished states, makes long-term dependence on international assistance more likely, and increases the pressure for international migration."

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