POPULATION GROWTH: UGANDA'S TICKING TIME BOMB

UNCLAS SECTION 01 OF 04 KAMPALA 000955 STATE FOR AF/E AND PRM FOR USAID/EA (TWAY, KADAMS) USAID/GH (LHARLEY, KSTEWART, MBOHRER) SIPDIS SENSITIVE E.O. 12958: N/A TAGS: ECON EAID PINS PGOV PREL UG SUBJECT: POPULATION GROWTH: UGANDA'S TICKING TIME BOMB REF: KAMPALA 1611 ¶1. (SBU) Summary: Population trends in Uganda are creating a demographic time bomb that is undermining the country's recent gains in economic and social development and threatening its longer-term political, economic, and environmental viability. Few countries in the world are growing as fast as Uganda. At current trends, Uganda's population will double (from 30 to 60 million) in 20 years and reach 130 million by 2050. This surge in population will stress the natural environment and strain the government's ability to provide basic health and education services, possibly to the breaking point, resulting in chronic political instability and social unrest. It's hard to see current trends changing anytime soon given the pro-growth sentiments of Ugandan President Yoweri Museveni. End Summary. -------------- By the Numbers, Not in Good Company -------------- ¶2. (SBU) A rash of recent reports has drawn increased attention to Uganda's unchecked population growth. An international study commissioned by the British Parliament ominously observes that, "Of the top 20 failing states, 17 have populations increasing at close to 3% a year. In five of these 17 countries, women have an average of nearly seven children each. In all but six of the top 20 failing states, at least 40% of the population is under 15." Uganda has traveled a long way from failed-state status, but tellingly, it still ranks 21st out of 60 in the failed state index, in large part due to demographic trends. Individual country data paint a gloomy picture: -- Uganda's population nearly doubled from 1987 to 2007 and is increasing at an annual rate of 3.2%, fifth highest in the world. The population is growing by 1.2 million people each year, one of the highest absolute increases in the world. -- Ugandan women have an average of 6.7 children (vs. 2.1 in the U.S. and the 5.1 average for sub-Saharan Africa). Only four countries worldwide have higher fertility rates. -- More than 50% of the population is under the age of 15, and according to a report published by the non-governmental Population Reference Bureau (PRB),Uganda's ratio of those not in the labor force compared to those currently working is the highest in the world at 116%. -------------- The Sheer Pressures of Population Growth -------------- ¶3. (U) Following a period of sustained economic growth over the past decade, 31% of the very young Ugandan population still live on less than $1 a day and the health of the population remains weak. According to "The State of Uganda's Population Report 2008," published by the GOU's Population Secretariat with support from the United Nations Population Fund (UNFPA),unchecked population growth is contributing to an increasingly unhealthy and under-productive Ugandan population: 12% of women of reproductive age are undernourished, while 38% of children under five years old demonstrate stunted growth. ¶4. (SBU) On July 11, World Population Day was celebrated in Uganda's Teso region, an area hit hard by national food shortages. The sad irony of the day was not lost on media outlets or the international community, which recognize rapid population growth as a contributing factor to the shortages. This rapid population growth is further exacerbating the problem of poverty in Uganda. While the percentage of Ugandans living in extreme poverty has decreased in the past decade, absolute numbers have not dropped significantly. Janet Jackson, UNFPA Country Director, made the case that, "Development gains must not be jeopardized by the challenges and sheer pressures of population growth. Population should be slowed down and counterbalanced by an equal pace in growth of other sectors, for example health, education, housing, utilities, job creation and food production." There is growing fear, from Ugandans and donors alike, that forward strides in these sectors may be negated by unsustainable population growth, driven in part by unmet family planning needs. ¶5. (U) At the current levels of unmet family planning needs and population growth, policy makers will face increasingly tough decisions on access to land, employment, energy, clean water, education, housing, transportation, and health services. Even in the unlikely event Uganda experiences a complete fertility transition (from high to replacement level fertility) over the course of the next 30 years, its population will still double during the same KAMPALA 00000955 002 OF 004 period. Recent history in Kenya, Madagascar, and Nigeria does not bode well for Uganda. When increasingly scarce resources are spread thinly amongst a young, growing population, it only takes a spark for violence to erupt, even in a growing economy. An estimated 80% of civil conflict from 1970 to 1999 occurred in countries where at least 60% of the population was under age 30. 76% of Uganda's population was under age 30 at the time of the 2006 DHS. -------------- Economics of Population Growth -------------- ¶6. (SBU) The GOU is sending mixed signals about whether it views rapid population growth as a fuel for economic growth or as a roadblock to its long-term vision of economic success. The revised National Population Policy, whose theme is "Social Transformation and Sustainable Development," aims to ensure that all aspects of creating a quality population are addressed, including slowing the population growth rate that is now too high for the country's economy to sustain. Yet, President Museveni's own comments continue to indentify the population boom as a foundation for growth and transformation: "The wealth of a nation is not in the soils and stones. It is in its people, its population. I do not agree with the alarmism over the high rate of population growth...we need to educate our children, give them skills and create an enabling environment for employment and job creation. That way, we shall create wealth, make savings and Ugandans will invest and spur economic productivity and growth." Unfortunately, what Museveni is unable to grasp is that while Uganda's economy has grown steadily over the last decade, growth would need to increase dramatically to generate enough government revenue and new jobs to keep up with the ensuing population surge. Moreover, because the education system is underfunded and failing to keep pace with population growth, an overwhelming majority of young Ugandans are not acquiring the skills and knowledge they need to be competitive, productive, and prosperous in the 21st century economy. ¶7. (SBU) Ugandan policy-makers often remark on their desire for the country to emerge as a strong middle-income economy by emulating the performance of the "Asian Tiger" economies of the late 20th century (e.g. Thailand, South Korea, and Taiwan). By 1965, each of the Asian Tigers had established family planning programs and by 1995, six of the eight Tigers had lower fertility rates than the U.S. The resulting demographic shifts led to slower growth in the number of school-age children, a lower ratio of dependents to working-age adults and a reduced rate of labor force growth. Left alone, these were not enough to create the educated workforce, high wages, savings rates, and capital-intensive industries that now characterize the Asian Tigers. But when linked to an innovative business sector, sound government investment and an equitable education system, demographic shifts soon fostered economic opportunity. Economists credit declining fertility rates as a major contributor to sustained economic growth in Asian Tigers, attributing up to 50% of their high per capita growth to this demographic dividend. ¶8. (SBU) Thus, while Uganda would like to emulate the Tigers' success, it ironically appears unwilling or unable to follow the formula that led to that success. To its credit, Uganda is committed to sound economic policies, and has made some strides in education through its commitment to universal primary education. However, in reality, the education sector remains seriously underfunded, leaving a surfeit of young people with just enough education to get into trouble. Indeed, Ugandan women with no education or only primary education have fertility rates of 7.7 and 7.2 respectively, while those relative few with a secondary education have a rate of 4.4. Moreover, in sharp contrast to the Tigers, the GOU has done little to curb population growth through family planning programs. ¶9. (U) In short, as a 2004 study by Dr. Stephan Klasen argues, per capita income will not improve if population growth continues to put a "brake on physical and human capital accumulation, the key drivers of economic growth." Uganda's current makeup (very young population, comparatively few working age people, and even fewer elderly) is a "demographic burden." Uganda has the potential to capitalize on its demographic make-up, but only if fertility rates are reined in quickly during this period of burden. But after a decade of sustained economic growth in Uganda with no change in fertility rates, it is clear that the economy and service delivery are struggling to keep up, even at current population levels. -------------- Family Planning and MDGs: More Bang for Your (Donor) Buck -------------- KAMPALA 00000955 003 OF 004 ¶10. (SBU) Lack of adequate family planning services in Uganda continues to be a key driver of population growth and the numbers (dire even by sub-Saharan African standards) tell the story. One in four Ugandan girls will get pregnant before the age of 20; only one in four married women use any form of contraception, while "unmet need" (women who say they prefer to avoid pregnancy but are not currently using a contraceptive method) stands at 40.6%, revealing a severe dearth in delivery of and access to family planning services. In contrast, at least 75% of married women use contraception in Vietnam, Colombia and Brazil, while only about 7% of women in these countries have unmet need. Although poverty in Uganda has been reduced considerably from 56% in 1992 to 31% in 2006, infant and maternal mortality has remained nearly stagnant with 76 deaths per 1,000 live births and 435 deaths per 100,000 live births, respectively. These data, when combined with the high levels of unintended pregnancies and induced abortions, make it clear that a continued lack of family planning services has grave implications for the health, and thus the productivity, of Uganda's women and children. ¶11. (SBU) A recent USAID study indicates improved family planning services in Uganda could help it achieve its Millennium Development Goals (MDGs). By fulfilling unmet need for family planning, 450,000 child deaths and 5,500 maternal deaths could be averted between 2008 and 2015. In addition, more than 10,000 HIV-positive births per year could be averted. Consequently, the MDGs could be achieved faster and at a lower cost. An investment of $1 in family planning would yield a $2 savings in reaching goals in other sectors such as health, education and environmental sustainability. These figures are particularly eye-catching for donors and aid-recipients who have pledged, as the United States and Uganda have, to overcome poverty and address many of the most enduring challenges of human development. -------------- USG Role -------------- ¶12. (SBU) USAID and UNFPA are the GOU's largest partners in supporting programs that provide and strengthen family planning services. After several years of stagnating resources, USAID's family planning budget increased to $10 million in FY2008 and to $15 million in 2009. USAID expects modest increases in allocations to continue in light of the new Global Health Initiative, in which family planning figures prominently. In early 2009 USAID awarded a $39 million five-year project to focus on improving family planning services in terms of access and quality, as well as child survival in 15 of Uganda's 80 districts. USAID also regularly supports the procurement of contraceptive commodities. Together, USAID and UNFPA provide the lion's share of Uganda's contraceptive supply. While such donor programming is a step in the right direction, all of Uganda's political and economic gains of recent years are in jeopardy unless the GOU itself adjusts course and takes action now to address its impending demographic disaster. ¶13. (SBU) Comment: The Population Secretariat's report is evidence that some GOU officials understand Uganda's demographic challenges, but Museveni's own staunch, pro-growth position is probably the single greatest obstacle to turning the tide in Uganda. While the GOU has developed policies for reproductive health and family planning, in coordination with UNFPA and donors including USAID, political commitment to implementation of those policies is lacking. The GOU has not spent funds on contraceptive commodities in the past two years, and few high-level officials outside of the Population Secretariat have ever made statements contradicting the President's position on this issue. Family planning needs to play a central role in Uganda's development plans, as it is crucial to reducing poverty, improving education, health and the environment, safeguarding women's health, and enhancing the standard of living. But without an about-face from the country's leadership on this issue, we remain pessimistic that family planning will play such a role, with potentially dire consequences for the country's long-term socio-economic viability. ¶14. (SBU) Comment continued: Collectively, the USG also needs to think seriously about population trends in Uganda (and probably elsewhere). While the USG laudably spends billions of dollars saving lives through programs like PEPFAR and the President's Malaria Initiative, we are underplaying at best and ignoring at worst the fact that the gains made through these programs are being simultaneously undermined by runaway population growth. Moreover, it's no coincidence that the Failed State Index takes population trends so heavily into account. Where we now have a relatively stable ally in Uganda, the future may bode much worse given current population trends. Perhaps it's time to think about an emergency KAMPALA 00000955 004 OF 004 plan or a presidential initiative for family planning. End comment. Hoover