Policy Implications

Though probably inclined to accept the positive economic effects that fertility decline and slower population growth can have in the long run, revisionists seem relatively confident that the majority of developing economies will manage to adjust to larger and denser populations. Their confidence is highest for parts of South Asia and Latin America where countries are enjoying economic recovery (following recession in the 1980s) amidst promising democratic reforms, market liberalization and declining fertility. The outlook is quite different for the poorest countries, particularly those in sub-Saharan Africa, where high fertility continues to raise economic concerns. Still heavily dependent on domestic natural resources and agricultural output and short on foreign exchange, many countries--such as Pakistan and Haiti,⁶¹ as well as many in sub-Saharan Africa⁶²--are experiencing rapid depletion and degradation of freshwater supplies, arable land and forests. Even if resource depletion ended, the already low per capita availability of natural resources in some of these countries are projected to shrink to between one-half and one-third of their present levels by 2050 as a result of population growth.

That said, most revisionists do not consider expansion of access to family planning a substitute for either direct investments or policy reforms in each economic sector.⁶³ Rather, these economists tend to see investments in family planning as complementary to institutional strengthening and an important health intervention. Moreover, the quality of institutions has much to do with the outcomes of population programs and policies in developing countries.

Where adaptive institutions are in place--as in parts of Asia and increasingly in Latin America--a growing number of economists recognize opportunities for positive demographic-economic feedbacks. Conversely where institutions are weak, revisionists expect few of the benefits of fertility decline to be reflected any time soon in national economic statistics. Historical evidence suggests that fertility decline requires a sound institutional framework to boost economic growth over the short run. However, establishment of effective family planning programs in the poorest countries has long-term economic implications. Here too, the Asian example offers lessons. Establishing the foundations for eventual economically significant fertility decline--organizing reproductive health services, disseminating information, and overcoming obstacles to access--takes several decades.

This was the case for East and Southeast Asia where investments in family planning made as early as the 1950s and 1960s proved essential. Once services were established, however, remarkable progress in fertility decline occurred in a single generation. When developing countries of East and Southeast Asia began investing in family planning, in the early 1960s, their own fertility rates (excluding Japan¹s) were comparable to today's averages in sub-Saharan Africa.⁶⁴ In 1960, average levels of human development in East and Southeast Asia (using the UN's Human Development Index) were considerably below those estimated for sub-Saharan Africa⁶⁵ today--demonstrating, at least, that the presence of poverty and weak institutions need not impede the early introduction of family planning service programs.