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CGD in the News

May 23, 2011

Room for 10 Billion (New York Times)

Rachel Nugent authored a piece on population growth and family planning for the New York Times.

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People have been talking about threat of the population bomb facing the world since the dawn of the Industrial Age. Malthus’s long shadow has loomed over many issues: too many mouths to feed; too much pressure on scarce water resources; densely populated urban settlements producing scary new pathogens that would sweep through populations like the choleric rats of yore and kill us.

Yet, I didn’t duck and cover when I heard the United Nations’s latest report (more like an admission, really) that it was wrong about the world’s population leveling off at 9 billion by 2050. Instead, global population will keep growing until around 2100 and level off around 10 billion.

Even if I don’t lose sleep worrying about when the population bomb is going to hit us, some do worry, and they are likely unhappy with the news from the United Nations that fertility has not dropped as fast as expected in Africa and South Asia. There is no denying that the global environment is already suffering in many ways, some believe as much as if not more from excess consumption than from population totals.

In releasing the report, Hania Zlotnik, the U.N. population division director, said about fast-growing African countries: “If they don’t achieve the lower level of fertility we are projecting, they could have serious problems.”

What happened on my way to the future is that I stopped worrying about figurative bombs and realized that it’s individuals — how they are born, live and die — that determine whether resources are wisely used, whether children are healthy at birth or whether the spread of disease is minimized. A population number doesn’t tell us that.

Fertility and mortality are part of population change, but as David Canning, a demographic economist at Harvard University likes to say, “they have very different effects.” Reducing both is desirable in most developing countries, yet slowing down fertility reduces population, while slowing down mortality increases it.

Demographers have been saying for years that the United Nations was too optimistic in its assumptions about how long it would take for many countries and some states in India (which are just as populous as many countries) to reach replacement level fertility rates, which is when a couple has only enough children to replace themselves. In some places like Kenya, Nigeria and Chad, the decline in fertility rates has stalled, or is being reversed.

The new U.N. projections acknowledge as much. They assume a global fertility rate of about 2.17 in 2050, whereas the earlier projection assumed a global rate very close to replacement level at 2.02 in 2050. This small difference per person translates into 156 million more people in 2050 than earlier projected.

Now that we are likely to see a faster and longer rise in global population, we can focus our efforts on preventing the many little bomblets that explode when fertility and mortality are too high.

There is now very good evidence about how to reduce fertility and create better and healthier lives for women and children. From research in Bangladesh and Ghana, we’ve learned that a comprehensive reproductive health, child health and family planning programs delivered to people’s doorsteps can reduce women’s overall fertility by one child. And the economic, environmental, and social benefits are powerful. In Bangladesh, this meant 40 percent higher earnings for women and 25 percent more assets in the family. It led to families having more access to clean water and to children staying in school longer.

Good programs and policies — such as what my friend Jotham Musinguzi works on in Uganda to allow trained community health workers to administer injectable contraceptives to rural women — can reduce fertility in high population growth countries. This means fewer women with anemia and fewer low-birth weight babies. Those same programs and policies can also reduce childhood and maternal mortality. Even though one of those changes lowers the population and the other increases it, together they produce an incredible win-win that is not evident in the population growth numbers. Maybe it’s best described as the choice between “quality versus quantity” that demographers talk about. Let’s make that the easy choice and the projections will follow.

This article was also published in:

Saati, Georgia; Delo, Slovenia; Der Standard, Austria; Eleftherotypia, Greece; El País, Spain; La Repubblica, Italy; Le Figaro, France; The Observer, U.K.; Poslovni Dnevnik, Croatia; România Libera, Romania; Sabah, Turkey; Süddeutsche Zeitung, Germany; Tages-Anzeiger, Switzerland; Clarín, Argentina; El Espectador, Colombia; Folha de Sao Paulo, Brazil; Grupo Reforma, Mexico; La Prensa, Panama; La Prensa Gráfica, El Salvador; La Razón, Bolivia; La Segunda, Chile; El Observador, Uruguay; Listin Diario, Dominican Republic; Prensa Libre, Guatemala; El Diario de Yucatan, Mexico; El Nuevo Diario, Nicaragua; Trinidad Express, Trinidad; Folha de Sao Paulo, Brazil; Grupo Reforma, Mexico; La Prensa, Panama; La Prensa Gráfica, El Salvador; La Razón, Bolivia; La Segunda, Chile; El Observador, Uruguay; Listin Diario, Dominican Republic; Prensa Libre, Guatemala; El Diario de Yucatan, Mexico; El Nuevo Diario, Nicaragua; Trinidad Express, Trinidad; Manila Bulletin, Philippines; The Asian Age, India; Today, Singapore; United Daily News, Taiwan; The Korea Times; Toronto Star, Canada

May 3, 2011

U.N. Forecasts 10.1 Billion People by Century’s End

Rachel Nugent was quoted in a New York Times piece on world population and family planning.

From the Article

The population of the world, long expected to stabilize just above nine billion in the middle of the century, will instead keep growing and may hit 10.1 billion by the year 2100, the United Nations projected in a report released Tuesday morning.

Growth in Africa remains so high that the population there could more than triple in this century, rising from today’s one billion to 3.6 billion, the report said — a sobering forecast for a continent already struggling to provide food and water for its people.

The new report comes just ahead of a demographic milestone, with the world population expected to pass 7 billion in late October, only a dozen years after it surpassed 6 billion. Demographers called the new projections a reminder that a problem that helped define global politics in the 20th century, the population explosion, is far from solved in the 21st.

Read the Article

December 7, 2010

U.S. Must Reorient Global Health Strategy (CNN)

CNN opinion referenced a CGD report on noncommunicable diseases by deputy director of global health Rachel Nugent.

From the article:

Every year, according to the World Health Organization, noncommunicable diseases such as cardiovascular disease, cancer, diabetes and chronic obstructive lung disease claim 35 million lives worldwide.

These diseases are the world's leading cause of disability and death, amounting to about 60 percent of the global death toll. Cancer alone kills more than HIV/AIDS, malaria and tuberculosis combined. The vast majority of these largely preventable deaths happen in low- and middle-income countries -- the areas often least prepared to mount a fight against this deadly epidemic.

In addition to their human toll, these diseases wreak havoc on family budgets and national economies. According to a report by the American Cancer Society and Livestrong, just two of these diseases -- cancer and heart disease -- cost more than $1.6 trillion in losses from premature death and disability in 2008. That number may be double when you include direct medical costs.

Despite these alarming facts, programs to address noncommunicable diseases and invest in health system infrastructure receive little funding. According to a report released recently by the Center for Global Development, in 2007, noncommunicable diseases received less than 3 percent of the development assistance devoted to global health.

Read the article.

August 19, 2010

Report: Cancer Is the World's Costliest Disease (Associated Press)

The Associated Press cites deputy director of global health Rachel Nugent on the impact of chronic diseases.

From the article:

Cancer is the world's top "economic killer" as well as its likely leading cause of death, the American Cancer Society contends in a new report it will present at a global cancer conference in China this week.

Cancer costs more in productivity and lost life than AIDS, malaria, the flu and other diseases that spread person-to-person, the report concludes.

Chronic diseases including cancer, heart disease and diabetes account for more than 60 percent of deaths worldwide but less than 3 percent of public and private funding for global health, said Rachel Nugent of the Center for Global Development, a Washington-based policy research group.

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June 21, 2010

Media Coverage of CGD's Drug Resistance Report Launch

On Tuesday, June 15, 2010 the Center for Global Development hosted the launch event of The Race Against Drug Resistance at the National Press Club. Representative Jim Matheson (D-Utah), Member, House Energy and Commerce Subcommittee on Health provided opening remarks. The event featured a presentation by Rachel Nugent, Chair, Drug Resistance Working Group and Deputy Director, Global Health, Center for Global Development and a film screening of The Race Against Drug Resistance by Back to Earth Films.

Read media coverage from the launch event

March 22, 2010

Cardiovascular Ills Could Hurt Economic Development (Reuters)

Reuters quoted deputy director, global health Rachel Nugent on rising cardiovascular disease rates in developing nations.

From the article:

"The IOM report emphasizes the role of health in economic development, said Rachel Nugent of the Center for Global Development in Washington, who worked on the report.

"The evidence that we have examined shows that CVD reduces productivity and, over the long run, threatens the economic growth potential of low- and middle-income countries," Nugent said."

Read the article

February 8, 2010

Bad Malaria Pills in Africa Raise Resistance Fears (Associated Press)

The Associated Press quoted CGD deputy director of global health Rachel Nugent on drug restitence.

From the article:

""I am alarmed by these results because it means there are many cases of malaria that are being only partially treated, and that just guarantees acceleration of artemisinin drug resistance," said Rachel Nugent, deputy director for Global Health at the Center for Global Development, a U.S. think tank. "It is the most comprehensive study out there on antimalarials and should be a wake-up call."

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September 5, 2009

Non-communicable Diseases and the Paris Declaration (The Lancet)

The Lancet published a letter to the editor by Rachel Nugent on non-communicable diseases.

From the article:

"Nirmala Ravishankar and colleagues (June 20, p 2087)1 present the results of a formidable undertaking: to collect, analyse, and track donor assistance for health for almost two decades. Although the researchers recognise and acknowledge shortcomings in their data analysis, more worrisome is that it took a monumental effort by an experienced and well connected team to complete work that should be readily available. One reason for this is that the global health architecture now includes a patchwork of private donors and foundations."

Read the article (subscription required)

June 20, 2009

An Assessment of Interactions between Global Health Initiatives and Country Health Systems (Lancet)

The Lancet quotes CGD deputy director, global health Rachel Nugent on ways to strengthen global health programs.

From the article:

"The Bank is not alone in facing these controversies; tensions between programmes for health-system strengthening and specific diseases have been running for some time. “The IEG report is important in giving the global health and donor communities an opportunity to air some views and have a debate that was heretofore behind the scenes”, says Rachel Nugent, deputy director for global health for the Center for Global Development, Washington DC, USA. “Now, the question is how to change that performance?” First, “the Bank should set transparent goals for the HNP portfolio and engage with stakeholders in discussion about whether it is reaching those goals”, she says."

Read the article (subscription required)

May 23, 2009

World Bank Health Projects Get Mixed Review (Lancet)

The Lancet quotes CGD deputy director, global health Rachel Nugent on the World Bank's health projects.

From the article:

"The Bank is not alone in facing these controversies; tensions between programmes for health-system strengthening and specific diseases have been running for some time. “The IEG report is important in giving the global health and donor communities an opportunity to air some views and have a debate that was heretofore behind the scenes”, says Rachel Nugent, deputy director for global health for the Center for Global Development, Washington DC, USA. “Now, the question is how to change that performance?” First, “the Bank should set transparent goals for the HNP portfolio and engage with stakeholders in discussion about whether it is reaching those goals”, she says. ... HNP strategy is now focused on synergy between health-system strengthening and projects for specific diseases. Nugent notes that much material is already available on “what works and what doesn’t” for global health improvements. It is time, she says, to follow basic principles on “clarity, conduct, and coherence”."

Read the article (PDF)

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