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The Cholera Quandary
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The original version of this article first appeared in the Stimson Center Spotlight series, November 19, 2010.
Cholera is usually seen as one of the most devastating infections of the 19th century. Trade routes carried cholera from India to the great cities of Europe and the United States. Disease, fear, and political unrest spread in great waves that cost millions of lives. After much destruction, it was only with science and resources that certain populations were able to curb the epidemic.One of the most celebrated lessons in the history of public health involves a cholera outbreak in London in 1854 and efforts by John Snow – celebrated as the father of epidemiology – to control it. At the time, it was not clear that cholera was a waterborne bacterial infection that caused severe diarrhea and vomiting, and sometimes fatal dehydration. Snow proved that the outbreaks decimating communities spread from contaminated water. Water and sanitation services had virtually eliminated cholera epidemics in the developed world by the early 1900s.
Today, cholera has been nearly eradicated in the developed world, but continues to be endemic in poorer countries. Risks seem to be rising as larger populations are crowded into unsanitary conditions. The World Health Organization (WHO) estimates three to five million illnesses and 100,000-200,000 deaths from cholera each year. If caught early, infections are treatable with inexpensive oral rehydration solutions. For much of the world, these options are unavailable or underused – the mere presence of cholera serves as an indicator of a country’s socioeconomic status and health system capabilities.
The cholera epidemics that are currently menacing countries on three different continents – Asia, Africa, and North America – raise tough questions about what is required to protect the world’s vulnerable populations. We know how to predict the crisis of cholera, prevent outbreaks, and contain them when they occur. To control cholera, what is needed is not cutting-edge technologies, but will, transparency, and resources – and where cholera appears, at least one of these three factors has failed.
Currently, cholera outbreaks in Pakistan, Haiti, and Nigeria are piling misery upon misery. Cholera in post-flood Pakistan comes as no surprise. When floodwaters left millions homeless and without access to clean drinking water in a region where cholera remains endemic, health officials could have reasonably assumed infected human waste would seep into water supplies and spread disease. The inability of health networks on the ground to prevent and then detect cholera demonstrates cracks in the country’s health system. What is apparent here is a lack of will and resources. Disease surveillance is especially vital in a post-disaster scenario where steps can be taken, such as treating water with chlorine, to prevent an outbreak.
Haiti had been free of cholera for at least 50 years, but the disease struck and spread rapidly 10 months after the devastating January 2010 earthquake. It reached Haiti’s capital and spread to its neighbor, the Dominican Republic. Since October, more than 114,000 people have become ill and more than 2,500 have died (Editor’s note: updated since original publication).
Haiti lacked resources for basic infrastructure even prior to the earthquake; the cholera crisis is not only costing lives, but also diverting aid from “building back better.” But regardless of the source of the cholera strain, if basic infrastructure and resources to protect Haiti’s vulnerable populations had been in place, cholera’s re-emergence would have been far less devastating.
This particular outbreak draws attention to the practical and political challenges of identifying health risks in humanitarian workers and peacekeepers, many of whom come from developing countries themselves. Evidence suggests that peacekeepers from Nepal, housed at a UN base, may have been the source of the outbreak clustered around the Artibonite River. Cholera outbreaks frequently exacerbate frictions between communities and aid workers – suspicions that have led to riots and murder more than once in recent years. At least two people were killed in Haiti in riots with peacekeepers during November.The delayed decision by the UN to investigate whether the outbreak originated with peacekeepers may have conserved resources for the race to stave off more cases, but did little to build trust between communities and foreign workers. Further violence and protests surrounding the recent disputed presidential election in Haiti do little to ease the devastation and in fact, threaten the relief effort. There has been discussion in Congress of cutting direct aid and suspending visas for Haitian officials until the dispute as been resolved. The Organization of American States is now reviewing the results.
In Africa, Nigeria is experiencing its worst cholera outbreak since 1991, and the disease is crossing borders. An onslaught of cases raised the 2010 death toll to more than 1,500 fatalities out of 40,000 cases. This mortality rate is three times higher than the seasonal cholera outbreaks of 2009, and seven times higher than 2008. Despite Nigeria’s oil wealth, most of the population is impoverished. Two-thirds of rural Nigerians lack access to safe drinking water and fewer than 40 percent of people in cholera-affected areas have access to toilet facilities, according to the Nigerian Health Ministry. A combined lack of will, transparency, and resources mean that cholera epidemics occur annually, and in clusters throughout sub-Saharan Africa.
A century and a half after John Snow’s discovery, we know how to control cholera. Globally, the resources exist, but the question of a collective will remains. For those who lack clean water to drink, to wash, or even proper toilets, the gap between knowing and doing is not easily closed. The international community has shown repeatedly that it can confront cholera outbreaks like those in Haiti, Pakistan, and Nigeria in the midst of crisis. The question remains as to how those efforts can eliminate the conditions that fostered outbreaks in the first place. The answer is not as riveting as the causes that often receive funding: basic infrastructure and resources. Roads, wells, clean water, toilets, education, and the willingness to recognize that if the foundation is not sound, nothing will be able to stand. Sometimes the simplest problems are the most difficult to solve.
Sarah Kornblet is a research fellow at the Global Health Security Program at the Stimson Center. Her research focuses on the International Health Regulations, health systems strengthening, global health diplomacy, the intersection of public health and security, and the potential for innovative and dynamic health policy solutions in developing countries.
Sources: Agence France-Presse, BBC, Washington Post, World Health Organization.
Photo Credit: “UN Peacekeepers Provide Security During Port-au-Prince Food Distribution,” courtesy of flickr user United Nations Photo. -
Those Who Would Carry the Water
›December 24, 2010 // By Mark NepoThis article will appear as the introduction in the forthcoming Fetzer Institute and Wilson Center publication, Our Shared Future: Environmental Pathways to Peace, based on an event cosponsored at the Wilson Center in January 2009.
It is fitting to say “welcome,” since this timeless greeting originally meant “come to the well.” Let me try to describe the well we are coming to. We are at once trying to gather the best experience and thinking of current environmental practice, to help advance the issue of water as a resource, and to use environmental work around water as a case study for the lessons and challenges of global community engagement. In convening leading practitioners and thinkers in the field of environmental peace-building and focusing on the ever-present issue of water, we hope to surface the strengths of human resources and how they impact the emerging global community.
In truth, the issues that bring us here have been present in the human condition forever. They are spoken to in every tradition. A few stories will help create a context for our time together.
If we turn to the Hindu tradition, we learn that Saraswati is the goddess of knowledge, music, and the arts. Her name means “the one who flows” and legend has it that she was born of the Saraswati River, which is an invisible river that carries the waters that sustain all life. From the earliest times, in many traditions, the waters that sustain all life refer to both natural resources and human and spiritual resources; actual water and the water we have come to know since the beginning of time as wisdom and love.
In Hindu lore, Saraswati’s ageless counterpart on earth is the serpent-demon, Vritrassura, who is driven to hoard all the Earth’s water. And so the endless struggle begins; at least this is one tradition’s beginning. Thankfully, in the Rig-Veda, the sacred collection of Sanskrit hymns, we are given hope as Saraswati – with help from her brother Ganesh, the provider and remover of obstacles, and Indra, the god who connects all things – kills the demon who would hoard the Earth’s water.
But clearly, throughout the ages, those who would carry the water and those who would hoard the water have appeared again and again and again. This is why we are here. Unspoken or not, unaware or not, we are by care and kinship of the lineage that would carry the water.
If we turn to the Haitian tradition, we find a very telling teaching story called The Chief of the Well. This story speaks of a time of drought when the streams are dry and the wells are parched. There is no place to get water. The animals meet to discuss the situation and decide to ask God for help. God creates a well that will have endless water as long as one of the animals serves as caretaker and welcomes all who would come in need. The lizard Mabouya volunteers. But intoxicated with his newfound power, Mabouya becomes a gatekeeper, not a caretaker, and sends everyone in need away. Eventually, God replaces the lizard with the frog who croaks to all, “Come! This is God’s well! The hole in the ground is yours, but the water belongs to God.” And we are left, in each generation, to discover what is ours and what is God’s, and to understand what turns the caretaker in us to the gatekeeper?
If we can accept our role as caretakers of resources that outlive us, then the history of the acequia might be relevant. An acequia (a-sā’kē-e) is a community-operated waterway used for irrigation. It is the name for a sluiceway or gravity chute that flows down a mountainside, providing water for a village. The Spanish word acequia, which means “ditch or canal,” comes from the Arabic al saqiya, which means “water conduit.” The Islamic occupation of Spain, beginning late in the eighth century, brought this technique of irrigation to Spain.
Acequias were then brought to the Americas by the Spanish, only to find their indigenous counterparts already in use. Particularly in the Andes, northern Mexico, and the modern-day American Southwest, acequias exist as the outgrowth of ancient systems created to carry snow runoff or river water to villages and distant fields. Many South American villages have settled around the mouth of an acequia that begins high and out of sight in the crags of a mountain. There, the source-water collects all winter near the top and, in spring, with the thaw, it streams into the village.
In many of these South American villages, as in Peru for example, there is an annual ritual in which an entire village climbs the acequia in early spring to clear the rocks and tree limbs and snake nests that during the winter have blocked the path of water that the village depends on. This ancient pragmatic ritual of clearing the acequia provides a powerful model for how community can care for its natural resources together.
In fact, keeping the acequia clear and flowing is a useful metaphor for interdependence and cooperation. The life of the acequia and our responsibility to keep its path of flow clear represents a cycle of natural and human erosion and cleansing that is intrinsic to life on earth. Therefore, keeping the acequia clear – both the actual acequia and the acequia of humanity – bears learning how to do well.
With all this in mind, I am drawn to lift up one more story. It comes from Éliane Ubalijoro, a professor at McGill University in Montreal, who as a Rwandan is working with the generation there orphaned by the genocide. After the mass killings, those surviving were confined to refugee camps. In this particular settlement, women had to cross a dark field outside of the camp and risk being raped to get water for their children, which they did repeatedly. This difficult situation points to the complex levels of the issues before us; all of which demand our attention.
First, we might consider access to the water itself. With regard to the conservation and preservation of natural resources, we are asked to solve the perennial question: How do you bring the water to those who need it? At this level, a direct solution might be to move the water supply inside the refugee camp.
Under this, however, we might consider access to the human resources. What is blocking the human acequia? With regard to conflict transformation and peace-building, we are compelled to ask: What are the values implicit in this situation by which the refugee camp guards put the water outside of the camp in the first place in order to create the opportunity to rape the women?
This leads to the work of education, the work of clearing the human acequia. So with regard to the development of social equity, we are now compelled to ask: What are the assumptions and traditions in this community that enable them to believe that exploiting women is not only permissible but entitled? How do we clear the human acequia so that wisdom and compassion can flow?
Finally, we might consider the conservation and preservation of human resources. For at the heart of this insidious atrocity is the resilience and courage and love of these women who went into the dark to get water for their children knowing the violation that awaited them. What kind of deep water is this and how can we insure access to this resource?
This story from Rwanda is one more example that shows how natural resources and human resources are inextricably linked. One central question before us is: How do we tend all levels at once? How do we develop multiple strategies? How do we convene and surface the wisdom of all frames?
Part of our inquiry here is to take our turn in trying to understand how natural resources and human resources are so linked. What blocks their access? What lets them flow together and sustain life? How do we understand the water of humanity and the water of the earth and how both kinds of water are shared or not in the world today?
We could say that knowledge flows like water between countries and communities. If this is so, then each of you is such water. We are here to drink from you and people like you, and to understand the currents that run between us and beneath us; to insure the clear flow of natural and human resources into the world; and to keep the global acequia clear; to embody and to further the art and science of carrying the water in all its forms to those who need it.
Mark Nepo is the author of The Book of Awakening as well as the forthcoming As Far As the Heart Can See.
Photo Credit: Adapted from “The Water Carrier,” courtesy of flickr user Portrait Artist – Enzie Shahmiri. -
‘New Security Beat’ Goes Mobile and a Guide to ECSP Media Sources
›December 22, 2010 // By Schuyler NullThanks to a handy tool from Blogger, The New Security Beat now has a more mobile-optimized version that will load automatically if you visit the site from your phone. The formatting is lighter to ease your strained, possibly cubicle-choked 3G connections, and it is easier to navigate using touch. Alternatively (or just because it’s so cool) you can scan the QR code to the right to load it right up on your Android or iOS-powered device (no guarantees with Blackberry).
The Environmental Change and Security Program has a wealth of media resources available online which we try to make as accessible as possible straight from the blog, but just in case you’ve forgotten, here’s a comprehensive listing:Be sure to also follow ECSP on Facebook and Twitter to see and comment on posts as they roll out on The New Security Beat and keep abreast of the latest population, environment, and security-related news.
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Evidence, Links, and Solutions
Maternal Undernutrition
›“Maternal undernutrition is often overlooked as a strategy for reducing poverty and as a key intervention to reduce maternal mortality and morbidity,” said Mary Ellen Stanton, senior maternal health advisor at the U.S. Agency for International Development. Stanton was joined by Dr. Doyin Oluwole, director of the Africa’s Health in 2010 program, and Amy Webb Girard, assistant professor at the Emory University School of Public Health, in the final meeting of the Advancing Policy Dialogue on Maternal Health series on December 15 where they addressed the linkages between poverty, undernutrition, and poor maternal health outcomes.
The Cycle of Malnutrition and Poverty
Many factors contribute to a woman’s nutritional status, including lack of capital, access to land, and poverty; thus, said Oluwole, “we must adopt a multi-pronged and multi-sectoral response.”“General malnutrition is usually associated with iron-deficiency anemia, which leads to poor cognitive function and educational achievement, poor health, and fatigue.” Oluwole said. “These three factors lead to low worker productivity, and low worker productivity leads to income poverty.”
“All of these aggravate malnutrition and so the vicious cycle of malnutrition and poverty continues,” said Oluwole. To break this cycle, she pointed out that countries like Malawi and Mexico have implemented various multi-sectoral interventions that have “stimulated economic growth; implemented targeted social, health, and nutrition programs; and put in place safety nets.”
“In the window of opportunity during pregnancy and the first two years of life, we can make a big difference,” Oluwole said. She advocated for an “integrated anemia package” that provides anti-malarials, de-worming medicine, iron folic acid tablets, and extra food during pregnancy. She also noted the importance of family planning and targeted high-coverage interventions, such as salt iodization, vitamin A supplementation, and breastfeeding promotion.
In conclusion, Oluwole provided several recommendations for the development community to improve maternal mortality rates and undernutrition of women:
Maternal Undernutrition: Our Global Disgrace- Promote universal primary and secondary education, especially for girls
- Stimulate economic growth with a focus on gender and equity
- Invest in infrastructure to reduce transportation time to hospitals
- Postpone age of marriage and of first pregnancy
- Provide targeted and effective nutrition and health interventions
- Encourage private sector participation and government leadership
- Integrate the maternal health and nutrition communities and services
“We don’t tend to look at maternal nutrition and its impacts on the woman herself,” said Girard. The lack of data on the relationship between nutrition and maternal health outcomes “hampers our ability to move maternal nutrition onto the health and development agenda,” she added.“Anemia is widespread; worldwide, it is a significant public health burden, both in women of reproductive age as well as in pregnant women,” said Girard. Studies have shown that moderate anemia increases risk of hemorrhage and may also increase the risk of sepsis, while severe anemia has been shown to directly contribute to maternal mortality. Targeted interventions can help reduce these risks greatly. “For every one gram per deciliter increase in hemoglobin level, you can reduce maternal mortality by approximately 25 percent, but the mechanisms by which this occurs are not well elucidated,” noted Girard.
“We need to include women not as just targets of nutritional interventions, but as beneficiaries in their own health,” said Girard. Key nutritional interventions such as micronutrient supplementation, fortification, and behavior change communication can help to improve not only fetal, infant, and child health, but can also reduce maternal morbidity and mortality. In addition, Girard recommended the following strategies to achieve greater impact:
Together, these strategies can help improve access to nutrition and health services, as well as adequate food for women throughout their lives. “We need to integrate health and nutrition – they are actually the same pillar, complementing each other,” Girard concluded.- Improve nutrition throughout the life cycle, not just during pregnancy
- Look for alternate strategies for micronutrient delivery
- Integrate maternal nutrition into food security and agricultural strategies
- Collect indicators specific to women’s health impacts
- Recognize and address gender bias
Photo Credit: “Bangladesh mothers, kids,” courtesy of flickr user Bread for the World. -
The Role of Population Dynamics in Climate Adaptation
›December 21, 2010 // By Wilson Center StaffThis post is a synthesis of a panel discussion at the UNFPA Population Dynamics and Climate Change conference in Mexico City with Marcia Castro, of the Harvard School of Public Health; Heather D’Agnes, of USAID; and Lori Hunter, of the University of Colorado at Boulder.
It is well-known that environmental change — including climate change — has important impacts on human health. However, it is less well understood how health systems shape the responses of individuals and households to environmental change. Population dynamics — such as fertility, migration, and mortality and morbidity — influence community health and greatly affect community resilience in the face of environmental changes, including the capacity to adapt to climate change.
Mortality and Morbidity
Morbidity and mortality dramatically shape a household’s ability to adapt its livelihood strategies to a changing climate. For example, in areas of high HIV prevalence, such as sub-Saharan Africa, adult mortality seriously undermines livelihood options. In the face of such loss, the household’s reliance on local natural resources intensifies. If environmental change reduces the amount of available resources, the household has fewer options for energy and sustenance.
Morbidity also affects adaptive capacity, and morbidity itself can be shaped by environmental change. For example, environmental scarcity can increase poverty, which can lead to an increase in risky transactional sex, further fueling the HIV pandemic. Malnutrition resulting from drought and environmental shocks can suppress the immune systems of HIV-positive people, making them more vulnerable to illness and less able to adapt to other external changes.
Fertility and Family Planning
Healthier households are more resilient households, so increasing access to health services, including reproductive health services, is essential for building adaptive capacity. High fertility poses challenges to a family’s livelihood and has negative health effects on women and children. Providing reproductive health services is an effective way to improve the capacity of these vulnerable groups to adapt to climate change. For example, a recent study argues that lowering fertility rates in the Himalayan region could increase community resilience to the predicted fluctuations in water quantity.
However, there is a high level of unmet demand for contraception across the globe. How can community adaptation programs help meet this need? Importantly, research from the Philippines suggests that integrating population, health, and environment programs in a package approach to community development is more effective than single-sector interventions. Including family planning and reproductive health services in community-based climate adaptation programs could not only more effectively meet the community’s needs, but could also improve its adaptive capacity better than health or climate programs alone.
Migration
Another population process, migration, can both impact health and affect the capacity for adaptation. For example, internal migration in the Brazilian Amazon appears associated with the spread of malaria, which negatively impacts the adaptive capacity of households. To mitigate climate change’s health impacts, states should more effectively plan settlements and health systems, including health impact assessments for infrastructure and development projects. (Editor’s Note – northern Nigeria and Niger present another example of similar climate-related migratory patterns that significantly impact health and economic resilience.)
In summary, the scientific evidence is clear that population dynamics — such as mortality, fertility, and migration — and environmental trends are linked. Projects intended to improve a community’s ability to adapt to a changing climate should consider and address these linkages in their design and implementation.
Sources: Foundation for Environmental Conservation, UNFPA, USAID.
Photo Credit: “Toureg family in Niger,” courtesy of flickr user ILRI. -
Emily Gertz, Momentum Magazine
U of M’s ‘Momentum’ on Water Scarcity, Population, and Climate Change
›December 20, 2010 // By Wilson Center StaffExcerpted from the original article, “Water Tight,” by Emily Gertz in the University of Minnesota’s Momentum magazine.
The next time you stop off at a pub for a quick bite, think about this: It took around 630 gallons of water to make your burger. Your pint of beer used around 20 gallons. Manufacturing your blue jeans and t-shirt drank up about 1,218 gallons of water: 505 and 713 gallons, respectively.
Total: nearly 1,900 gallons of water – and that’s without fries on the side.
These quantities are the “water footprint” of each product: the total amount of freshwater used in its manufacture, including producing the ingredients.
For many products, that footprint is Paul Bunyan–sized: With water seemingly cheap and plentiful, there has been little incentive to try to keep it small.
But today, that’s changing. Even though much of the water we use for growing food and making products is replenished by natural hydrological cycles, freshwater will be less reliable and available in the coming century. Population growth is increasing both demand for water and pollution of potable supplies. At the same time, climate change is disrupting historical precipitation patterns, shrinking freshwater sources such as glaciers and snowpack, and creating unprecedented droughts and floods.
According to an analysis published in Nature in September 2010, the freshwater supplies of most of the world’s population are at high risk.
“If you look at the global distribution of people and the global distribution of threat levels to human water security, the places with the highly threatened water security represent about 80 percent of the world population, over four billion people,” says study co-author Peter McIntyre, assistant professor at the University of Wisconsin’s Center for Limnology.
In the United States, a 2010 analysis by the consulting firm Tetra Tech for the Natural Resources Defense Council found that more than 1,100 counties – fully two-thirds of all counties in the lower 48 states – will contend with higher water risk by 2050 due to climate change alone. Fourteen states can expect extremely serious problems with freshwater supply, including Florida, Mississippi, New Mexico, and California.
It’s not surprising, then, that businesses are increasingly considering their corporate water footprint. They encounter water risk – and opportunities to reduce it – at many stages of their operations, from growing crops to running retail stores. Factoring such risks into their present and future planning is helping companies present themselves as good environmental stewards to the public, and potentially reduce risks to their earnings from water scarcity.
“It’s often said that water is going to be the oil of the 21st century, in the sense of becoming an ever-more scarce commodity,” McIntyre says. “In the grand scheme of things, you can live without oil, but you can’t live without water. Water is fundamental for all life. And that’s certainly true for business as well.”
Continue reading on Momentum.
Sources: Natural Resources Defense Council, Nature.
Photo Credit: Adapted from “Lake Hume at 4%,” courtesy of flickr user suburbanbloke. -
Too Few or Too Many? Joel E. Cohen on How Education Can Address Both
›December 17, 2010 // By Wilson Center Staff“So which is it: Is it too many people or is it too few people?” asks Joel E. Cohen of the Rockefeller University in this interview with ECSP. “The truth is, both are real problems, and the fortunate thing is that we have enough information to do much better in addressing both of those problems than we are doing – we may not have silver bullets, but we’re not using the knowledge we have.”
Cohen has studied the population-resources equation, trying to determine how best to support global demographics in a sustainable, equitable way. He points to the cross-cutting power of education to both curb rapid population growth in the developing world and ease the cost of aging populations in the developed.
“On continuing rapid population growth, we know that more education is associated with reductions in fertility,” said Cohen. And when combined with voluntary family planning, it’s also cheap “compared to the costs of having children that are not well cared for – the opportunity costs,” he said.
On aging, “we know that people who are educated well in their youth – both at primary, secondary, and especially tertiary levels – have better health in old age,” said Cohen. “So the costs of an aging population are diminished when people are educated. They take better care of themselves and they have options – they can use their minds as their bodies mature.”
Education is a long-term solution, but shorter-term policy options, like France’s bump of the retirement age to 62 that prompted rioting this fall, will also be necessary. “Sixty-two is only a way station,” Cohen said. “The retirement age has to move up, because people are living longer, they’re more productive, they’re in better health, and they’re going to have to keep working to take care of themselves.” -
Demographic Security Comes to the Hill
›December 16, 2010 // By Hannah Marqusee“We are now in an unprecedented era of demographic divergence,” said Population Action International’s Elizabeth Leahy Madsen at a September briefing held by Congressman John Tierney’s Subcommittee on National Security and Foreign Affairs and Congressman Russ Carnahan’s Subcommittee on International Organizations, Human Rights and Oversight.
Eighty percent of the world’s conflicts occur in places where 60 percent or more of the population is under 30, and 90 percent of countries with young populations have weak governments, said Chairman Tierney in his opening remarks. He said that while such demographic trends “appear to be issues for the future…it is important that we start this dialogue today, so that we can make steps to address [them].” ECSP Director Geoff Dabelko and the Stimson Center’s Richard Cincotta joined Madsen on the panel titled, “The Effects of Demographic Change on Global Security,” at the Capitol Visitor Center.
Youth Bulges and National SecurityThe countries of greatest security threat to the United States are also those with the youngest age structures and rapidly increasing populations, said Madsen. By next year, the world’s population will have reached seven billion, with 95 percent of that growth occurring in the developing world.
Large youthful populations can be a source of national strength because they provide innovation and manpower, said Dabelko, but without significant investment they may also contribute to state instability. When there are often few opportunities to obtain a job or an education for young people, there are low “opportunity costs” to joining a rebel group, said Madsen.
State instability can be affected by youth bulges, shifting religious or ethnic compositions, or food and water insecurity, but age-structural transitions are the strongest indicator of state performance, said Cincotta. Despite conventional wisdom, there is actually little evidence to link state failure with premature adult mortality due to AIDS or a high male-to-female ratio, he added.
It is not only developing countries with high fertility rates that face demographic difficulties, Cincotta noted. Countries such as Japan and Germany will soon have reached a “post-mature” age structure in which their aging populations and comparatively small workforces will tax state institutions and threaten economic stability.
Population Policies: Using “Soft Tools” to Improve National Security
Recently, leaders in the U.S. government have been paying increased attention to the linkages between demography and security through the “three Ds:” diplomacy, development, and defense. In 2008, the National Intelligence Council’s Global Trends 2025 included demographic assessments to analyze security trends, and this year, the National Security Strategy featured demographic trends along with the environment and other non-traditional areas.
Dabelko said that while this growing recognition signals progress, the “hard tools” of the traditional security community must be bolstered with “soft tools” commonly used by the international aid community, such as female empowerment, education, health services and youth employment.
Madsen argued that empowering the 215 million women with an unmet need for family planning worldwide through increased funding for voluntary family planning programs is a cost-effective way to shape population trends and ultimately reduce security threats.
“Demography is not destiny,” said Madsen. “Family planning has been an unsung signature of U.S. foreign assistance for decades.”
Similarly, Cincotta said that policies should help states transition out of youth bulges, and help countries with aging populations reform social institutions to protect older people.
Dabelko added that while progress has been made in acknowledging the linked nature of population trends and national security, there is significant room for improvement. Pointing to the successes of integrated population, health, and environment (PHE) programs, which provide environmental conservation and family planning services simultaneously, he called for similar programs to address population dynamics and conflict prevention. Long-term solutions call for coordinated resources and integrated strategies, he said.
Read the speakers’ full remarks: Chairman John F. Tierney, Richard Cincotta, Geoff Dabelko, and Elizabeth Leahy Madson (slides).
Sources: Guttmacher Institute, Population Action International, National Intelligence Council.
Image Credits: “World Age Structure 2005” and “Risk of Civil Conflict by Age Structure Type, 1970-2007,” courtesy of Population Action International.
A Publication of the Stimson Center.
