81. The challenges of global reproductive health

Abstract

The latest UN estimates of growth rates of global population in the next 150 years point to a decrease, no doubt due in part to the increase in contraceptive prevalence and to socioeconomic development in many countries. Using the medium fertility scenario of two children per family, total world population should level out at about 10 billion by 2050. Compare this to a population of 27 billion by 2150 if the fertility rate rises to 2.5–2.6 per family. However, the estimates are uneven and there is more to the demographic challenge than total population numbers. It is important to consider the reproductive health of individuals and populations. The proportion of adolescents and people over 60 years will increase, requiring special consideration of their reproductive health needs. It is estimated that over 120 million couples do not have access to safe and effective methods of family planning. The burden of maternal and perinatal ill-health remains persistently high in many developing countries, with maternal deaths that could be avoided in excess of 500,000 per annum. It is estimated that 340 million new cases of sexually transmitted infections occur annually and are disproportionately found in adolescents and in developing countries. Many of these STIs are curable, but not in the case of HIV/AIDS, of which there are over 15000 new cases a day. Much of this burden falls on women and children in developing countries. The International Conference on Population and Development held in 1994 articulated a comprehensive approach to population and development including poverty alleviation, provision of health care and education, and preservation of the environment. Its emphasis on gender equality and equity and on meeting individual reproductive health needs remains as pertinent today as it was in 1994.