Karl Hofmann: Demography can be a key to progress with the right policy environment in place, but it can also be a burden when we don’t have the right framework in place to take advantage of growing populations. Some have described this as the demographic dividend – growing populations as a potent driver of economic growth and development. Give us your perspective on that.

Babatunde Osotimehin: I spoke at the 17th African Union Summit this year and one of my messages was that we have the opportunity right now to take advantage of the demographic dividend of young people. It’s important for African governments to understand that they have a youthful population. Most of Africa is under the age of 35. If 85 percent of the African population is under 35, the implication is that you have to have education, social services, housing, all of that, tailored to meet the needs of this population.

Beyond that, given what we’ve seen with the Arab spring uprising and others in many parts of the developing world, young people who are out of work want education and economic opportunities. We want to appeal to member states to provide skills appropriate to development and also ensure that we have continuing conversations with young people about their reproductive health and rights so they can make the choices that will ensure they plan for their families.

KH: There are lots of conversations going on in global health circles these days around the synergy of integration. From your perspective, what are the barriers to this integration?

BO: I think it’s bipolar. Some countries are satisfied with vertical programs. Others are resistant to changing their system at the request of a donor. One argument for integration is that you can have the one-stop shop situation where one, two, three trained providers can deliver services at the same time. These include integration of HIV counseling, testing and treatment with family planning, with health education for non-communicable diseases, with immunization for children or with maternity services.

When you look at the components of an integrated system, it is very easy to sell. In terms of investment, it makes sense for the governments to build and put this together. The supervision becomes a lot easier, and the training of health workers would then capture all of the skill sets that would be required. Some countries, like India, Ethiopia and Nigeria have started this kind of integration.