'We have to make population growth compatible with development'

DEVELOPING countries have accepted the inarguable importance of the link between population and economic and social development and natural resources, says NAFIS SADIK, secretary-general of the International Conference on Population and Development, 1994, to be held in Cairo September this year. Since 1988, Sadik, who was born in Jaunpur, India, has been the executive director of the United Nations Population Fund (UNFPA) -- the world's largest source of multilateral assistance to population programmes, with its 1994 budget of nearly $225 million. Sadik studied at Loreto College in Calcutta, received her degree in medicine from Karachi's Dow Medical College and did her internship in gynaecology and obstetrics in America. From 1954 to 1963, she served as a civilian medical officer in charge of women's and children's wards in various Pakistani armed forces hospitals. She headed the health section of the government's planning commission and in 1970 became director-general of the Pakistan Central Family Planning Council, before joining UNFPA in 1971. During a seminar on Population and Environment, held in Geneva, Sadik spoke to Suren Erkman about UNFPA's role in tackling the population problem:

What are the priorities of the United Nations Population Fund?
When I became executive director of UNFPA, I emphasised on 3 things. I insisted on providing information and family planning services on a very large basis, starting at the individual level. Ways have to be found to create an environment in which the individual most affected -- in this case, the woman -- also becomes a part of the decision-making process. And, we also need to have a population policy as part of the development strategy.

Is there anything new, after the previous conference on population, held in Mexico 10 years ago?
At the 1984 conference we didn't have any goals because the governments, especially those of the African and Latin American countries, could not agree on any quantitative goals. Now, the developing countries have acknowledged the link between population and development. For the first time, they have set goals for themselves in their regional conferences. This is a major change.

What are your goals for the Cairo conference?
I am going to propose some quantitative goals, with a time-frame of 20 years, in 3 areas: fertility, mortality and education. Interim goals of 5, 10 and 15 years will also have to be set. These will be different for each region because the conditions in each region are not alike.

Regarding fertility, the aim is to provide access to family planning information and services to everybody in the reproductive age group. If this is done, fertility levels will decline to 2.0 or 2.1 by 2015.

I also suggest that we try to reduce mortality rates to 35 per 1,000. Infant mortality is about 120 per 1,000 live births in some countries. For them to reduce this to 3.5 per cent in 20 years will be a major achievement. Besides, maternal mortality will also have to be considered. The absolute number of maternal deaths -- estimated at 500,000 to 600,000 a year -- is not very large. But 99 per cent of these are preventable and this is the disparity between developed and developing countries: maternal mortality rates are approximately 50 times higher in developing countries. Half of these result from abortions. This brings family planning into the picture.

Also, many of the maternal deaths are because of the low age of the mother during her first delivery. Mortality rates of mothers below the age of 20 is very high and if the mothers have children too narrowly-spaced, or if they have children after the age of 35, mortality goes up in developing countries because of the vicious circle of anaemia, malnutrition, etc.

In the field of education, we propose that all children should have completed primary education by 2015 and that at least 50 per cent of them should be enrolled in secondary education.

What specific actions do you plan to take to empower women?
We plan to provide access to training for income-generating activities and access to credit resources at the local and national levels. Besides, at the decision-making level, men must recognise their responsibility in empowering women.

How do you intend following up the Cairo conference? Or will you just wait 10 years before the next population conference?
No, I think that we should follow up every year, starting at the national level, then at the regional level and finally at the global level. We think that this can be done in the context of the Commission on Sustainable Development. Otherwise, the Population Commission can be given the mandate to review the implementation. In the first year, we should analyse all the things that have been done with regard to the results we expected.

Are you going to ask for more funds?
Resources play a very big role. We are going to adopt the United Nations Development Programme proposal that 20 per cent of the national budget should go to social development, which includes education, health, nutrition, family planning and low-income housing. And 20 per cent of all international aid should also go to the social sector. This adds up to $9 billion per year from both sources, domestic and international.

Much more than it used to be...
It's about $5 billion today. So it will be almost double. We are suggesting that UNFPA should reach $1 billion by 2000. At the moment only about 1.4 per cent of international aid is spent on population.

Resource mobilisation is a collective responsibility. Developing countries have to shoulder some of the responsibility for their own sake. I don't want what happened at the United Nations Conference on Economics and Development to happen at the Population Conference -- that developing countries are not prepared to do anything without external financing. One of the criteria for external assistance must be the priority given by the nation to population programmes.

Some NGOs, especially feminist NGOs, have criticised UNFPA on women's rights...
It's just lack of information or understanding. Women's groups feel that a lot of emphasis is given to family planning but not enough to other aspects of reproductive health or women's health. Others fear coercive programmes. However, many women's groups have started realising that what we were saying was not different from what they were saying. But some women's groups want a perfect programme, which is not very realistic.

Besides, women's NGOs of developed countries act as the mouthpiece for the developing world. But the developing nations must speak for themselves. In the second preparatory committee meeting, we had many NGOs from developing countries and some of them totally disagreed with the extremist feminist views.

Apart from increased funding, what action would you like to be taken in the industrialised countries regarding their population policy?
The industrialised countries should give some importance to poverty alleviation and not just through aid policies, because aid is a very small part of economic resources and transactions. Besides, they have to change their lifestyles and consumption patterns.

Also, as far as UNFPA is concerned, the developed countries are miserly about the resources we could use for public information. In the developing countries, funds for public information are part of the country programmes, but the developed countries were not willing to let us use our resources for public information and education activities.

But now they tell us that we are right, that there must be more publicity, public information and education on population issues in the developed countries. Recently, our work was evaluated by Germany, Canada and Finland and one of the things they said was that we had not done enough for public awareness in the developed countries. It is a vicious circle: they wouldn't allow us to do it and they also complained that we had not done it.

Is population growth compatible with development?
We have to make it compatible. We have to look at population growth as one of the elements in population policy that is the most seriously addressed by developing countries.

The UN has forecast 3 possibilities about the global levels of population. According to one scenario, population will continue to grow without any change until it reaches something like 20 billion. The second is the medium projection, which is supposedly the most feasible and also ends up with a population of about 11.5 billion in about 100 years from now. The third scenario, which is the low projection, assumes that if replacement level fertility (that is 2.1 children per woman) is reached by the year 2000, then world population levels could stabilise at about 8.5 billion.

I think that the most optimistic scenario is that population levels could stabilise between the low and the medium projections if we take immediate action. Going by this estimate, we need to plan for a population of 9 billion in 2025.

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