Population and Development: the 1994 Cairo Conference

Curt Tarnoff
Specialist in International Relations
Foreign Affairs and National Defense Division
94-533 F
Updated August 25, 1994

SUMMARY

On September 5-13, 1994, the United Nations will hold an International Conference on Population and Development in Cairo, Egypt. Representatives from more than 170 countries will review and approve a World Population Plan of Action, adopting recommendations for the next decade. One of its chief goals is to stabilize world population.

The long-planned conference will consider several issues that are both fundamental and controversial, including sexual and reproductive health and rights, the role of women's status, health, and education in limiting population growth, and funding of population programs. International population issues have long engendered interest and some controversy in Congress, particularly in the context of foreign assistance legislation. The Cairo Conference is likely to focus renewed attention on a number of concerns, including U.S. support for access to abortion services.

BACKGROUND

The Problem of International Population Growth. Current world population is estimated at 5.5 billion. According to the draft final document for the Cairo Conference, it took 123 years for the world's population to increase from 1 to 2 billion, but each succeeding increment of 1 billion people has taken 33 years, 14 years, and 13 years. The transition from 5 billion to 6 billion is expected to take 11 years and will be completed in 1998.

The effect of this growth is most profound in developing regions where the bulk of the increase is occurring. (For example, the population of Arab countries is expected to double by natural increase in 25-30 years, whereas that of Western Europe will double in 200 years.) Among other things, rapid population growth exacerbates environmental damage, urban over-crowding, maternal and infant mortality, high rates of illiteracy, preferential treatment of males, pressures on migration within and between nations. and food crises in many less developed countries (LDCs).

To mitigate such problems, the main aim of the U.N. Conference is to draw up a plan of action to stabilize the world's population at 7.27 billion in the year 2015. At current rates of growth, failure to do so will mean a projected 12.5 billion people by 2050.

Bucharest and Mexico City. The Cairo Conference will be the third major intergovernmental meeting on population to set policy goals and make recommendations. The first was held in Bucharest in 1974, the second in Mexico City in 1984. Two earlier conferences - in Rome in 1954 and Belgrade in 1965 were only technical, statistics-focused, meetings.

The Bucharest Conference resulted in approval of a Population Plan of Action. It contained a set of goals, including specific targets for increased life expectancy and reduced infant mortality. Numerous general recommendations were also made on a wide spectrum of population-related subjects, including migration, family, education, health, data collection, socioeconomic policies, and other concerns. For example, the Plan of Action encouraged education for girls, suggested that marriages should be entered into only by free consent of spouses, and proposed that migrant workers be provided proper treatment and adequate social welfare services. Ten years after the Bucharest Conference, in Mexico City, governments approved 88 new recommendations for the "further implementation" of the World Population Plan of Action based on a review of progress up to that time and a reappraisal of goals and objectives.

The Cairo Conference continues this process, assessing progress and encouraging governments to adopt agreed-on policies. Unlike Mexico City, however, the Cairo Plan of Action is intended to be a free-standing document, emphasizing actions and the means to accomplish them. Nonetheless, there is no enforcement mechanism involved, simply an evolving set of international standards and guidelines. The conference process itself will place much international attention on the population issue. In the short run, the media of every nation will focus on the issue. In the long run, it is expected that governments and NGOs (non-governmental organizations, of which more than 500 have participated in the process) will use the forum's recommendations to promote their agendas.

Cairo Preparations and Agenda. The Conference Secretary-General is Nafis Sadik, head of the U.N. Population Fund (UNFPA). Its deputy is Shunichi Inoue, Director of the Population Division for the Department of Economic and Social Development in the U.N. Secretariat. Since 1991, when the U.N. Economic and Social Council approved a resolution authorizing the Cairo Conference, groundwork for the conference has been laid by a number of national activities and international meetings and conferences.

More than 100 governments have formed National Committees, often composed of both government and non-government representatives. These groups prepared a National Report on Population that each country was invited to submit. The National Committees also organize seminars and other events to increase public awareness of the issues.

Regional population conferences were held in Indonesia (August 1992), Senegal (December 1992), Switzerland (March 1993), Jordan (April 1993), and Mexico (April-May 1993). Expert group meetings were held in 1992 and 1993 to provide the scientific basis for recommendations of the conference. Finally, three preparatory committee (PrepCom) meetings were held in 1991, 1993 and 1994 by participating governments to thrash out the basic language of the final documents to be approved at the conference. Remaining disagreements will be resolved in Cairo.

Six broad groups of issues are to be discussed at the conference: population growth and demographic structure, including aging and regional diversity; population policies and programs, including the mobilization of resources; population, environment, and development; population distribution and migration; population and women, including adolescent motherhood, maternal and child health, education, and employment; and family planning, health, and family well-being.

MAJOR ISSUES

As the Cairo Conference nears and a draft of the new Population Plan of Action is fashioned, many have expressed surprise at the broad level of agreement reached on many issues, particularly on the role of women. According to one U.S. official, only 10 percent of the draft language is under contention, compared to 90 percent just prior to the Mexico City conference. However, one area of controversy, in particular, remained unresolved following the third and final PrepCom held in New York in April - issues concerning sexual and reproductive health and rights. The protracted debate on this subject, in the view of many, prevented more comprehensive discussion of other substantive issues - international migration, follow-up mechanisms to the plan of action, and others - that might have led to stronger language in the draft document.

Nevertheless, the version of the Plan of Action that will be taken up in Cairo exhibits many important features. It represents a change of emphasis from previous international approaches - from a family planning orientation to one focused on the broader questions of reproductive health. It integrates population concerns into the general context of the development process. And, as discussed below, it emphasizes the role of women in finding solutions to the problems of population.

Women's Health and Education. Perhaps the most significant departure from previous population conferences is the emphasis placed on women's status and the importance of women in the broader context of sustainable development. A number of women delegates to the Third PrepCom expressed the belief that, with the empowerment of women, a solution to the population problem will follow naturally. The Plan of Action contains extensive language on the empowerment of women, including the need for expanded education, elimination of discrimination and violence against women, and need to encourage grass-roots and activist groups for women. It focuses as well on girls, urging the prohibition of female genital mutilation, and prevention of infanticide, prenatal sex selection, and trafficking in girl prostitution. It calls for universal primary education of girls. Achievement of this goal by the year 2015, however, was left open for discussion at Cairo at the request of the European Union. The document also emphasizes men's shared responsibility and the need to promote their active involvement in responsible parenthood.

Sexual and Reproductive Health and Rights. By far the most controversial issue expected to be taken up at the Cairo Conference is language in the Plan of Action addressing aspects of sexual and reproductive rights and health. According to the draft Plan of Action, the full range of family planning methods is unavailable to at least 350 million couples worldwide; survey data suggests that roughly 120 million more women would be using a modern method if it were easily available. The Plan calls for universal access to a full range of safe and reliable family planning methods.

The stage for confrontation was set at the April 1994 PrepCom in New York where a coalition led by Vatican City consistently opposed references in the action program to access to safe abortion, voluntary choice in family planning, the use of condoms to prevent the spread of AIDS, and sexual and reproductive health services for adolescents. What many believed to be a consensus favoring a more health-oriented approach to sexual and reproductive issues became enmeshed in discussions on definitions of terms, such as "reproductive and sexual health", "safe motherhood", and "family planning". The Vatican, supported by Guatemala, Ecuador, Argentina, Malta, Costa Rica, Honduras, and others, ensured that much of this language remained tentative - bracketed in the draft Plan - and, therefore, subject to debate at Cairo.

Two examples from the PrepCom illustrate the kinds of discussions likely to be heard in September. One issue in dispute is the need for counseling and services for adolescents who are sexually active. In the highly disputed chapter on family planning, some argued that a reference to "individuals and couples" should be replaced with "men and women" because the former might include adolescents. Similarly, a reference to the provision of reproductive health care to individuals "of all ages" was disputed by Honduras and Morocco because it might include adolescents.

Another issue is abortion, particularly unsafe abortion. According to Dr. Sadik, "the draft Program of Action does not advocate or promote abortion, let alone abortion on demand. What it does advocate is that all Governments, intergovernmental and non-government organizations deal openly and forthrightly with unsafe abortion as a major public health concern for women. It also makes it explicitly clear that women should have access to services for the management of complications arising from unsafe abortions. The Program of Action suggests the need for abortion should be reduced by providing family planning programs, as is the case in a growing number of countries."

In the chapter regarding health issues, the Vatican and its supporters, Honduras and Malta in particular, argued that references to "safe motherhood" should be bracketed because the term could be construed to include safe abortion. While the Vatican insisted on a written assurance that the term does not include abortion, Dr. Sadik, supported by a reportedly passionate plea from India and Nepal, argued that safe motherhood means protecting the health of women. The final draft document contains two alternative paragraphs dealing specifically with unsafe abortion (chap. 8, para. 25) that will be debated in Cairo. To slightly differing degrees, both discourage abortion, but appear to defend the right to information, counseling, and choice where it is legal.

Neither alternative is likely to gain the support of the Vatican, which, since the PrepCom ended, has campaigned vehemently against the conference document. It has sought support for its views from the developing world by accusing the West of "biological colonialism" in promoting family planning programs and has sought allies in the fundamentalist Islamic nations of Libya and Iran. Compromise appears unlikely. Discussing a conference that seeks to stabilize the world's population, Pope John Paul II has said that he opposes "all propaganda and misinformation directed at persuading couples that they must limit their family to one or two children." Although seemingly at odds with a majority of the world's nations, the Vatican appears determined to pursue its course at the Cairo Conference.

Funding. Finding sufficient resources to support the objectives and goals of the Population Action Plan is problematic and, as is often the case in international conferences and treaty discussions, is a cause of some tension between countries of the industrial "North" and the developing world of the "South".

According to the draft document, meeting unmet needs for family planning information and services would cost an estimated $10.2 billion in the year 2000. Assuming that recipient countries could cover two-thirds of the costs - an assumption developing countries question - donor resource requirements would be an estimated $4.4 billion in that year. This compares to present annual allocations for population programs estimated at $6 billion, including only $1 to $1.2 billion from the international donor community. Less than 1.4 percent of official development assistance (ODA, economic assistance provided for development purposes on concessional terms) has been directed in recent years to population programs. Some have called for this assistance to increase to at least four percent.

At the New York PrepCom, proposed amounts for increased assistance were left in brackets as was a proposal that donors and recipients both devote at least 20 percent of ODA and domestic spending, respectively, to social sectors. A suggestion by India and China that donors adopt favorable macroeconomic policies for promoting sustained economic development in developing countries was also bracketed. Despite these disagreements, the pending conference has already had a positive effect on promised donor contributions for population activities. Earlier in the year, the Administration proposed a $75 million increase in U.S. population assistance, to $585 million for next year, and hoped to provide significantly more by the year 2000.(1) The Japanese have announced an increase in their contribution from $40 million to $3 billion over seven years, roughly $400 million a year. The European Union doubled its contribution. Others are expected to follow suit.

CONGRESSIONAL ACTION AND U.S. POSITION

Members of Congress have shown interest in deliberations leading up to the Cairo Conference and a number are expected to participate in the U.S. delegation. H.Con.Res. 234 (Morella), introduced on March 24, 1994, expresses the sense of the Congress recommending giving the Cairo Conference high priority through the participation of the President, supporting the financing of efforts to slow population growth, establishing a process of regular high-level consultations on the issues, and supporting programs of maternal and child health, education for women, and voluntary family planning.

The Administration appears to be giving the conference high priority. At the PrepComs, the U.S. delegation played a leading role in formulating the Plan of Action. Vice President Gore is expected to lead the U.S. delegation at Cairo. President Clinton himself asserted in June that "In Cairo, the United States will ... join the international community in launching new high-quality, voluntary family planning and reproductive health programs. Our goal is to make these programs available to every citizen of the world by early in the next century."

Influential U.S. policy statements leading up to and throughout the third PrepCom have emphasized U.S. support for assuring family planning and reproductive health services, improving the status of women, resource mobilization, and access to safe abortion. The abortion position has attracted substantial opposition by American anti-abortion activists. The press has characterizedthe United States as a prime force at the New York PrepCom supporting access to abortion services, a position in sharp contrast to the strongly anti-abortion U.S. stance during the previous international population conference in Mexico City. The current U.S. position is, in the words of State Department Undersecretary for Global Affairs Tim Wirth, that "abortion should be safe legal, and rare." The State Department argues that because as many as half; the 50-60 million abortions performed worldwide each year are considered unsafe and a quarter of maternal deaths are caused by unsafe abortion, many delegations believed that the problem of unsafe abortions should be addressed. The United States, they say, is attempting to address these issues as a matter of public health, not as a means of population control.

Endnote

1. The United States has long been the leader among donor nations in population assistance. For more on this subject, see CRS Issue Brief 85187, International Population and Family Planning Programs: Issues for Congress (Updated Regularly).