Showing posts by Gib Clarke.
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9.2 Billion Carbon Copies: The Impact of Demography on Climate Change
›July 21, 2009 // By Gib ClarkeAs the number of contributing factors to (and potential solutions for) climate change grows, one—population growth—is conspicuously absent from most discussions. For obvious reasons: After finally prevailing over climate change “skeptics,” why would U.S. climate advocates court more controversy by adding population, and thus family planning and even abortion, to the mix?
Because it could be an important—perhaps significant—and definitely cheap part of solving the climate crisis, argued David Wheeler of the Center for Global Development (CGD) at an ambitious June 23rd event in the CGD series on “Demographics and Development.” Covering both climate change and population issues, he offered a compelling economic analysis of the effectiveness of family planning and female education programs at addressing climate change. Equally impressive was Wheeler’s engaging style, including graphics and animations that could make Gapminder guru Hans Rosling blush.
Describing Pacala and Socolow’s oft-cited “wedge” theory of stabilizing emissions, Wheeler pointed out that slowing population growth is rarely discussed, compared to the more popular—and more costly—wedges related to reduced deforestation, energy efficiency and conservation, renewable electricity and fuels, and carbon capture and storage.
Wheeler argued that slowing population growth has great potential for reduce emissions at a lower cost. As population increases, so do emissions. As a country develops, its per-capita emissions increase, so population increases in more developed countries are especially important. As the middle class in the BRIC and other large developing nations grows, this sizable group of “New Americans” (to use Thomas Friedman’s term) will contribute more and more emissions.
Two interventions will contribute the most to slowing population growth: family planning and female education, said Wheeler. According to his calculations, a $10 billion increase in female education in the developing world would lead to a change in population growth substantial enough to achieve one of the stabilization wedges. Wheeler found that family planning and female education are among the most cost-effective strategies, as evidenced by their placement on the far left side of slides 22 and 25.
Though an economist by training, Wheeler did not make only financial arguments: He emphasized throughout his presentation that family planning and female education are worthy and necessary programs in their own right. And he pointed out the most glaring injustice of climate change: While people in developed countries have the largest carbon footprints, people in developing countries will disproportionately suffer the impacts. (Suzanne Petroni makes similar points in her ECSP Report 13 article, “An Ethical Approach to Population and Climate Change.”)
Tim Wirth, the president of the UN Foundation and the Better World Fund, called for more political and financial support for this link. Funding for family planning has fallen and support for female education is not as high as it should be. Reaching the unmet need of the world’s women would cost about $20 billion, and the U.S. “share” is $1 billion, an amount that many U.S. family planning leaders are advocating.
As CGD’s Rachel Nugent noted in her introduction, demography and climate are classic cases of long-term issues: difficult to understand and address. It is ironic and important, she said, that two such long-term issues are simultaneously at critical moments. The work of David Wheeler on population and climate change, along with that of Leiwen Jiang of Population Action International and Brian O’Neill of the National Center for Atmospheric Research, may help us find an important and inexpensive piece of an elusive and otherwise expensive pie.
More data is needed to confirm these initial findings. However, the devil may not be in the details but in the debate: convincing weary and wary climate warriors to take on a bit more controversy. -
With Demography, the Devil Is in the Details—and the Assumptions
›May 6, 2009 // By Gib ClarkeA micro-economist friend of mine likes to say that macro-economists have correctly predicted nine of the last five recessions. In “The World’s New Numbers,” in the Spring 2009 Wilson Quarterly, Wilson Center Senior Scholar Martin Walker argues that demographers should be so lucky.
Problematic Projections
Demographers base their projections on complex models that incorporate current population numbers, fertility rates, age structures, and other variables. Predicting how many children women and their families will want to have in the future—across different countries and cultures—is not easy. The result is that different demographers get different results. To cover their backs, even the most esteemed organizations offer a range of projected population sizes; the United Nations, for example, says that world population in 2050 will be anywhere from 7.9 to 11 billion people.
As Walker points out, these calculations are often revised. Between 1998 and 2000, for example, the United Nations’ middle projection (or “best guess”) increased by 500 million people. Seemingly miniscule changes in fertility rates often produce big changes in later decades, as Sean Peoples and Liz Leahy explain in the current issue of World Watch magazine.
So Close, and Yet So Far
Why are the projections so far off? Human behavior—particularly the status of women and the availability of family planning—is notoriously hard to predict. Walker points out that the United Nations “rather daringly assumes” that global fertility will drop to 2.02 children per woman by 2050, and to 1.85 further in the future. He doesn’t discuss, however, that these projections are based on an increase in the availability, accessibility, and use of contraceptives in all parts of the world.
Since increased use of contraceptives is highly associated with increases in supply (assuming associated high-quality, culturally sensitive services are provided, including reproductive health education), the burden of reaching global fertility levels of 2.02 and 1.85 is on funders. But when adjusted for inflation, U.S. funding for family planning has declined by almost 40 percent since 1995. We won’t reach the middle UN projection without some significant commitments from the U.S. government and others.
Communicating Probability
With so many (changing) projections and so much nuance, how is demographic information communicated to the public? Poorly, says Walker, with the result that “sensationalist headlines soon become common wisdom.” This “wisdom” includes the belief that Western countries are having fewer babies, aging rapidly, and will soon strain their social safety nets to the breaking point; that mass immigration to Europe is changing the cultural landscape; and that population growth will continue unabated in developing countries for the foreseeable future.
Walker tackles these misconceptions masterfully, pointing to lesser-known or perhaps ignored data. For example, high levels of Arab and Muslim immigration to Europe are unlikely to continue, given that many of the sending countries are experiencing steep declines in birth rates. Meanwhile, birth rates have recently rebounded in several European countries, and social policies such as increasing female participation in the workforce and raising the retirement age may lessen the stress on social safety nets.
Walker does well to point out that 30 countries—mostly in sub-Saharan Africa—continue to grow rapidly, and that they are the least prepared to tackle the challenges associated with rapid growth, given their weak governments, poor economies, and inadequate health and education systems.
Why Bother?
Given the difficulty of making and interpreting projections, why bother with demographic “best guesses” at all? Because the size of a population—and its composition by age, gender, and other variables—impacts many areas, including health care, infrastructure, environmental degradation, and security. So while population projections and economic forecasts may be difficult to parse, basic demographic or financial literacy and the ability to see through sensationalized headlines are essential to understanding both. -
Former USAID Population Directors Argue for Major Boost in Family Planning Funding
›April 7, 2009 // By Gib Clarke“We know how to do family planning, we know what it costs, and we know that it works,” said Joseph Speidel of the University of California, San Francisco, at the launch event for Making the Case for U.S. International Family Planning Assistance sponsored by the Wilson Center’s Environmental Change and Security Program on March 17, 2009. The key missing element, he said, is political will.
Speidel and his co-authors—all former directors of the U.S. Agency for International Development’s (USAID) Office of Population and Reproductive Health—argued that Congress should more than double spending on international family planning in the coming years for health, economic, and environmental reasons.
The Big Ask
Making the Case recommends that the USAID population budget be increased from $457 million in FY2008 to $1.2 billion in FY2010, growing further to $1.5 billion in FY2014. According to the speakers, this increase is necessary to:- Meet the “enormous pent-up and growing unmet need for family planning”;
- Stabilize population growth rates, especially in Africa; and
- Achieve the Millennium Development Goal of universal access to reproductive health services.
Duff Gillespie of the Johns Hopkins Bloomberg School of Public Health showed that U.S. funding for family planning has been stagnant in real dollars since the late 1960s, despite the fact that there are 200 million women with an unmet need for family planning. Without champions within USAID and the Obama administration, he said, the dollar amounts appropriated for family planning are unlikely to increase.
Speidel explained that growing populations, combined with stable or increasing rates of consumption, contribute to climate change. The current rate of population growth is unsustainable, given Earth’s finite natural resources. Changes in behavior and technology—such as eating less meat or using clean energy—could improve environmental outcomes.
Absolute numbers still matter, however: Although population growth rates have declined, the global population continues to grow. Addressing the nearly one-half of all pregnancies that are unplanned would bring great health and environmental benefits, said Speidel.According to Steven Sinding of the Guttmacher Institute, although most economists and demographers agree that economic growth leads to lower fertility, whether lower fertility reduces poverty is still a matter of much debate. But the “demographic dividend” generated by slowing population growth is a reality, he argued, and countries can benefit from it if their institutions are prepared to take advantage of it. For example, a USAID study found that one dollar invested in family planning in Zambia saved four dollars in other development areas.
A Broader Base of SupportRuth Levine of the Center for Global Development urged the authors to avoid “preaching to the choir.” One way to engage other constituencies interested in demographic issues is to broaden the scope of “population” to include not only family planning, but also migration, urbanization, and other key demographic issues.
In addition, convincing World Bank economists, especially the Bank’s next president, of the connections between declining fertility and poverty reduction should be a priority, said Levine, because developing countries put a lot of stock in the Bank’s advice.
By Gib Clarke
Edited by Rachel Weisshaar
Photos: From top to bottom, Joseph Speidel, Duff Gillespie, Steven Sinding, and Ruth Levine. Courtesy of Dave Hawxhurst and the Wilson Center. -
Global Public Health: An Agenda for the 111th Congress
›February 11, 2009 // By Gib ClarkeThis is an exciting time to be working global public health, with more attention and money going to the field in the last decade than perhaps ever before. In the past, the struggle has been to direct more money and attention to these issues, but recent efforts have focused more on maximizing funds’ impact—by strengthening health systems, focusing on prevention, and finishing so-called “unfinished agendas” in maternal health, child mortality, and family planning. In my remarks at a recent panel on foreign policy challenges facing the 111th Congress, I focused on four issues: infectious diseases, neglected health issues, funding, and capacity building. -
From the Director’s Chair
›December 17, 2007 // By Gib ClarkeECSP Director Geoff Dabelko and I recently attended “Population, Health, and Environment: Integrated Development for East Africa,” a conference held in November in Addis Ababa, Ethiopia. The conference was attended by more than 200 development practitioners from around the world, including many from Rwanda, Uganda, Tanzania, Kenya, and Ethiopia.
Throughout the conference, organizers, presenters, and participants all professed the many benefits of integrating population, health, and environment (PHE) initiatives. President Girma Wolde-Giorgis and Ethiopia’s ministers of health, environment, and agriculture and rural development opened the conference by praising the comprehensive basket of services that PHE offers. All that said, perhaps the best evidence that this conference was a success, and that PHE’s integrated approach is both necessary and valued in countries like Ethiopia, came in comments from Glenn Anders, the U.S. Agency for International Development (USAID) Ethiopia Mission Director, during the closing ceremony:
As I wrote in my previous post, it is rare that a conference galvanizes such momentum and captures the imagination of so many people from so many countries. It’s good to know that policymakers are listening.
I myself have been in development for over 25 years. I know first-hand the challenges that arise from addressing a development issue as one problem with one cause and one solution. Sometimes it might seem like a more simple approach, but we know that development—and life—is much more multi-faceted and complex. The only way to find a common ground, common solution, and common funding is to recognize the interconnectedness between people and their surrounding environment.
Integrated programs touch more lives, improve program efficiency, and strengthen cross-sectoral collaboration. We see better, measurable results from an integrated approach, and that is something we certainly all want …
Let me share with you how USAID in Ethiopia is utilizing this holistic approach. We support the government of Ethiopia’s community health extension workers, who work on the ground in communities addressing much more than just health. There have been over 18,000 workers deployed to date across the country. All of the community health workers are women and they are empowered to educate their neighbors. The workers are immunizing children and providing family planning services in the community. The program is also improving water and sanitation, introducing clean water and hygiene practices. The community health extension workers in Ethiopia are combining development solutions to address environment, health, population, and gender issues. We applaud Ethiopia’s vision to prioritize this program, and we will continue to support its implementation. -
Role-Playing—for a Serious Purpose
›December 10, 2007 // By Gib ClarkeThe country of Arborlind is in bad shape. It falls in the bottom quarter of countries on the Human Development Index, and much of the majority-rural population lives on $1 a day. In addition, Arborlind is experiencing rapid population growth, and 40 percent of the population is under the age of 15. Deforestation and environmental degradation continue unabated in Arborlind, as families depend on natural resources for their livelihoods, and agriculture is often carried out unsustainably.
Nevertheless, there is hope that Arborlind’s natural beauty, impressive landscapes, and unique flora and fauna will translate into an adventure tourism market that will help turn around the country’s economy. This is particularly true in Floriana National Park, home not only to unique plants and animals, but also to the indigenous Sedentaire and—for part of the year—Wandran tribes.
The future of Floriana is a topic of much debate in Arborlind. The Conservonly Foundation of California wants to preserve it, but demands that all people be removed and prevented from re-entering. Civil society prioritizes poverty alleviation and livelihood generation, and is also fighting for improving human health and the environment. The private sector wants a positive regulatory environment that allows the tourism and agribusiness industries access to land and water resources. Finally, the government of Arborlind wants to improve the economy and protect the tribes, but more than anything else wants to prevent the conflict between these groups from turning into an embarrassing scene just two months before it hosts soccer’s African Cup.
This was the situation that health and environment practitioners, policymakers, scholars, and journalists were presented with at a conference last month in Addis Ababa, Ethiopia.
The participants in the Arborlind simulation—written by ECSP’s Geoff Dabelko and Gib Clarke, along with Shewaye Deribe Woldeyohannes of the Ethio Wetlands and Natural Resources Association—switched roles for an afternoon, as they sought solutions to the problems in Arborlind. Wearing different hats—a health minister playing the part of a hotelier, for example—participants reported gaining new perspectives and increased understanding of sustainable development challenges and potential solutions.
The simulation exercise was part of the “Population, Health, and Environment: Integrated Development for East Africa” conference, attended by more than 200 people from Rwanda, Uganda, Tanzania, Kenya, Ethiopia, and 17 other countries. Participants presented real-world solutions to problems very similar to those in Arborlind, explaining how all parties can—and must—come together to address people’s multifaceted needs.
I have attended more conferences than I care to remember. But this conference was unique: There was tremendous excitement about the potential of integrated programs to address population, health, environment, and other challenges in East Africa. There was also a palpable sense of community, as different organizations from different countries realized that there were others like them, also seeking to solve complicated problems with integrated solutions. Hopefully, the lessons learned and the networks formed will sustain the energy that came out of the conference, and lead to an increase in the number and sophistication of integrated programs in East Africa. -
Public Health Bonanza
›November 7, 2007 // By Gib ClarkeLast month, George Washington University’s School of Public Health hosted its annual “Mini-University”, a day-long conference showcasing novel approaches to improving global health.
The conference featured seventy presentations on topics including child marriage, monitoring and evaluation, fistula, urban health (with Wilson Center Global Health Initiative Senior Advisor Vic Barbiero), contraceptive security, male circumcision, XDR TB, nutrition, water and sanitation, gender, and the effects of the brain drain.
A few of the presentations looked at the relationships between conflict and health. One notable presentation (see #12) looked at the transition from relief to development in post-conflict states, examining best practices for strengthening health systems in these settings. Drawing on examples from Liberia, Afghanistan, and Sudan, the presenters discussed what the health priorities should be, how to execute them, and acknowledged the difficulty in accomplishing these tasks in such difficult environments.
The population, health, and environment (PHE) field was on display as well. Along with Johns Hopkins Ph.D. student Yung-Ting Kung, I (ECSP Program Associate Gib Clarke) presented “Is the whole better than the sum of its parts? Operations research design and initial evidence from integrated population and environment projects.” I offered background on integrated PHE programs, as well as a PHE case-study from the Philippines, I-POPCoRM. Kung’s presentation reported findings from statistical analysis of the Madagascar Environmental Health Project, with the goal of determining whether family planning and conservation outcomes are significantly better when services are delivered in an integrated PHE program than when they are delivered in isolation.
Though the conference sought to inform graduate students of the variety of new approaches being developed, the number of seasoned professionals present indicated that many members of the public health field recognize the importance of innovation. That monitoring and evaluation was emphasized throughout the day, and that many time-tested programs were on display as well, however, showed that in many cases new energy and commitment—not new technology or strategies—is what is needed. -
Frist Returns to the Health Fray
›September 13, 2007 // By Gib ClarkeFormer Senate Majority Leader Bill Frist, who was a practicing surgeon before his political career, announced last week that he would return to medicine—in a big way. The New York Times reports that Frist will lead Save the Children’s new “Survive to Five” initiative. This program aims to reduce the number of children—estimated at nearly 10 million annually worldwide—who die before they turn five years old. Save’s website describes five solutions to the five biggest contributing factors to child mortality. By applying these solutions—all of them proven, and most of them very inexpensive—they hope to save as many as 6 million children every year.
The Times mentions that other American politicians, such as Jimmy Carter and Bill Clinton, have dedicated much of their post-political lives to global health, with excellent results. Perhaps even more encouraging is that some current world leaders are addressing these issues as well. Last month, British Prime Minister Gordon Brown and German Chancellor Angela Merkel vowed “urgent action” on health issues in developing countries. Their International Health Partnership, which began on September 5, will address child mortality, as well as maternal mortality and HIV/AIDS prevention and education.
The Times notes that Frist is playing a key role in a similar campaign with the Bill and Melinda Gates Foundation, along with former rival Senator Tom Daschle—although it doesn’t mention that while majority leader, Frist broke with political tradition by campaigning against his counterpart. It is encouraging that they have put political differences behind them and are working together on a new campaign that could save and improve the lives of millions of children around the world. Hopefully, they will be successful in persuading Americans and their elected officials that child mortality is not only unacceptable and preventable, but that reducing it is a worthy use of taxpayer dollars.
This effort may seem daunting, given that less than one-half of one percent of the U.S. budget goes to international assistance. Frist was successful in ushering through the President’s Emergency Plan for AIDS Relief (PEPFAR), which dedicated $15 billion over five years to fighting AIDS, principally in Africa. This was a major victory for global health, but there is room in the budget and the priorities of American leaders for more global health programs—especially if PEPFAR is doubled, as is now being considered, to $30 billion over the next 5 years. Campaigns to reduce childhood mortality do not face the political scrutiny of HIV/AIDS programs such as PEPFAR, but it will still be important that Frist and others involved allow science-based medicine to dictate funding priorities; one of PEPFAR’s main failings is that it has caved to ideology in placing an unadvisedly large emphasis on abstinence education.
Frist and his colleagues certainly have a difficult battle against child mortality ahead of them. But Frist—a surgeon, politician, and businessman—has an impressive range of skills and an equally enviable Rolodex of supporters to call upon.
Duff Gillespie of the Johns Hopkins Bloomberg School of Public Health showed that U.S. funding for family planning has been stagnant in real dollars since the late 1960s, despite the fact that there are 200 million women with an unmet need for family planning. Without champions within USAID and the Obama administration, he said, the dollar amounts appropriated for family planning are unlikely to increase.
According to Steven Sinding of the Guttmacher Institute, although most economists and demographers agree that economic growth leads to lower fertility, 
Ruth Levine of the Center for Global Development urged the authors to avoid “preaching to the choir.” One way to engage other constituencies interested in demographic issues is to broaden the scope of “population” to include not only family planning, but also 
