It is estimated that for every dollar invested in family planning, governments can save up to four dollars on expenditure for health, housing, procurement and other public services. While fertility may decline with progress in economic and social development, access to contraception is needed and can also support development. There is a pressing need to take action on demographic change in Africa, if we want to give this continent the opportunity of building its development potential, which truly exists.
Africa in 2050: over 2 billion inhabitants
For many observers, the 21st century will be African. While Africa could well be the world’s new economic engine, it will unquestionably be that of the growth of its population. According to the United Nations Population Division’s Medium Variant for the decline in fertility, the region’s population is expected to increase from 831 million people in 2010 to 2.1 billion by 2050, and perhaps even to 3.8 billion by the end of the century. The main reasons for this strong population growth are the considerable progress achieved in terms of mortality and, especially, fertility, which on average remains high.
Compared to the rest of the world, Sub-Saharan Africa is a specific case: most countries in the region are still a long way off from completing their demographic transition. The region is thus marked by a gap between the decrease in mortality, on the one hand, which is underway, although the levels of infant and child mortality still remain very high (73 children die before the age of one year, i.e. 22 times more than in France), and the slow decline in the high levels of fertility on the other hand.
There is no doubt that these generalizations conceal a variety of situations among the 48 Sub-Saharan African countries. Southern Africa, for example, has already achieved its demographic transition. East Africa is also engaged on this path. However, West Africa and Central Africa have both made little progress with their demographic transition.
Is this demographic boom a real opportunity for Africa?
A very rapid population increase is not without consequences for development. The growth rate of per capita income, the pressure on available natural resources, and the scale of investments required to meet the social needs of the increasing number of children, are all factors that need to be taken into account. As the Asian tigers’ experiences of economic development have shown, it is the age structure of populations that plays a key role: when it changes due to the decline in fertility, the ratio between active workers and dependents also changes.
When the age pyramid for the entire world is compared to that of Sub-Saharan Africa, the difference is striking. While there is an almost rectangular form to the base of the pyramid for the world, as a result of a marked decline in fertility, the pyramid for Sub-Saharan Africa shows that the decline in fertility has not really started yet.
Each five-year period brings more children to the base of the pyramid. It is on these young people, the adults of tomorrow, that the region’s future depends. For them to fully participate in development, they are the ones who will need to be fed, educated and cared for and, especially, it will be necessary to find decent employment.
It is also the future form of the age structure and, especially, the ratio between active adults and dependents (children under 20 and elderly people) that are the cornerstones for achieving a demographic dividend. The latter occurs when a sudden decline in fertility brings about a stabilization of the base of the pyramid. This has the dual effect of increasing the number of working people in the population in relative terms, and of reducing the weight, in terms of investment, of dependent children. There is subsequently an opportunity to accelerate economic growth. However, to fully benefit from this requires creating high-quality human capital, as well as appropriate economic policies for productive investments to be made.
Commit to reducing fertility
The possibility of obtaining a demographic dividend is currently central to discussions concerning the future of Sub-Saharan Africa. Yet for most countries, nothing is certain. The main unknown factor is precisely the speed at which the demographic transition and, especially, that of fertility, will take place. Between 2010 and 2050, the United Nations forecasts a decline in the number of children per woman from 5.1 to 3.2. This is a significant decrease of some 40 per cent. But this decrease will not be automatic. There is therefore a pressing need in a number of countries to put in place policies able to influence demographic changes in the hope of achieving the social, economic and human development targets that they have set. Consequently, how can the transition, and especially the decline in fertility, be accelerated while respecting individual rights?
In the short term, there is a need to strengthen the provision of family planning services in order to ensure that it is varied, high-quality and accessible (provide a wide range of methods, with no stock-outs, and with appropriate counseling activities). Indeed, too many African women suffer from a twofold denial of the right to avoid or space pregnancies: the denial of information and the denial of access to methods. This situation gives rise to unacceptable rates of maternal and child mortality. Almost one-third per cent of women have an unsatisfied need for modern methods of contraception, the contraceptive prevalence rate (modern methods) in Sub-Saharan Africa only stands at some 20 per cent. In most emerging countries, it stands at over 60 per cent. Initiatives that aim to put the issue of family planning back on the international development agenda, such as those promoted by the Ouagadougou Partnership or Family Planning 2020, are a first step in this direction.
However, service provision, even if it is a long-term process, will not be sufficient. In order to consolidate the achievements and increase demand for services, it is necessary to promote the socioeconomic changes that influence it. The education of young girls, the fight against early marriage and pregnancy, women’s empowerment and their participation in an income-generating activity, are all basic factors on which action is also required. Today, it is essential to think in a crosscutting and multi-sectoral manner.
Another vital need is to convince African leadership of the validity of population policies that aim to accelerate the decline in fertility. It is still widely agreed that fertility will automatically decline with progress in economic and social development. However, while development fosters the decline in fertility, access to contraception can also support development. The experience of the last 60 years in Asia, Latin America and the Caribbean, as well as in certain African countries such as Rwanda or Ethiopia, does show that it is possible to take action on demographic developments via evidence-based policies, and to do so in an effective manner that respects human rights.
However, to achieve this, the starting point is to actually raise the demographic issue instead of ignoring it, as has too often been the case. Furthermore, as the demographic issue is inherently linked to ongoing economic and social developments, it will also be necessary to address it by taking account of the most urgent development issues, which today are the social demand for education and health, as well as employment and youth integration. Finally, to act effectively, it will also be necessary to define development strategies that are tailored to the local situation. These strategies will need to be participatory and crosscutting, i.e. involve all citizens across all the development sectors.
 The population data is from the 2012 revision of World Population Prospects conducted by the United Nations Population Division; see http://esa.un.org, consulted in March 2013
 J.F. May, Agir sur les évolutions démographiques, Bruxelles: Académie royale de Belgique, 2013.