the current state of world population: a north-south contrast

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The current state of worldpopulation: A North-South contrastMakoto AtohPublished online: 17 Jun 2010.

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The current state of worldpopulation: A North-Southcontrast

MAKOTO ATOH*

ISSN 1343–9006 print; 1469–2937 online/00/020121–15Carfax Publishing, Taylor and Francis Ltd. http//www.tandf.co.uk/© 2000 Institute for International Policy Studies http://www.iips.org/DOI: 10.1080/1343900002001313 0

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Asia-Pacific Review, Vol. 7, No. 2, 2000

World population trendsExplosive growth tapering off?The twentieth century can be broadly described as an era of technological progressand economic growth on the one hand, and an era of population growth on theother. The world population started to grow at a faster rate around the middle of theeighteenth century, climbing from 950 million in 1800 to 1.65 billion in 1900. Inthe first half of the twentieth century, the annual rate climbed to about 1 percent,bringing the world population to 2.52 billion in 1950.1

The rate of population growth in the first half of the twentieth century, however,was merely a prelude to what was in store for the second half. World populationgrowth soared to an annual rate of 1.76 percent in 1950–1955, then continued torise until it reached a peak of 2.04 percent in 1965–1970 as is shown in Figure 1.2

It was at this time that this explosive growth came to be viewed with a strongersense of impending crisis.3 In the 1950s and 1960s, this served as a catalyst for thegovernments and nongovernmental organizations (NGOs) of industrialized nationsto extend population aid to developing countries. It also led to the establishment ofthe United Nations Population Fund (UNFPA) and the prompt initiation of its

While the world population continues to demonstrate explosive growth as a whole,the current state of population in developing regions, the so-called “South,” is insharp contrast with that of industrialized regions, the so-called “North.” TheSouth has a disproportionately high proportion of child population, as well ashigh overall population growth rates. Most governments in these areas have soughtfertility decline to around the replacement level through family planning programs.The North is characterized by continuous population aging and will facepopulation decline. In order to cope with stagnant low fertility, some governmentshave sought to raise fertility to around the replacement level by strengtheningfamily policies. In this paper, Professor Makoto Atoh, Director General at theNational Institute of Population and Social Security Research, Tokyo, contraststhe populations of the North and South and recommends possible policy optionsfor the governments of developed countries, especially Japan.

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122 ASIA-PACIFIC REVIEW u NOVEMBER 2000

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The current state of world populations: A North-South contrast

123ASIA-PACIFIC REVIEW u VOLUME 7, NUMBER 2

activities in 1969.In the 1970s, world population growth began to decelerate, with the slowdown

in the rate of growth in China (which accounted for one-fifth of the world population)reaching a rate of 1.33 percent in 1995–2000. Despite this deceleration, the sheermagnitude of the population meant that by the 1970s the margin of increase hadcontinued to rise until it peaked at an annual average of 86 million in 1985–1990.While there was a downward trend after this period, this margin still stands at 78million in 1995–2000.

Since 1987—a period of only 12 years—the world population has risen from 5billion to 6 billion. It has, however, shown a clear deceleration in recent years. It isinteresting to note that the United Nations Population Division and other researchfacilities have continued to make downward revisions in each new projection forthe world population since 1990. In 1990, for example, the UN projected that theworld population would grow to 10 billion by 2050;4 but in 1998, it projected afigure of only 8.9 billion. This is because the world’s fertility rate has decreased onthe whole, while the mortality rate has shown a slower decline or even risen insome regions—both factors that are beyond the previous expectations of populationexperts.

Population explosion and global systemsAccording to the most recent UN projections, the world population will reach 7.82billion in 2025 and 9.50 billion in 2100.5 The question is whether or not this increaseis possible given the various limitations on global systems; that is, whether or not itis compatible with humankind’s common goal of “sustainable development.”6

The Club of Rome’s The Limits to Growth (1972) projected that if the populationand economic growth rates of the 1960s were to continue, humankind would befaced with several new predicaments. There would be massive resource depletionand environmental pollution, leading to the collapse of economic systems, a dropin food production, and a decline in living standards, which would cause catastrophicpopulation decline due to a sharp increase in the death rate.7 In its more recentpublication Beyond the Limits (1992), The Club of Rome projected that the worldpopulation would be static at 7.7 billion and global systems would stabilize if percapita industrial production in 1995 was maintained at South Korea’s 1990 level;resource conservation and anti-pollution technology were applied worldwide; andthe global fertility rate was lowered to replacement level—a total fertility rate (TFR)of approximately 2.1.8

For the world as a whole, the current TFR average is 2.7 (3.0 overall fordeveloping regions). Can this be brought into line with the replacement level in thenear future? This depends on several factors, including:

1. Whether many developing countries can achieve the kind of dramatic fertilitytransition seen in Japan in the 1950s and in China during the 1970s and 1980s;

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2. Whether fertility in China (currently with a TFR of 1.8) will dip substantiallylower than the replacement level; and/or

3. Whether fertility in India (currently with a TFR of 3.1) will rapidly approachthe replacement level.

If any of these conditions cannot be fulfilled, will humankind in fact face thekind of catastrophe projected by the pessimists9 for the twenty-first century—thatpopulation decline will be due to a rapid rise in mortality?

Population trends in developing regionsRegional disparitiesThe rapid growth of the world population following World War II occurred primarilyin the developing countries. The annual population growth rate in these regions—at 2.04 percent in 1950–1955—had already surpassed the historical high ofapproximately 1.5 percent in the industrialized regions and reached a peak of 2.53percent in 1965–1970 due to a sharp drop in post-war mortality. The rate of growthbegan to slow after the 1970s and dropped to 1.59 percent in 1995–2000. Thepopulation growth rate in developing regions continued to outstrip the growth rateof the industrialized regions, and the developing regions expanded their share ofthe world’s population from 67.8 percent in 1950 to 80.4 percent in 2000.

In the first half of the 1950s, the annual population growth rate in the developingregions was fastest in Latin America (2.7 percent), where mortality had alreadyrapidly declined, followed by Africa (2.2 percent) and Asia (1.9 percent). This rateof increase, however, began to slow down from the 1960s in Latin America andfrom the 1970s in Asia, dropping to 1.6 percent and 1.4 percent respectively in1995–2000. In Africa, where there was also a rise in fertility for a period followingWorld War II, the population growth rate is still 2.4 percent in 1995–2000, althoughit has declined since the 1970s when it reached what was probably the highest rateof growth in the history of humankind at 2.8 percent.

The current character of population growth in the three main developing regionscan be summarized as follows. The African population has sustained high fertility:it has a low crude death rate due to the young population (even though gains in lifeexpectancy are stagnant), which has resulted in an extremely high population growthrate. As a consequence, the African share of the world population is projected toincrease from 12.7 percent at present to 19.8 percent by 2050. Asia includes countrieswith huge populations and it already accounts for some 60 percent of the worldpopulation. These trends indicate that even if the rate of population growth decreases,the scale of population growth will remain large. In Latin America, the populationdensity is low and the population growth rate is on the decline, but the extent ofurbanization is on a level comparable with the industrialized regions.10

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Key to fertility transition in developing regionsFertility decline in developing regionsOne reason world population growth has slowed more than expected in recent yearsis that the TFR has decreased across all developing regions.11 The TFR for thedeveloping regions as a whole has decreased from 6.2 in 1950–1955 to 3.0 in 1995–2000, as shown in Figure 2.

In 1950–1955, there was little difference in the fertility rate among the threedeveloping regions—the TFR ranged between 5.9 and 6.6. The moderate declinein Latin American TFR that had begun in the 1960s was in the final stage of fertilitytransition with a TFR of 2.7 in 1995–2000.

Asia as a whole saw its fertility rate begin to decline from the 1970s and wassimilarly in the final stage of fertility transition with a TFR of 2.6 in 1995–2000.Within the region, however, while East Asia (including China) has already completedthe transition (TFR of 1.8) and Southeast Asia is currently in the final stage (TFRof 2.7), South Asia (including India) and West Asia are still only at the intermediatestage (TFRs of 3.4 and 3.8, respectively) .

Africa taken as a whole is in the initial stage of fertility transition with a TFRof 5.1 in 1995–2000. There are wide disparities within the region, however, withNorthern and Southern Africa at the intermediate stage while Eastern, Western andCentral Africa are still at the initial stage.

What are the determinants of fertility transition?The key to stabilizing the world population is to achieve fertility transition fromhigh fertility to low fertility in the developing regions. What are the determinantsthat will trigger such a transition?

The first determinant is the modernization of society that inevitablyaccompanies economic development. Economic growth promotes industrializatio nand urbanization, lower infant mortality rates, higher educational levels, moreopportunities for social advancement and a higher ratio of employees to employers.This presumably encourages later marriage, creates an incentive for fewer childrenand lowers the fertility rate.12 In fact, many of the countries that have alreadycompleted or reached the final stage of fertility transition have undergone economicdevelopment at the same time. This has been the case in the newly industrializedeconomies (NIEs) of Asia, some Southeast Asian countries, Mexico and Brazil.

The second determinant is social development, which includes the eradicationof poverty, the dissemination of primary health care and primary education,improvement of nutrition and the advancement of women.13 While these socialchanges are attainable through economic development, considerable advances canbe made even at a low level of economic development if effective social policiesare in place. The drop in fertility in China, Sri Lanka, Cuba and Bangladesh, forexample, can be attributed in part to social development policy efforts.

The third determinant, family planning programs, have now been adopted by

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83 percent of developing countries.14 These programs provide information andservices on modern contraception to individuals seeking birth control, although insome countries there is forced compliance or the use of economic incentives/disincentives. 15 Every country that has completed or is in the process of completingfertility transition has had a family planning program supported either directly orindirectly by the government. The effect of these programs in facilitating fertilitytransition is indisputable .16

The fourth determinant is the role played by values. In promoting familyplanning programs, governments typically send strong messages to their citizensthrough the media about the desirability of small families and/or the importance ofadequate spacing between births. Regardless of whether or not these messagesfundamentally change family values, it is clear that they do play a role in “justifying”the activities of those who choose birth control. In some countries, such as Indonesiaand Iran, governments will sometimes turn to a major religion, which plays a centralrole in society, to justify and facilitate acceptance of their messages.17

Population control or reproductive healthAs noted above, when the growth rate of the world population peaked during the1960s and the population explosion started to be viewed with a stronger sense ofimpending crisis, many industrialized nations began to extend population assistanceto developing countries and UNFPA support activities were first implemented. Thebasic strategy behind population assistance at that time was to set population orfertility targets and control population growth through government-funded familyplanning programs in order to promote economic development in the developingregions. This thinking was clearly reflected in debate at the United Nations WorldPopulation Conference in Bucharest in 1974. At the time, many developing countriesin Africa and Latin America were adamantly opposed to the policy of populationcontrol on the grounds that “development was the best contraceptive.” Nevertheless,the World Population Plan of Action adopted almost unanimously at the conferencesuggested the need for governments to set population or fertility targets and controlpopulation growth.18

When the United Nations International Conference on Population was held inMexico 10 years later, the rate of economic growth had fallen below the populationgrowth rate in many developing countries due to the impact of the global recessiontriggered by the oil crisis. This brought a sense of impending crisis about populationgrowth, and as a consequence many developing countries finally adopted familyplanning programs.

In 1994, the United Nations International Conference on Population andDevelopment that was held in Cairo brought about a Copernican revolution in termsof the basic strategy toward international population assistance. The Programme ofAction adopted at the Cairo conference introduced the concepts of reproductivehealth and reproductive rights, emphasizing the rights of women and couples to

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make free and responsible decisions regarding pregnancy and childbirth. Thisreplaced the existing concept of government-promoted family planning aimed atpopulation control. As a result, family planning came to be recognized as a centralpart of reproductive health and reproductive rights.19 The switch to this newpopulation strategy could be related to decelerating population growth in the worldin general, or developing regions in particular, as well as to the influential lobbyingefforts of women’s groups throughout the world. It may also be related to the factthat the countries facing the most serious population issues today are those in sub-Saharan Africa and South-Central Asia, where the social and economic status ofwomen is low, and women’s rights to make decisions about childbirth are weak.20

AIDS and the African populationAnother reason world population growth has slowed more than expected is thatsome regions have demonstrated a slowing decline in the mortality rate; in somecases, there has even been a rise. This trend is evident in Central and Eastern Europeand the former Soviet Union, especially among men.21 It began prior to thechangeover of political and economic structures and was probably due in large partto stress stemming from the totalitarian regime. There were major consequencesfrom the changeover, including a deterioration in the standard of living, a declinein medical care and health services, and an increase in stress due to the upheaval insocioeconomic systems. The average life expectancy (men and women combined)in Central and Eastern Europe was 68.5 years in 1995–2000, compared with 69.2years in Latin America.

The slowing decline or rise in the mortality rate in sub-Saharan Africa willhave an even greater impact on the world population than in countries of the formerSoviet Union and in Central and Eastern Europe. The main cause is the spread ofAcquired Immune Deficiency Syndrome (AIDS). In 1998, the total number of peopleinfected with human immunodeficiency virus (HIV) had reached 33.4 millionworldwide, of which 5.8 million were newly infected. Sub-Saharan Africa accountedfor 22.5 million and 4 million of these cases, repectively.22 In the 29 countries ofsub-Saharan Africa, where AIDS has had its greatest impact, the current averagelife expectancy (men and women combined) is 47 years, which is estimated to beabout seven years shorter than it would have been without AIDS.23

The population growth rate in these countries is also very different than itwould have been without AIDS-related deaths. In Botswana, for example, where itis estimated that one out of every four people is infected with HIV, the populationgrowth rate was 1.4 percent in 1995–2000. Without AIDS-related deaths, it is estima-ted that the population would have grown by 2.5 percent. In 1994, the UN estimatedthat the population of Africa would reach 2.14 billion and thereby account for 21.8percent of the world population by 2050.24 In 1998, it revised these figures to 1.77billion and 19.8 percent respectively, primarily as a result of factoring in the impactof AIDS, a misfortune that came fully to light after the earlier figures were released.

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Population trends in industrialized regionsAging and shrinking of the populationThe population in developing regions, which continues to rise, is young. In theyear 2000, children under 15 years of age will make up 32.5 percent of the totalpopulation in developing regions (44.2 percent in sub-Saharan Africa). Thepopulation in industrialized regions, by contrast, is aging as shown in Figure 3. Thepopulation has been aging in most industrialized regions since the beginning of thetwentieth century, and in the year 2000 people aged 65 years or older will accountfor 14.4 percent of the total population in industrialized regions. In some countries,the proportion will be as high as 18 percent; children under 15 years of age, however,will constitute only 18.2 percent of the total. This aging will continue into thetwenty-first century: by 2025 the proportion of people aged 65 years or older isprojected to account for 20.9 percent of the total, rising to 25.9 percent by 2050. Incountries expected to show the most rapid aging, such as Italy and Japan, thatproportion will likely exceed 30 percent by 2050.

The aging of population is the result of demographic transition. If a countrysucceeds in curbing population growth through low birth and death rates, it naturallyages. Accordingly, the countries in developing regions that have succeeded indemographic transition (for example, China and Asian NIEs) will also experiencerapid aging in the twenty-first century. In some of today’s industrialized countries,however, there is a kind of previously unforeseeable “hyper-aging” due tounprecedented longevity and long-term below-replacement fertility. At the sametime, negative natural increase of population is expected to continue over the longterm.

The principal socioeconomic issue in these hyper-aging societies is the questionof how the declining working-age population will support the burgeoning elderlypopulation. In Japan, one of the world’s most rapidly aging nations, the ageddependency ratio, that is, the ratio of the elderly population (65 years or older) tothe working population (15–64 years), is projected to increase 2.8-fold from 20.9percent of the population in 1995 to 59.1 percent in 2050.25 In developing regions,the expansion of services (for example, health and education) required to copewith the increasing number of children is expected to hinder economic growth andprevent improvement in living standards. In industrialized regions in the twenty-first century, there is the question of whether limitations in the labor force supplyand the expansion of social security services for the increasing number of elderlywill be a drag on economic growth and lead to a lower standard of living.26

Longer lives, fewer childrenFrom the beginning of the nineteenth century to the middle of the twentieth century,many industrialized regions experienced an epidemiological transition from a highdeath rate (short life expectancy at birth), when infectious diseases were the principalcause of death, to a low death rate (long life expectancy at birth), when degenerative

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diseases (cancer as well as circulatory organ diseases) were the principal cause ofdeath.27 After this period of transition, life expectancy at birth began to showrelatively stagnant growth. In the 1970s, however, degenerative diseases started toshow a delayed onset, with a noticeable shift from the middle/elderly age group tothe elderly age group. The life expectancy for the middle-aged and the elderlycontinues to lengthen due to this trend.28 This extension of life expectancy for themiddle-aged is one of the factors contributing to population aging in industrializedcountries, and it is particularly notable in Japan. Public health and demographicresearchers have shown great interest in the question of what the limit is for lifeexpectancy in the industrialized world.29 There is also growing interest in the“productive aging”30 of the elderly in an aging society, as well as in the “healthylife expectancy” of the elderly in light of the noticeable increase in the number ofelderly with disabilities .

Decline in fertility to below replacement levelThe fertility rate in most industrialized nations has continued to fall below thereplacement level (well below in some countries) since the 1970s. Demographictransition theory, which has served as the theoretical guideline for many populationresearchers, supposes that once the death rate and birth rate have stopped fallingfrom high to low levels, they will come into balance, the rate of natural increase ofpopulation will reach zero and the population will stabilize. However, the declineof the fertility rate below the replacement level that has already lasted a quarter ofa century in many industrialized countries has begun to undermine the predictionsof this theory.

Some argue that the industrialized nations (at least those of Western Europe)have entered a second demographic transition.31 According to this argument, theindustrialized nations that have completed their first demographic transition willshift to a state in which the crude birthrate constantly falls short of the crude deathrate and negative natural increase of population will continue. In the first stage ofdemographic transition, the positive natural increase served as an emigration pressureand international migration showed a net outflow trend. In the second demographictransition, however, it is argued that the negative natural increase of populationwill serve as an immigration pressure and that international migration will shift toa net inflow.

Is fertility recovery possible in industrialized regions?Declining fertility rates below the replacement level in the industrialized world aredue to a complex mixture of factors. In Western European countries, these factorsare said to include:

1. A reduction in “unwanted births” due to the spread of modern contraceptivemethods and the legalization of abortion;

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2. Widespread prosperity accompanied by the secularization of values and greateremphasis on self-fulfillment;

3. Rising opportunity costs for having children accompanying the higher educationof women and increase in their work opportunities; and

4. A declining net balance of costs to benefits to parents of having children, dueto the trend toward higher levels of education, an increased proportion ofemployees in the workforce and the development of social security systems.32

At the same time, there are large regional differences among industrializednations in terms of TFRs. The Northern European countries, “Anglo-Saxon”countries and France all have TFRs closer to the replacement level (TFR between1.7–2.1); while Southern European countries, German-speaking countries and Japanall maintain TFRs that are well below the replacement level (TFR between 1.1–1.5).

Comparing these two groups of industrialized countries in the 1990s, it is evidentthat in the former there is generally less disparity between men and women interms of education (with women having a higher level of education in some cases);a higher population of women in the workforce; greater participation by men inhousework; higher prevalence of cohabitation and children born out of wedlock;and a higher utilization of female contraceptive methods and abortion.33 The statisticssuggest that women in the higher fertility group gained more economic and socialpower than those in the lower fertility group and in this respect the former grouphas come to be a more gender egalitarian society than the latter.

It is well-known that in the higher fertility group, the Nordic Countries havebeen strengthening their family policies (especially year-long parental-leave withhigh income compensation, and the public nursery system) since the late 1970swith the aim of achieving a gender-equal society. In the “Anglo-Saxon” countries,although there have not been any explicitly family policies, the supply of privatenursery services are relatively abundant and the opportunity cost of childbearingand childcare is relatively cheap due to the flexibility of the labor market. In contrast,among the lower fertility group, the traditional value systems (such as machismoin Southern Europe and Confucianism in Asia) that support the idea of gender-segregation and a division of labor based on gender are strong enough to hinder thetransition toward gender equality.

The comparison of the two groups of industrialized countries suggests that,while fertility decline below the replacement level is caused mainly by the increaseof women’s socioeconomic participation in an employee-centered society, it maybe possible to maintain fertility at around the replacement level if societies canbecome more gender-egalitarian.

ConclusionPopulation issues in the “South” are in sharp contrast with those in the “North.”

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While people in the former suffer from rapid population growth and the rejuvenationof population accompanying high fertility; in the latter, people are worried abouthyper-aging and population decline with low fertility. In order to deal with populationissues, developing countries need to strive to promote economic and socialdevelopment, and reproductive health programs including family planning. But inorder for the efforts of these developing countries to succeed, the internationalcommunity must provide assistance. As a member of the international community,and with the second largest economy in the world, Japan has an obligation to increaseits international contributions to population-related projects to a degree thatcorresponds with its gross national product (GNP).34 As a guideline for populationassistance, respect for reproductive rights—the principal ideal which was advocatedin the Programme of Action adopted at the Cairo conference—is essential.Dissemination of family planning resources and prevention and treatment of HIV/AIDS should also be included in broader reproductive health services.

On the other hand, population issues in developed regions are not as acute asthe problems faced in developing regions, but they do seem to be more difficult todeal with. This is because fertility decline is at least partly an inevitable result ofeconomic and social development and because the socioeconomic consequencesof low fertility are very long-term and indirect in nature. In addition, governmentsin the developed world find it politically difficult to justify pro-natal policies sincelow fertility is regarded as a consequence of rational choices being made in ademocratic society. In order to deal with low fertility, governments of developedcountries, including Japan, should promote policies conducive to increasing thecompatibility of work and family life, including implementing policies which lessenthe economic burden of childcare for parents, while respecting the principle ofreproductive rights. Faced with the advent of a hyper-aging and depopulating society,these governments should also implement measures to support the employment ofthe elderly; construct sustainable social security systems; and revise immigrationlaws so that necessary foreign labor can be accepted.

Notes* This paper was originally presented at the conference “Population Problems: Recent

Developments and their Impact,” hosted by the Institute for International Policy Studies,Tokyo, 7–9 December 1999.

1. United Nations, The World at Six Billion, (New York: United Nations, 1999).2. United Nations, World Population Prospects: 1998 Revision, Vol. 1, (New York: United

Nations, 1999). All further figures on population are derived from this source unlessspecified.

3. Paul R. Ehrlich, Population Bomb, (New York: Ballantine Books, 1968); Ansley J.Coale, et al., Population Growth and Economic Development in Low-income Countries:A Case Study of India’s Prospects, (Princeton N.J.: Princeton University Press, 1958).

4. United Nations, Long-Range Population Projections, Two Centuries of Population

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Growth, (New York: United Nations, 1992).5. United Nations, Long-Range Population Projections: Based on the 1998 Revision,

(New York, United Nations, 1999).6. Gro H. Brundtland, Our Common Future: World Commission on Environment and

Development , (Oxford: Oxford University Press, 1987). In this report, “sustainabledevelopment” is defined as “development that meets the needs of today’s generationwithout sacrificing the capacity to meet the needs of future generations.”

7. D. H. Meadows, et al., The Limits to Growth: A Report for the Club of Rome’s Projecton the Predicament of Mankind, (New York: Universe Books, 1972).

8. D. H. Meadows, et al., Beyond the Limits, (Post Mills, Vermont: Chelsea Green, 1992).9. UNFPA, Population Growth and Economic Development, (New York: UNFPA, 1993);

Geoffrey McNicoll, “On Population Growth and Revisionism,” Population andDevelopment Review, 21–2, 1995, pp. 307–340. In contrast to the well-known orthodoxMalthusian views expressed by the Club of Rome, P. Ehrlich and L. Brown, there arealso the optimistic views of J. Simon, A. C. Kelley and other so-called “revisionists.”

10. United Nations, World Urbanization Prospects: 1996 Revision, (New York: UnitedNations, 1998). While the urbanization rate in 1995 was 75 percent for industrializedregions as a whole, it was 73 percent for Latin America, 35 percent for Africa and 33percent for Asia.

11. John Cleland, “A Regional Review of Fertility Trends in Developing Countries: 1960to 1995,” in The Future Population of the World, ed. Wolfgang Lutz, (rev. ed.), (London:Earthscan Press, 1996), pp. 47–72.

12. Richard Easterlin, The Fertility Revolution: A Supply-Demand Analysis, (Chicago:University of California Press, 1985); and R. A. Bulatao, et al., eds., Determinants ofFertility in Developing Countries, Vols. 1 and 2, (New York: Academic Press, 1983).

13. United Nations, Report on The World Social Situation 1993, (New York: United Nations1993). Even within the same country, there is a tendency for regions with more advancedsocial development (for example, Kerala State in India) to see an earlier drop in fertilitythan other regions.

14. United Nations, World Population Monitoring 1996: Selected Aspects of ReproductiveRights and Reproductive Health, (New York: United Nations, 1998). If we includegovernments that support family planning programs indirectly, this figure reaches 90percent.

15. Bernard Berelson,“Beyond Family Planning,” Science Vol. 163, 1969, pp. 533–543.Berelson groups such cases under the all-inclusive phrase “beyond family planning.”Examples include forced compliance in India under the Gandhi administration in 1976and the use of economic incentives and disincentives in China and Singapore.

16. W. Parker Mauldin, et al., “Family Planning Programs: Efforts and Results, 1982–89,” Studies in Family Planning, 22–6, 1991, pp. 350–367.

17. The World Bank, Population and the World Bank: Implications from Eight Case Studies,(Washington, D.C.: The World Bank, 1992) (regarding Indonesia); and A. Aghajanian,“Family Planning and Contraceptive Use in Iran, 1967–1992,” International FamilyPlanning Perspectives, 20–2, 1994, pp. 66–69 (regarding Iran).

18. Stanley P. Johnson, World Population—Turning the Tide: Three Decades of Progress,(London: Graham & Trotman, 1994), (regarding the first and second UN-sponsoredpopulation conferences among governments).

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International Conference on Population and Development, Cairo, 5–13 September1994, (New York: United Nations, 1995).

20. United Nations, World Population Monitoring, 2000: Population, Gender andDevelopment, (New York: United Nations, 2000) (draft report presented at the 33rdsession of the Commission on Population and Development).

21. M. Bobak, “Health and Mortality Trends in Countries with Economies in Transition,”in Population Division, United Nations, Health and Mortality Issues of Global Concern,(New York: United Nations, 1999), proceedings of the United Nations Symposium onHealth and Mortality (Brussels, 19–22 November 1997), pp. 203–226; EvgueniAndreev, “The Dynamics of Mortality in the Russian Federation,” in Ibid, pp. 262–290.

22. UNAIDS, AIDS Epidemic Update: December 1998, (Geneva: UNAIDS, 1998).23. See n 1.24. United Nations, World Population Prospects: 1994 Revision, Vol. 1. (New York: United

Nations, 1995).25. National Institute of Population and Social Security Research, Population Projections

for Japan: 1995–2050 as of January 1997, (Tokyo: NIPSSR, 1997).26. Ministry of Trade and Industry, ed., Structural Renovation of Japanese Economy,

(Tokyo: Toyo Keizai, 1997).27. Abdel R. Omran, “The Epidemiologic Transition: A Theory of the Epidemiology of

Population Change,” Milbank Memorial Fund Quarterly, 49–4, 1971, pp. 509–538.28. S. Jay Olshansky, and A. Brian Ault, “The Fourth Stage of the Epidemiological

Transition: The Age of Delayed Degenerative Diseases,” Milbank Memorial FundQuarterly, 64–3, 1986, pp. 355–391.

29. K. G. Manton, et al., “Limits to Human Life Expectancy: Evidence, Prospects, andImplications,” Population and Development Review, 17–4, 1991, pp. 603–637.

30. R. Butler, (translated by Yuzo Okamoto), Productive Aging: Elderly Open the Way tothe Future, (Tokyo: Nihon Hyoron Sha, 1998).

31. Dirk J. Van de Kaa, “The Second Demographic Transition,” Population Bulletin, 42–1, (Washington D.C.: The Population Reference Bureau, 1987); Dirk J. Van de Kaar,“Europe and its Population: The Long View,” in European Population Conference,European Population: Unity in Diversity, (Dordrecht Kluwer Academic Publishers,1999), pp. 1–50.

32. Makoto Atoh, ed., Population Issues in Industrialized Nations: Below ReplacementFertility and Family Policy, (Tokyo: Tokyo University Press, 1996).

33. Makoto Atoh, “The Declining Fertility Issue from a Demographic Perspective,” MentalHealth, (Tokyo: Mental Health Society of Japan, 1996) 11–2, pp. 2–16.

34. Shanti R. Conly, et al., Paying Their Fair Share?: Donor Countries and InternationalPopulation Assistance, (Washington D.C.: Population Action International, 1998).Japanese population assistance in 1996 was the fifth largest among developed countriesin terms of its absolute amount but fifteenth in terms of its ratio to GNP.

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the current state of world population: a north-south contrast

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