"We have not found any country that has developed or gotten out of poverty while maintaining high birth rates," said Martha Campbell, president of Venture Strategies for Health and Development. "Family planning is not a cost to a Ministry of Finance – it's an investment," said Malcolm Potts of the University of California Berkeley.

Campbell and Potts were joined by panelists Eliya Msiyaphazi Zulu, director and founder of the African Institute for Development Policy, Jotham Musinguzi, director of the African Region at Partners in Population and Development, for a Woodrow Wilson Center discussion of the implications of rapid population growth on human and economic development.

Africa's Key Population Growth Challenges

"Africa's population of one billion can reach between 1.8 and 2.3 billion by 2050, depending on how well the continent actually does in reducing fertility," Zulu said. In 2010, Africa accounted for 15 percent of the total world population, but current estimates suggest this will grow to 23 percent by 2050.

"Rapid growth, young age structures, and urbanization are Africa's main population challenges," said Zulu. "Addressing these concerns is increasingly seen to be the key to the continent's development prospects and realization of the Millennium Development Goals." With 40 to 50 percent of populations in Africa under the age of 15, there is "high momentum for further population growth," he said.

"Africa has a very high demand for fertility control, and the demand will undoubtedly increase," said Zulu. "The main challenge, therefore, is not that of demand, but how to ensure those who are in need actually have access to contraception." In many African regions, current rates of contraception use are as low as seven percent. In some areas, as many as 97 percent of women cannot afford the full cost of contraception, he said.

"It's not just about reducing fertility," said Zulu. Improving education and increasing labor force opportunities will not only help populations develop economically, but will also allow African countries to take full advantage of the demographic dividend, he said.

"The international development community should build on Africa's success stories and support efforts to achieve universal access to family planning, expand public education on reproductive matters, improve the status of women, and improve the situation in urban settings," Zulu concluded.

Family Planning and the MDGs

"Women are dying; children are dying. They shouldn't be," said Musinguzi. "By investing US$1 million in family planning, you can prevent 800 maternal deaths, 11,000 infant deaths, 14,000 deaths in children under five, and 360,000 unwanted pregnancies."

"Women are clearly saying they have a need for family planning," Musinguzi said. Presenting statistics from sub-Saharan Africa, he noted that 31 countries have a total fertility rate of more than five. Fourteen million unintended pregnancies occur each year, but only 25 percent of women use family planning. In Uganda, for example, the population has more than doubled in less than 20 years; women on average have more than six children each; and only 18 percent of married women use modern contraception.

"For a country trying to achieve the MDGs…the question of addressing total fertility rate is very important," said Musinguzi. Reducing unmet need for family planning services can help African countries reduce the costs of achieving several of the Millennium Development Goals, including offering universal primary education; reducing child mortality; improving maternal health; combating HIV/AIDS, malaria, and other diseases; and ensuring environmental sustainability.

Policy Implications

"This is an urgent message – waiting 10 years to get family planning back on the international agenda will be enormously costly," said Potts. "Of all the medical interventions that exist, contraception is the single most powerful. It is the only one that can have an impact on maternal and infant mortality, on the autonomy of women, on economic progress, on social stability and the rate at which we destroy the environment," he said.

"Education and family planning are the driving mechanisms of development – they're synergistic," said Potts. "One of our needs is to get economists, family planning, and development experts on the same page."

Drafted by Ramona Godbole and edited by Schuyler Null and Meaghan Parker.