In January, the U.S. Agency for International Development released its long-awaited climate change strategy. Climate Change & Development: Clean Resilient Growth provides a blueprint for addressing climate change through development assistance programs and operations. In addition to objectives around mitigation and adaptation, the strategy also outlines a third objective: improving overall operational integration.

The original version of this article, by Michael Kugelman, appeared on Foreign Policy’s AfPak Channel.

Pakistan’s 2011 census kicked off in April, but less than three months later, it is embroiled in controversy. Several members of the Sindh Census Monitoring Committee have rejected as “seriously flawed” the recently completed household count. They allege that census workers, directed by an unspecified “ethnic group,” have counted Karachi’s “inns, washrooms, and even electric poles” as households in an effort to dilute the city’s native “Sindhi” presence.

Between 1994 and 2007, India reduced its carbon dioxide emissions by 35 percent. As a result, the country’s emissions per capita now register at just over a ton per year – less than China (nearly five tons) and much less than the United States (18 tons). On May 10, Wilson Center Public Policy Scholar Ajay Shankardiscussed how India made these reductions, and what the nation plans to do to bring them down further in the decades ahead.

“Health and Health-Care Systems in Southeast Asia: Diversity and Transitions,” launches a series in The Lancet on health in Southeast Asia. While social, political, and economic development have paved the way for substantial health improvements in some countries, demographic transitions are taking place at among the fastest rates in the world, including reductions in fertility, population aging, and rural-to-urban migration. An epidemiological shift is occurring as well, from infectious to chronic diseases. Rapid urbanization and population movement can not only affect the emergence and spread of new infectious diseases directly, but can also exacerbate environmental changes that indirectly contribute to the burden of waterborne and vector-borne diseases. The series, available early online, addresses these concerns in more detail. Moving forward, the authors advocate for “enhanced regional cooperation in the health sector to share knowledge and rationalize health systems operations, leading to further public health gains for the region’s diverse populations.”

“The whole push for population control or to stabilize populations in Africa in the ’70s and the ’80s mostly came out of the West,” said Eliya Zulu of the African Institute for Development Policy (AFIDEP) in this interview with ECSP. Then new research brought to light the fact that many women in Africa actually wanted to control their fertility themselves, but they didn’t have access to family planning.

“It kind of put the African leaders who really didn’t want to talk anything about fertility control and so on in a fix,” Zulu said. “Because all of sudden now it was the African women themselves who are saying we need these services – it was not an imposition from the West.”

Celebrating World Health Day, the World Health Organization, with its partners around the globe, today launched an initiative for healthly lives in urban settings, through the theme “1000 Cities, 1000 Lives.” “We are at a critical turning point in history where we can make a difference,” said Dr Ala Alwan, assistant director-general for noncommunicable diseases and mental health.

Since the first World Health Day 60 years ago, the world has seen a dramatic rural exodus. Today, more people live in urban areas than anywhere else. Providing healthy livelihoods for the urban poor is a challenge, as poverty-stricken urban centers face a number of health obstacles, from high child mortality rates, environmental pollution, and widespread disease, to a lack of access to basic water, sanitation, and health care.

“In general, urban populations are better off than their rural counterparts,” said WHO Director-General Margaret Chan. “They tend to have greater access to social and health services and their life expectancy is longer. But cities can also concentrate threats to health such as inadequate sanitation and refuse collection, pollution, road traffic accidents, outbreaks of infectious diseases and also unhealthy lifestyles.”

The 1000 Cities campaign hopes to encourage all cities to promote healthy activities during the week following World Health Day (4/7-4/11). Through a new website, the WHO is collecting profiles and pictures in an easy-to-navigate map. Notable activities include HIV/AIDS-awareness flashmobs, skateboarding and cycling competitions, car-free days, outdoor sports events, and dance performances,  in cities as diverse as Mandalgobi, Mongolia; Bangalore, India; and Luanda, Angola.

The Wilson Center’s Environmental Change and Security Program and its Comparative Urban Studies Program have collaborated on urbanization events and publications that examine the strong and critical connections between healthy urban populations and environmental sustainability.

With proper attention paid to delivering population, health, and environmental services in our urban centers, it may be possible to leverage the benefits of higher urban densities—such as lower aid dispersion costs, communication access, infrastructure services, and fertile environments for ideas and productivity—to ensure urban sustainability for the future.

“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 Support

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 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.