Cairo: 10 years later.

Ten years ago experts worried about a looming demographic catastrophe. In 1994 the International Conference on Population and Development convened in Cairo and changed the way that world leaders think about population issues, substituting a social development approach for their narrow birth control programs.

A recent gathering in London, convened by the United Nations Population Fund, reviewed progress since the Cairo meeting. What they found was encouraging: the rate of population growth has been reduced.

Before the Cairo conference, population policy in much of the Third World was guided by politicians and bureaucrats educated in our best western and soviet universities. Regardless of where they learned their lessons, they shared the same Big Brother approach. With the help of foreign advisors, they set out to impose birth control practices in their countries. They propagandized and hectored people on birth control measures in terms that people could neither understand nor accept. Some tried aggressive, threatening and punitive policies, and some governments experimented with programs in which men and women were pressured to "volunteer" for abortion and sterilization.

These approaches were socially and politically disruptive and had to be abandoned. Only China retains a punitive approach; it limits education and social benefits for the third child in a family.

Population programs were guided by the belief that unrestrained growth leads to poverty and disease. At the Cairo conference this stance was reversed. Poverty, disease and ignorance are now viewed as the principal causes of rapid population growth. The conference called for community-based programs and an end to top-down directives. Most importantly, the Cairo program focussed on the well-being of women.

The new approach emphasizes locally developed programs in basic public health such as clean water supply, training for midwives, and measures to improve maternal health and infant survival Literacy and basic education for girls and women were stressed and birth control became one part of a broad range of health programs.

At the recent London conference delegates learned that many more women are now able to read; many more girls are enrolled in schools, and have more opportunities for higher education; many more are engaged in productive activities that support their families. More women engage in politics and hold ministerial positions in their governments. The belief in their own powers has enabled and encouraged women to take charge of their own fertility.

The world's population is now estimated at 6.3 billion people; much still remains to be done. In the poorest countries one in 16 women die in child birth (compared to one in 2,800 in the developed world) and tens of thousands die in unsafe abortion procedures.

More than half the world's population is under 25 years of age and teen-age pregnancies are quite high. "This is the largest youth generation in human history," reports Thoraya Obaid, director of the United Nations Population Fund. "There must be services available to allow this generation to control their lives."

However, a new obstacle threatens and the problem lies in Washington. The u.s., which is a major supporter of international health and social development programs, has now changed its policies. The Bush administration insists on an abstinence-only program and refuses to support any health program that includes contraceptive and abortion services or advice. Funds for the United Nations Population Fund are withheld from any international or local agency that does not conform to its latest requirements.

The u.s. is pressuring other countries to follow its lead threatening the advances made since the Cairo conference in 1994. If George W. Bush is re-elected, Canada and other developed countries should respond by taking up more of the financial and political burden of health services in these underserviced countries. Canada should use all of its diplomatic skills to encourage the u.s. to take a more constructive path and live up to its responsibilities as a world leader.

--L.K.