COMMENTARY: Big issues deserve bold responses: Population and climate change in the Sahel

Malcolm Potts, Alisha Graves

Abstract

The challenge
Parts of Africa have the most rapid population
growth in the world. Recent studies by
climatologists suggest that, in coming decades,
ecologically vulnerable areas of Africa, including
the Sahel will be exposed to the harshest adverse
effects of global warming. The threat hanging over
parts of sub-Saharan Africa is extreme.
Fortunately, there are evidence-based achievable
policies which can greatly ameliorate what would
otherwise be a slowly unfolding catastrophe of
stunning magnitude. But to succeed such measures
must be taken immediately and on a large scale.
In 1950 there were 30 million people in the
Sahel, as broadly defined from Senegal on the
Atlantic to northern Ethiopia and Eritrea on the
Red Sea. Today there are 100 million. UN
demographic projections 2050 are for 300 million.
Last year, 18 million people in the West African
Sahel were chronically hungry and only about onethird
of children were enrolled in secondary
school1, 2. So examined on its own, this rapid
population growth is cause for grave concern. It
multiplies the number of individuals suffering
from poverty and makes it more difficult for
countries to develop3.
Now let’s consider the effect of climate change
in the Sahel. A rise of 3 to 5°C (7 to 10°F) is
projected by 20504.Today’s extreme temperatures
and weather events will become the norm. There
may be an increase in precipitation but it is likely
to come as flash floods or as rain that may
evaporate even before it can reach the root roots of
plants. On its own, climate change presents
another serious problem in a drought-prone and
vulnerable region.
Taken together, rapid population growth and
climate change pose a serious threat to the
livelihood of the majority of the one hundred
million people now living in the Sahel region and
about two hundred million more who will live
there in a generation’s time.
Traditionally, climatologists, physicians, those
interested in food security or raising the status of
women have worked in separate silos. And the
Sahel region – with its landlocked countries and
political instability – has been a low priority for
major donors. The first meeting bringing together
experts from Africa and from the United States to
analyze population growth and the impact of
climate change in the Sahel from the perspective
of demography, family planning, agriculture,
status of women and governance was put together
as recently as September 2012. The University of
California Berkeley and the African Institute for
Development Policy hosted a meeting called
Organizing to Advance Solutions in the Sahel
(OASIS4) to share evidence and ideas for
integrated approaches in the region.
Perspectives from Ethiopia
Global warming is a global problem demanding a
global solution. Steps must be taken both to
mitigate greenhouse gas emissions in the global
North and to enable vulnerable populations in
Africa adapt to a level of warming that is already
inevitable.
In the first ten days of each year the average
British citizen put out as many greenhouse
emissions as the average person in a less
developed country does in one year. The United
States (US), with 4% of the global population produces over 20% of the world’s greenhouse
emission5.Half the pregnancies in the US are
unintended6. Averting unintended pregnancies
benefits women and strengthens society. It also
happens to be the most cost-effective way of
reducing the carbon footprint of the US and other
industrialized nations5.
Just as family planning is key to mitigation of
climate change in high carbon producing
countries, it is also a key strategy for adaptation. In
low resource settings with a high unmet need for
family planning, like Ethiopia, voluntary family
planning can help families and countries as a
whole adapt to inevitable climate changes in the
near term. This edition of the African Journal of
Reproductive Health includes an article by Rovin,
Hardee, and Kidanu which examines Ethiopian
perspectives on population, fertility, family
planning and adaptation to climate. Participants in
focus group discussions, including agriculturalists
and pastoralists, described links between
population pressures and climate change. They
suggested family planning as an important
adaptation strategy. Indeed, ninety percent of the
National Adaptation Programmes of Action
(NAPA) mention population as a contributing
factor. Yet only two NAPAs identify family
planning as a priority strategy and neither of those
projects has been funded7. Given that the unmet
need for family planning is 25% in Ethiopia and
that the country is considering a longer-term
climate change adaptation strategy, national
prioritization of family planning programming is
recommended.
The publication of this edition coincides with
an international meeting on family planning taking
place in Addis Ababa. Ethiopia has a special role
to play in relation to rapid population growth and
climate change. The total fertility rate is 4.8 and
the population grows by 2.4% per year. However,
in Addis Ababa, unlike any other African capital
city, the TFR is now below replacement level
fertility at 1.58. This dramatic change is thanks in
no small part to Ethiopian leadership on two
important fronts. First, Ethiopia revised its
abortion law to improve access to safe abortion
services, including special provisions for minors,
who make up more than 45% of those seeking
abortion9. Second, Ethiopia has been a world
pioneer in task shifting, with the health extension
worker (HEW) initiative. Together, these
approaches are making family planning and safe
abortion more accessible and saving lives. A study
in Tigray, for example, shows that HEWs can
safely administer injectable contraceptives as well
as provide medication abortion10, 11. People living
in countries with high rates of unsafe abortion as
well as those with clinical human resource
shortages will benefit from Ethiopia’s example.
The need for urgent, large scale action
Ethiopia is right in taking these bold steps because
the situation in the Sahel is dire. And with the
spread of terrorism in the region, the window of
opportunity for taking action has already begun to
close.We propose three “pillars” for action: make
voluntary family planning universally available
and counter misinformation about contraceptive
methods; invest in the well-being of girls and
young women; and promote appropriate
technologies and practices to help subsistence
farmers and pastoralists adapt to climate change.
Doing any one of these three things alone will not
suffice. We must tackle all three on a regional
scale and with urgency. It will certainly be
expensive – but no doubt a fraction of the cost of
inaction. Somali pirates, for example, cost the
global economy a stunning $18 billion per year12.
The world cannot afford more failed states.
The London Summit on family planning in July
2012 represented a turning point in the willingness
of governments and large philanthropic
organizations to invest in family planning. The
goal of the Summit was to meet 50% of the unmet
need for family planning in developing countries.
But we know from country-level data that when
fertility falls, so does the desired family size. So
we should aim to meet 100% of the current family
planning need since unmet need will always prove
a moving target – with demand for contraceptives
growing as women have greater choices and
realize they can be used safely.
Any response to the problems set out above
must be on a large scale and immediate. Business
as usual is not acceptable. Obstetricians, physicians, development specialists, those
committed to improving the status of women need
to speak out in favor of universal, voluntary family
planning. We have to help policymakers and other
decision makers to understand the link between
population and climate and remind them that
demography is not destiny. We need to make the
case that – while the cost of region-wide,
integrated approaches are high – the cost of
inaction is unacceptable. And we need to set much
higher goals – because it is only when positive
change happens on scale that societies can thrive.

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