Asia And The Pacific A Region In Transition

Abstract

Extending from the Islamic Republic of Iran from the fringes of West Asia to the myriad islands of the South Pacific, the region of Asia and the Pacific is home to the majority of the world’s people – over 3.7 billion or roughly 60 per cent of the total. The present world population of 6.1 billion is projected to surpass 9.3 billion by 2050. Of the ten most populous countries, six are in Asia – China, India, Indonesia, Pakistan, Bangladesh and Japan. Five of these countries (excluding Japan) will account for 45 per cent of this growth: India (21 per cent), China (12 per cent), Pakistan (5 per cent), Bangladesh (4 per cent) and Indonesia (3 per cent). In the past two decades, the Asian economies have shown a rapid decline in average population growth rates, which at 1.3 per cent today is the lowest among developing nations and closely approximates the world average of 1.2 per cent. Yet, Asia still accounts for almost half the world’s annual population increase because of the already existing huge population base. Though wide regional variations persist in the demography of the region, significant progress has been achieved in the social sector, particularly reproductive health (RH), over the last decade. Better medical facilities and improvements in health and nutrition have resulted in declines in fertility and mortality rates. Life expectancy has improved markedly in the region, averaging over 65 years in most parts. Fertility levels have dropped throughout the region, with notable reductions in China, Democratic People’s Republic of Korea, Thailand, Sri Lanka and Republic of Korea, where due to effective population policies, total fertility levels are now below the world average of 2.68. Consequently, population is growing at one per cent or even lower in these countries. The reverse scenario is evident in some other countries of the region. Women in Afghanistan, Bhutan, Pakistan, Cambodia, Lao PDR and Nepal continue to bear more than 4 children on an average. In all these countries population is increasing at a rate exceeding 2 per cent. Even though significant progress has been achieved in reducing infant, child and maternal mortality, many countries like Afghanistan, India, Bhutan, East Timor, Nepal, Cambodia, Lao PDR continue to have maternal mortality ratios exceeding 400 per 100,000 live births and likewise infant and under five mortality rates are very high. Persisting inequities in gender and wealth distribution are serious deterrents to social and economic development. A vast majority of the people in the region continue to face serious deprivation and live in extreme poverty on $2 a day or less, lacking basic sanitation, clean water, and adequate housing. There are well over 600 million illiterate adults in Asia alone, with many countries having illiteracy rates of 40 per cent or more, women being clearly the more disadvantaged. The continuing high population growth rates in some countries are further neutralizing economic gains. Most of the countries of East and Southeast Asia are still on their recovery path from the financial crisis of 1997, albeit at a slow pace. As a result, many countries have concentrated on the management of the macro-economic and financial sectors; with the result the social crisis still remains a matter of concern. In the Pacific region, the young age-structure of the Pacific Island countries underscores the importance of responding to the RH needs of adolescents. However, the delivery of development assistance in the Pacific is made more difficult by the diseconomies of scale, with small populations scattered over a necklace of volcanic islands and coral atolls. Since population growth is seen as a serious threat to sustained economic development, many Asian economies developed population strategies and adopted government supported family planning (FP) programmes decades ago. Countries like India, Malaysia, the Philippines, Singapore and Thailand were among the first to provide integrated health services, including FP. To increase widespread availability of modern contraceptives, community-based distribution projects run by local volunteers were started, particularly in rural areas and urban squatter settlements. The contraceptives were distributed free or at greatly subsidized prices. The results were impressive. Contraceptive use soared in Asia. Several countries succeeded in bringing total fertility levels down significantly. Notable among them were China, DPRK, Iran, Republic of Korea, Thailand, Viet Nam, Indonesia, Malaysia, India, Sri Lanka and Bangladesh. The success of the FP programme can be attributed to: early recognition of population-related problems; political commitment; lack of strong imbedded religious obstacles to FP; existence of an appropriate health care infrastructure; and the influx of substantial international technical and financial assistance. Asian governments are struggling to come to terms with rapid urbanization, which is posing a serious threat to the surrounding environment leading to high levels of water and air pollution, land degradation and increasingly stressing the already weak social, health, housing and sanitation services in urban areas. The region has majority of the world’s most populous cities, where huge numbers live on the edge of survival in overcrowded slums, squatter settlements or on the streets. Apart from high volumes of rural-urban migration, there is substantial intra-regional migration as well that is causing concern to governments. Most economies of the region continue to grapple with high levels of poverty, low levels of literacy, gender inequalities and gender-based violence. However, the next biggest threat to the Asian and Pacific region is the rising incidence of HIV/AIDS. Even with HIV prevalence rates as low as 1-2 per cent across the region, an estimated 7.1 million people are currently living with the disease in the region. Adolescents (those aged 10-19 years) comprise a sizeable and growing proportion of the total population (more than one fifth), most at risk of unwanted pregnancies, STDs and AIDS. The reproductive health of adolescents is increasingly being recognized as a key area for UNFPA support. Likewise, Asia is home to the majority of the world’s older people (roughly 54 per cent) defined as those aged 60 years and above, majority being women. This new emerging issue has major ramifications for developing countries of Asia and the Pacific, which still do not have systems of social protection in place, particularly old age security and health insurance. The Fund’s presence in the Asia and the Pacific has been overall catalytic, not only in helping countries plan and expand their population and FP activities, but also in operationalizing their RH services, with an emphasis on national capacity building. Complimenting the efforts of the countries, the Fund has helped them increase their demographic monitoring capability and establish vital registration systems. As a result, the region now has considerable institutional capacity and expertise available to undertake policy research on important population and policy linkages. UNFPA has been extensively supporting projects that improve the status of women, by promoting programmes that improve their education, income and employment opportunities, and by providing access to quality RH services. In addition, UNFPA has supported emergency RH projects in several Asian countries torn apart by crisis, war, armed conflicts and natural disasters. The region as a whole has made important strides in implementing the ICPD PoA, especially in operationalizing the RH approach. However, there is still a large unmet need for FP in most countries of the region that needs serious attention, if population growth rates are to be contained and sustainable levels of development are to be achieved. From 1969 till the present, UNFPA has invested more than $1.4 billion in the region, majority being devoted to reproductive health, including family planning and sexual health.