02 Jul 2012Adam Cohen

Issues surrounding gender, poverty, population growth, philanthropy, foreign aid and global health were addressed at this week’s Aspen Ideas Festival. A panel discussion titled “The Politics of Sex” was moderated by Monique Villa, CEO of Thomson Reuters Foundation, and featured Dr. Chris Elias of the Bill & Melinda Gates Foundation, Musimbi Kanyoro of the Global Fund for Women, and Ezekiel Emanuel of the University of Pennsylvania. The conversation started on a harrowing note, the fact that 215 million women in the world are without contraception.

Dr. Elias started by setting the scene of the world we live in and what it is slated to become. The UN estimates that by 2050, the population will grow to approximately nine billion people (the low end of the estimate being 8.3 billion, and the high end being 10.5 billion). He talked about the three main factors driving population growth. The factor that plays the smallest role is a continued high amount of desired fertility. This generally exists in the poorest parts of the world where the infant mortality rate is highest. The second factor is an unmet need for contraception. The third, and more significant factor is that population growth is essentially guaranteed. The answer is population momentum, and it exists because the world’s population is very young, about half being under the age of 25.

The discussion then shifted to how we can improve the current situation. Kanvoro talked about the turning point in the global conversation, which took place in 1979 when governments began to discuss population growth and recognized the crucial need to address the issue of empowerment of women. They quickly realized that the best way to improve the world’s situation was to include women in the conversation. Educating women was recognized as being extremely important because there is a very tangible return on investment. Education leads to well managed fertility decisions, which in turn makes its way throughout the family and the community. Zeke Emanuel agreed with this point, adding that women are the glue of the household, and if they die, the chances of their children dying increases dramatically.

So, how can we improve our population situation, as well as the problems that women face in impoverished nations? According to the panel participants, the solution starts with foreign aid and global health initiatives. It is the goal of the Bill and Melinda Gates Foundation to reach 120 million new users of contraception by the year 2020. It’s estimated that this will require $4.3 billion in funds. But the panel was quick to point out that funding is much more complex than just acquiring the money. Corruption and lack of reliable infrastructure can often derail efforts to provide contraception and medication. And establishing reliable supply chains is really invisible from a political standpoint, because as solutions go, it’s “not sexy.” A politician is more concerned with showing that drugs were delivered to a certain area and X number of people were vaccinated, according to Emanuel, who used the example of HIV shots, which are needed every three months. If a supply chain is unreliable and the medicine isn’t available when the patient is supposed to come back, it derails the entire process. Not only does it make people receptive to disease, they lose faith in the system that’s in place.

The panel participants seemed optimistic about the direction things are moving, but they were quick to explain that it takes time, and trends are really only recognized over the duration of a generation. Improving awareness and education for women and improving infrastructure will support increased access to and use of contraception and medication, and will help us to remain in the low range of the population estimates by 2050.