The world’s population recently surpassed seven billion and, according to UN projections, the next milestone of eight billion will occur in 2025 and then reach 9.6 billion by 2050. These statistics, however, mask varying demographic trends across geographic regions. Almost all of today’s population growth is occurring in developing countries where approximately 90 percent of the world’s youth reside. Today there are nearly 2.5 billion people under the age of 19 representing one third of the world’s population. These young people will set the course of global health and population growth for many years to come. Yet, global fertility rates have begun to decline over the past few decades and in some countries, populations are aging rapidly placing increased pressure on public sector pension systems and social welfare programs. International migration may help mitigate the effects of population aging in some countries, but cannot completely compensate for it. These different circumstances result in sharply contrasting policy considerations.
The goal of U.S. international population policy is to promote healthy populations by supporting sexual and reproductive health and reproductive rights, voluntary family planning, women’s empowerment, development, and efforts to combat HIV/AIDS. The U.S. does not endorse population "stabilization" or "control." The "ideal" family size should be determined by the desires of couples, not governments. The U.S. strongly opposes coercive population programs. And, in keeping with PRM’s core mission to place protection of the worlds’ most vulnerable at the center of U.S. foreign policy, the Bureau also promotes the provision of essential reproductive health services, including voluntary family planning, in crisis settings.
The United States strongly supports the Program of Action of the International Commission on Population and Development (ICPD), which was negotiated and accepted by 179 governments in 1994 in Cairo and set far-reaching goals linking global health, human rights, and development. A key principle of the ICPD is that couples and individuals have the right to decide freely and responsibly the number, spacing and timing of their children and the right to have the information, education, and means to do so. Reproductive health care programs should not include any form of coercion.
Enabling women to determine whether, when, and how often to have children is crucial to safe motherhood and healthy families. Increasing access to reproductive health services, including voluntary family planning, has profound health, economic, and social benefits. It reduces maternal and child death and disability, reduces recourse to abortion, and empowers women by creating opportunities for education, employment and full participation in society.
PRM has the lead in international fora on matters related to population policy, working collaboratively with the Bureau for International Organizations, the U.S. Mission to the UN (USUN), the U.S. Agency for International Development (USAID), the Department’s Office of Global Women’s Issues (S/GWI), and other U.S. government offices and agencies. PRM has the policy lead for, and represents the United States on, the governing bodies of relevant international and multilateral organizations, such as the UN Population Fund (UNFPA) and the UN Commission on Population and Development (CPD). The Bureau also works to increase national and international awareness of population issues and integrate these issues into broader economic growth and development strategies. PRM is also involved in negotiations on a wide array of reproductive health and rights issues including gender-based violence, child, early, and forced marriage, obstetric fistula, and female genital mutilation/cutting (FGM/C).
Under the Obama Administration, improving health outcomes in the world’s poorest countries has been a key priority. Focus areas include expanding efforts to make pregnancy and childbirth safer by increasing access to voluntary family planning and reproductive health care and strengthening health systems to provide women and girls with integrated health services. The Administration’s efforts also support the following maternal and reproductive health goals and targets: reducing maternal mortality by 30 percent and preventing 54 million unintended pregnancies across assisted countries.
2014 marks the 20th anniversary of the ICPD and provides an opportunity to further shape the trajectory of population and development discussions worldwide. In twenty years since the ICPD, governments have made significant progress to reaching goals set forth in the ICPD Program of Action and the later Millennium Development Goals. One billion people have been lifted out of extreme poverty, the average global life expectancy has increased from 65 to 70, the number of maternal deaths has been reduced by nearly half, child mortality has declined by 40 percent and many more children, especially girls, now complete their primary education.
But progress has not been even and many of the most vulnerable people have been left behind, including many women and young people. At least 222 million women in the developing world would like to prevent or delay pregnancy but lack access to safe, effective contraception and each year an estimated 289,000 women still die from pregnancy-related causes, most of which are preventable. More than two million adolescents live with the scourge of HIV/AIDS, many without access to lifesaving treatment. The practices of early and forced marriage persist, despite near-universal commitment to eliminate them. One out of every three girls in developing countries will be married before reaching 18 and more than 15 million girls will give birth each year, robbing them of a chance to finish school and pursue their dreams.
The U.S. government will continue to partner with governments, the private sector, international and non-governmental organizations, and advocates to build on the progress we have made and advance the goals that empower women and young people to realize their full potential and help drive social and economic development.