State of World Population 2023

8 Billion Lives, Infinite Possibilities: the Case for Rights and Choices

Your Excellency, Ambassador Dr. Haifa Abu Ghazaleh, Assistant Secretary
General, Head of Social Affairs sector at League of Arab States (thank her and LAS
for co-hosting the event and being a strong partner for change)
Dr. Ahmad Al-Mandhari, WHO EMRO Regional Director
Distinguished guests, ladies and gentlemen, colleagues and friends.
One of the most difficult moments of my life to reconcile was when I realized I
would never have children. I was married, financially independent and an adult.
Despite my desire for a family, fate had other ends in store for me. What is one
less child in what is now the world of 8 billion you might ask?
UNFPA's State of the World Population Report 2023, “8 bn lives, infinite
possibilities: the case for rights and choices” sheds light on precisely why.
When human numbers are tallied and population milestones passed, the rights
and potential of individuals can easily be overlooked. In our quest for ‘an answer’
we tend to see birth rates polarized into either the problem or solution for our
countries, with little acknowledgement to the immensely personal and deeply
emotive choice it is, especially for the women of this world, who bear much of the
physical and emotional demands of reproduction and fertility.
This story was supposed to have changed in 1994 with the landmark International
Conference on Population and Development (ICPD) and explicit recognition that
advancing gender equality and the empowerment of women and ensuring

women’s ability to control their own fertility must be at the heart of population
and development.
Nearly 30 years later and sitting in the very spot where the conversation started,
the world views this monumental milestone with greater anxiety and
misunderstanding instead of a welcome opportunity to revisit the population
discussion from the positive angle of ‘infinite choices’ as this year’s report alludes
to.
The report demonstrates that fertility rates are neither a problem nor a solution.
In today’s interventions, you will hear from esteemed panelists from across the
region. Experts in their respective fields and renowned in the area of population,
we will delve into the reasons not only why the subject is seeing a resurgence but
also why we need to provide a healthy optimistic approach based on the right and
freedom to choose a family rather than a cookie cutter fallacy of 2.1 fertility rate.
It is easy to imagine at a moment of overlapping and escalating global crises, from
COVID-19 that ravaged our health, education and economic systems, to climate
change-imposed drought, floods and other natural disasters and unprecedented
levels of conflict across the globe, including in our region, that population and
reproductive health and rights may not take center stage. In some countries,
instability, migration and poverty gaps have tripled in recent years. A context
which lends itself to politically conflated messages from pundits on how
population concerns surrounding fertility, migration and mortality should be
addressed.  

Speaking of “reducing” or “increasing” fertility rates, does not account for
people’s rights to make their own reproductive choices, and it also fails to
recognise the agency of individuals and their bodily autonomy. We can avoid this
misunderstanding by stating affirmatively that reproductive rights and bodily
autonomy must be at the heart of any population or fertility policy. 

For example, the Arab region is home to nearly 468 million people with over a
quarter aged 10-24 years. This is largely attributable to the population
momentum of both previous high fertility and current fertility levels in countries
with a large population (Egypt, Sudan, Algeria, Iraq), coupled with increased life
expectancy in all Arab states.
Other countries, such as the Gulf Cooperation Council Countries witnessed
population growth due to labor migration rather than high fertility.
During this same period, we witnessed other gains. Age at first marriage in the
Arab states increased for both men and women. Reproductive and maternal
health improved significantly in the region, despite persisting disparities. In 2023,
for example, use of contraceptive methods for women aged 15-49 is 34% for
women. Strides in reducing maternal mortality were significant, especially marked
by the high percentage of births attended by skilled personnel which rose to 86%
in 2020.
We may ask ourselves why, after so much effort, investment and commitment to
population concerns, what is the main issue that has disconnected the
assumptions leading to prosperity and stability.
Child marriage, divorce rates and unequal access to health care remain pervasive.
Instability in the region from the last decade has led to mass migration and
refugee contexts in the majority of states outside the GCC. In 2020, Arab states
hosted around 41.4 million migrants and refugees.
Migration and forced displacement from Arab countries has continued to
increase, reaching an estimated 32.8 million people in 2020, 44% of whom stayed
within the region. This number has already started to increase as a result of the
devastating conflict in Sudan.
It is interesting, therefore, to see paradoxal rising anxieties and panic about
demographics and population trends, with people expressing fear about both

overpopulation AND underpopulation. The solution, however, lies in the approach
and not the numbers alone.

We have seen that high-fertility contexts do not simply need contraception while
low-fertility contexts need family-friendly policies. In fact, infertility is widespread
in high-fertility contexts, just as unmet need for contraception is prevalent in low-
fertility contexts. A full range of reproductive health care services and gender
equality protections is needed in all settings. Given that 14% of the Arab
population is also dealing with ageing, a new approach is needed to rethink the
optimal solution to making use of our immense talent and capacity in the region.

Our report has two clear messages:
First, we need to bust the myths around population.
To blame population growth and fertility rates for climate change and the
depletion of natural resources is to hold the wrong people to account. The
countries with the highest fertility rates have contributed least to global warming,
and they will suffer the most from its impacts. Blaming fertility rates distracts
from solutions that are less politically palatable, including reducing consumption.
We also need to bust the myth that low birth rates are the reason behind ageing
and its related economic concerns. In fact, all populations are ageing due to
increased lifespans. But to blame women for producing an insufficient supply of
babies is to ignore solutions that are much more viable in the short term and also
aligned with human rights norms: Ageing, low-fertility countries can increase
productivity by achieving gender parity in the workforce, and by looking to
migration to fill labour shortages.
Our second main message is that we need to rethink how we deal with
population. The question should not be whether the human population is too
large or too small. It is whether all people are able to exercise their fundamental
human right to choose, freely and responsibly, the number and spacing of their
children.

In such a crowded environment, UNFPA works to support governments to adopt
population and fertility policies that are in line with human rights to help ensure
that every person’s rights are upheld and every person is enabled to achieve their
full potential in all contexts.
We believe that, when reproductive rights and bodily autonomy are the starting
point for any population or fertility policy, countries will be able to achieve zero
maternal mortality, zero unmet need for family planning and zero gender-based
violence.
Outlining priorities in the region going forward, and the steps taken to address
the challenges that remain, including the focus on strengthening health systems
and expanding access to reproductive health services, promoting gender equality
and women's empowerment, and advocating for the rights of marginalized and
vulnerable populations remain central. By addressing the root causes that lead to
vulnerability, poverty, marginalization and deprivation, we automatically ensure
the resilience of both individuals and systems - a concern for many governments
of the region. This includes better social protection, health, education and welfare
for those most in need.
Today, the 2030 Agenda for Sustainable Development expressly acknowledges
that sexual and reproductive health and gender equality are essential for
unlocking a more prosperous and sustainable future. Why, then, are so many
women still deprived of choice? Women still are unable to make decisions about
their health care, marriage, family size or contraception. The result? Nearly half
of all pregnancies are unintended, an abrogation of women’s basic human right to
decide freely and responsibly the number and spacing of their children.
Women must be able to choose if, when and how many children they want to
have. The ICPD called for women’s reproductive health and rights to take centre
stage in national and global development efforts and firmly established that the

rights and dignity of individuals rather than numerical population targets, were
the best way for individuals to realise their own fertility goals.
With this in mind, UNFPA and its partners help governments analyse their
demographic data, plan for population change and develop tailored policies to
address demographic transitions including a focus on our young people,
promoting healthy ageing and protecting the rights of those who migrate.
In this regard, advancing gender equality is the best tool for managing population
change and building resilient societies.
As we unlock potential by empowering people, especially women and youth, to
make choices about their bodies and lives, they and their families thrive - as do
their societies.
In conclusion, our report shows that people today are still unable to achieve their
reproductive goals due to unplanned pregnancies, lack of access to contraception
or quality obstetric care, infertility and economic instability, among other serious
challenges. Instead of instituting policies to influence people’s choices, we must
work together to empower this planet of 8bn potential solutions to achieve their
individual reproductive goals in favor of prosperity for all. My child may not be
among them, but our collective children are.
I thank you.