TOPIC 4: GLOBAL POPULATION AND HEALTH ISSUES

THE WORLDS POPULATION

The term world population commonly refers to the total number of living humans on Earth at a given time. As of 5 August 2009, the Earth's population is estimated by the United States Census Bureau to be 6.776 billion. The world population has been growing continuously since the end of the Black Death around 1400.
Note : The Black Death was one of the deadliest pandemics in human history, peaking in Europe between 1348 and 1350. It is widely thought to have been an outbreak of bubonic plague caused by bacteria. The Black Death is estimated to have killed 30% to 60% of Europe's population, reducing the world's population from an estimated 450 million to between 350 and 375 million in 1400.

There were also short term falls in the world population at other times due to plague, for example in the mid 17th century. y The fastest rates of world population growth (above 1.8%) were seen briefly during the 1950s then for a longer period during the 1960s and 1970s.
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According to population projections, world population will continue to grow until around 2050. The 2008 rate of growth has almost halved since its peak of 2.2% per year, which was reached in 1963. World births have levelled off at about 134million-per-year, since their peak at 163-million in the late 1990s, and are expected to remain constant.

However, deaths are only around 57 million per year, and are expected to increase to 90 million by the year 2050. y Since births outnumber deaths, the world's population is expected to reach about 9 billion by the year 2040.
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Different regions have different rates of population growth, but in the unusual case of the 20th century, the world saw the biggest increase in its population in human history due to medical advances and massive increase in agricultural productivity made by the Green Revolution Note : The Green Revolution is the ongoing transformation of agriculture that led in some places to significant increases in agricultural production between the 1940s and 1960s. The associated transformation has been occurring as the result of programs of agricultural research, extension, and infrastructural development

Globally, the population growth rate has been steadily declining from its peak of 2.19% in 1963, but growth remains high in the Middle East and Sub Saharan Africa (the area of the African continent which lies south of the Sahara). In some countries there is negative population growth (i.e. net decrease in population over time), especially in Central and Eastern Europe (mainly due to low fertility rates) and Southern Africa (due to the high number of HIV-related deaths). Within the next decade, Japan and some countries in Western Europe are also expected to encounter negative population growth due to sub replacement fertility rates. Note : Sub-replacement fertility is a total fertility rate that is not high enough to replace an area's population

Population distribution
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Asia accounts for over 60% of the world population with almost 3.8 billion people. Peoples Republic of China and India alone comprise 20% and 16% respectively. Africa follows with 840 million people, 12% of the world population. Europe's 710 million people make up 11% of the world's population. North America is home to 514 million (8%), South America to 371 million (5.3%), and Australia 21 million. Note : Malaysia has a population of 28.39 million as at July 2009 (Department of Statistics Malaysia)

The 15 most populous nations Population by region, 2005

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China: 1.32 billion (about 20% of world population) India: 1.12 billion (about 17%) United States: 300 million (about 4.6%) Indonesia: 225 million (about 3.5%) Brazil: 186 million (about 2.8%) Pakistan: 165 million (about 2.5%) Bangladesh: 147 million (about 2.3%) Russia: 143 million (about 2.2%)

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Nigeria: 135 million (about 2.1%) Japan: 128 million (about 2.0%) Mexico 108 million (about 1.7%) Vietnam: 87 million (about 1.3%) Philippines: 86 million (about 1.3%) Germany: 82 million (about 1.3%) Egypt: 75 million (about 1.2%) Approximately 4.3 billion people live in these 15 countries, representing roughly two-thirds of the world's population.

REGULATION OF POPULATION AND HEALTH

1.What is overpopulation?

2.What are the causes of overpopulation? OVERPOPULATION 3.What are the effects of overpopulation?

4.How to control overpopulation?

Overpopulation
Overpopulation refers to when an organism's numbers exceed the carrying capacity of its habitat. In common parlance, the term usually refers to the relationship between the human population and its environment, the Earth. Overpopulation is not simply a function of the size or density of the population. Overpopulation can be determined using the ratio of population to available sustainable resources.

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If a given environment has a population of ten, but there is food or drinking water enough for only nine, then that environment is overpopulated; if the population is 100 individuals but there is enough food, shelter, and water for 200 for the indefinite future, then it is not overpopulated.

CAUSES OF OVERPOPULATION

1.Decline in the Death Rate

2.Rise in the Birth Rate

3.Lack of Education

4.Immigrati on

1) Decline in the Death Rate.

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The fall in death rates that is decline in mortality rate is one fundamental causes of overpopulation. Owing to the advancements in medicine, man has found cures to the previously fatal diseases. The new inventions in medicine have brought in treatments for most of the dreadful diseases. This has resulted in an increase in the life expectancy of individuals. Mortality rate has declined leading to an increase in population. Owing to modern medications and improved treatments to various illnesses, the overall death rate has gone down. The brighter side of it is that we have been able to fight many diseases and prevent deaths. On the other hand, the medical boon has brought with it, the curse of overpopulation.

2) Rise in the Birth Rate:

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The new discoveries in nutritional science have been able to bring in increase in the fertility rates of human beings. Medicines of today can boost the reproductive rate in human beings. There are medicines and treatments, which can help in conception. Thus, science has led to an increase in birth rate. This is certainly a reason to be proud and happy but advances in medicine have also become a cause of overpopulation. This combination of high birth rates and low death rates has led to the population explosion in many countries throughout the world.

3.Lack of Education
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Illiteracy is another important cause of overpopulation. Those lacking education fail to understand the need to prevent excessive growth of population. They are unable to understand the harmful effects that overpopulation has. They are unaware of the ways to control population. Lack of family planning is commonly seen in the illiterate lot of the world. This is one of the major factors leading to overpopulation. Due to ignorance, they do not take to family planning measures, thus contributing to a rise in population.

4.Immigration
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Immigration is a problem in some parts of the world. If the inhabitants of various countries migrate to a particular part of the world and settle over there, the area is bound to suffer from the ill effects of overpopulation. If the rates of emigration from a certain nation do not match the rates of immigration to that country, overpopulation makes its way. The country becomes overly populated. Crowding of immigrants in certain parts of the world, results in an imbalance in the density of population.

Effects of overpopulation
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Some problems associated with or exacerbated by human overpopulation: 1. Inadequate fresh water for drinking, water use as well as sewage treatment and effluent discharge. Some countries, like Saudi Arabia, use energy-expensive desalination to solve the problem of water shortages. 2. Depletion of natural resources, especially fossil fuels

3. Increased levels of air pollution, water pollution, soil contamination and noise pollution. Once a country has industrialized and become wealthy, a combination of government regulation and technological innovation causes pollution to decline substantially, even as the population continues to grow.

4. Deforestation and loss of ecosystems that sustain global atmospheric oxygen and carbon dioxide balance; about eight million hectares of forest are lost each year. 5. Changes in atmospheric composition and consequent global warming

6. Irreversible loss of arable land and increases in desertification. Deforestation and desertification can be reversed by adopting property rights, and this policy is successful even while the human population continues to grow.

7. Mass species extinctions from reduced habitat in tropical forests due to slash and burn techniques that sometimes are practiced by shifting cultivators, especially in countries with rapidly expanding rural populations. 8. High infant and child mortality. High rates of infant mortality are caused by poverty. Rich countries with high population densities have low rates of infant mortality

9. Increased chance of the emergence of new epidemics and pandemics  An epidemic is an outbreak of a contagious disease that spreads rapidly and widely among the population in a specific area. Immunization and quarantine are two of the methods used to control an epidemic.  A pandemic is a geographically widespread epidemic that occurs throughout a region or even throughout the world.

10. Starvation, malnutrition or poor diet with ill health and diet-deficiency diseases (e.g. rickets). Famine is aggravated by poverty. Rich countries with high population densities do not have famine.
Rickets is a softening of the bones in children potentially leading to fractures and deformity. Rickets is among the most frequent childhood diseases in many developing countries. The predominant cause is a Vitamin deficiency, but lack of adequate calcium in the diet may also lead to rickets. Although it can occur in adults, the majority of cases occur in children suffering from severe malnutrition, usually resulting from famine or starvation during the early stages of childhood

11. Poverty coupled with inflation in some regions and a resulting low level of capital formation. Poverty and inflation are aggravated by bad government and bad economic policies. Many countries with high population densities have eliminated absolute poverty and keep their inflation rates very low. 12. Low life expectancy in countries with the fastest growing populations

13. Unhygienic living conditions for many based upon water resource depletion, discharge of raw sewage and solid waste disposal. 14. Elevated crime rate due to drug cartels and increased theft by people stealing resources to survive. 15. Conflict over scarce resources and crowding, leading to increased levels of warfare

How to control overpopulation?

Population control is the practise of limiting population increase, usually by reducing the birth rate. y There are many ways to control the overpopulation such as: 1. Sexual abstinence, 2. Abortion, 3. Emigration, 4. Sterilization, 5. Contraception, 6. Infanticide.
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1.Sexual abstinence
It is the practice of refraining from some or all aspects of sexual activity for medical, psychological, legal, social or religious reasons. y Common reasons for practicing sexual abstinence include poor health - medical celibacy, material reasons (to prevent conception undesired pregnancy or sexually transmitted infection or transmission), psycho-sociological reasons (e.g., clinical depression, social anxiety disorder, increasing testosterone in males, or negative past experiences) or legal injunctions requiring conformity.
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2.Abortion
Abortion is the termination of a pregnancy by the removal or expulsion from the uterus of a foetus or embryo, resulting in or caused by its death. y An abortion can occur spontaneously due to complications during pregnancy or can be induced, in humans and other species. y In the context of human pregnancies, an abortion induced to preserve the health of the gravid (pregnant female) is termed a therapeutic abortion, while an abortion induced for any other reason is termed an elective abortion. y The term abortion most commonly refers to the induced abortion of a human pregnancy, while spontaneous abortions are usually termed miscarriages.
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3.Emigration
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Emigration is the act of leaving one's native country or region to settle in another. It is the same as immigration but from the perspective of the country of origin. Human movement before the establishment of political boundaries or within one state is termed migration. There are many reasons why people might choose to emigrate. Some are for reasons of religious, political or economic freedom or escape. Others have personal reasons such as marriage. Some people living in rich nations with cold climates choose to move to warmer climates when they retire.

4.Sterilization
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Sterilization is available in the form of tubal ligation for women and vasectomy for men. Sterilization should be considered permanent. In women, the process may be referred to as "tying the tubes," but the Fallopian tubes may be tied, cut, clamped, or blocked. This serves to prevent sperm from joining the unfertilized egg. The non-surgical sterilization procedure, Essure, is an example of a procedure that blocks the tubes, wherein micro-inserts are placed into the fallopian tubes by a catheter passed from the vagina through the cervix and uterus. Although sterilization should be considered a permanent procedure, it is possible to attempt a tubal ligation reversal to reconnect the Fallopian tubes in females, or a vasovasostomy by which vasectomies are reversed in males. The rate of success depends on the type of sterilization that was originally performed and damage done to the tubes as well as the patient's age

An important example of mandated population control is Chine's one-child policy in which having more than one child is made extremely unattractive. China's population policy has been credited with a very significant slowing of China's population growth which had been very high before the policy was implemented. y It has come under criticism that the implementation of the policy has involved forced abortions and forced sterilization. y However, while the punishment of "Unplanned" pregnancy is a fine, both forced abortion and forced sterilization can be charged with intentional assault, which is punished with up to 10 years' imprisonment. y Another noted example is Iran, which has succeeded in sharply reducing its birth rate in recent years.
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5.Contraception
Contraception is another important way to limit population growth is to increase the rate of contraception among the population. y Contraception, while not infallible, drastically reduces fertility rates, often with minimal expense. y While contraception and education about using contraception is widely available in rich countries, people in poor countries may not have access to simple contraceptive methods like condoms, or even know what they are. y Not only can poor nations in areas like Africa and Southeast Asia benefit from the fertility control aspect of contraception, but condoms can also help prevent the spread of STDs like AIDS, which is an epidemic in many poor nations.
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6.Infanticide
Infanticide is the practice of intentionally killing an infant. Often it is the mother who commits the act, but criminology recognizes various forms of nonmaternal child murder. y In many past societies, certain forms of infanticide were considered permissible. y Female infanticide is more common than the killing of male offspring due to sex-selective infanticide. y In the United Kingdom, the Infanticide Act defines "infanticide" as a specific crime equivalent to manslaughter that can only be committed by the mother intentionally killing her own baby during the first twelve months of its life; in other cultures, the concept of infanticide includes the intentional killing of children older than twelve months.
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CONCLUSION
There are many causes and effects of global overpopulation which much depends on the circumstances of each country. y The factors of overpopulation actually may be control by the peoples themselves. As the factors being controlled, the negative effects of overpopulation also could be reduced. y This will lead to healthier and peaceful countries without any problems of limited resources and any other negative consequences. Therefore, peoples have to be alert and start to do something to prevent this problem of overpopulation from being worsen.
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ASSIGNMENT 4
GROUP 1 - According to the World Health Organization health care cost around the world is increasing by the day. Discuss the reasons for such an increase and methods to be taken to ensure that medical treatment is available for every human being. y GROUP 2 - There is enough food in the world for everyone to have enough to eat but it is unevenly distributed or poorly harvested or productivity was destroyed through war and natural disaster. Discuss what can be done in order to secure enough food for everyone. y GROUP 3 - Discuss the major steps to eradicate poverty in order to accelerate global economic growth.
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THE WORLD HEALTH ORGANIZATION (WHO)

History of WHO
When diplomats met to form the United Nations in 1945, one of the things they discussed was setting up a global health organization. y WHOs Constitution came into force on 7 April 1948 a date we now celebrate every year as World Health Day.
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What is WHO?
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WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for :providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends.

In the 21st century, health is a shared responsibility, involving equitable access to essential care and collective defence against transnational threats.

The role of WHO in public health

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WHO fulfils its objectives through its core functions: providing leadership on matters critical to health and engaging in partnerships where joint action is needed; shaping the research agenda and stimulating the generation, translation and dissemination of valuable knowledge; setting norms and standards and promoting and monitoring their implementation; articulating ethical and evidence-based policy options; providing technical support, catalysing change, and building sustainable institutional capacity; and monitoring the health situation and assessing health trends. These core functions are set out in the 11th General Programme of Work, which provides the framework for organization-wide programme of work, budget, resources and results. Entitled "Engaging for health", it covers the 10-year period from 2006 to 2015.

Governance of WHO
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WHO's objective, as set out in its Constitution, is the attainment by all peoples of the highest possible level of health. The Constitution defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The World Health Assembly is the supreme decision-making body for WHO. It meets each year in May in Geneva, and is attended by delegations from all 193 Member States. The Executive Board is composed of 34 members technically qualified in the field of health. Members are elected for three-year terms.The main Board meeting, at which the agenda for the forthcoming Health Assembly is agreed upon and resolutions are adopted for forwarding to the Health Assembly, is held in January, with a second shorter meeting in May, immediately after the Health Assembly, for more administrative matters.

WHO - its people and offices

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More than 8000 people from more than 150 countries work for the Organization in 147 country offices, six regional offices and at the headquarters in Geneva, Switzerland. In addition to medical doctors, public health specialists, scientists and epidemiologists,WHO staff include people trained to manage administrative, financial, and information systems, as well as experts in the fields of health statistics, economics and emergency relief.

The WHO agenda

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WHO operates in an increasingly complex and rapidly changing landscape. The boundaries of public health action have become blurred, extending into other sectors that influence health opportunities and outcomes. WHO responds to these challenges using a six-point agenda. The six points address :two health objectives, two strategic needs, and two operational approaches. The overall performance of WHO will be measured by the impact of its work on women's health and health in Africa.

1. Promoting development
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During the past decade, health has achieved unprecedented prominence as a key driver of socioeconomic progress, and more resources than ever are being invested in health. Yet poverty continues to contribute to poor health, and poor health anchors large populations in poverty. Health development is directed by the ethical principle of equity: Access to life-saving or health-promoting interventions should not be denied for unfair reasons, including those with economic or social roots. Commitment to this principle ensures that WHO activities aimed at health development give priority to health outcomes in poor, disadvantaged or vulnerable groups. Attainment of the health-related Millennium Development Goals, preventing and treating chronic diseases and addressing the neglected tropical diseases are the cornerstones of the health and development agenda.

2. Fostering health security

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Shared vulnerability to health security threats demands collective action. One of the greatest threats to international health security arises from outbreaks of emerging and epidemic-prone diseases. Such outbreaks are occurring in increasing numbers, fuelled by such factors as :rapid urbanization, environmental mismanagement, the way food is produced and traded, and the way antibiotics are used and misused. The world's ability to defend itself collectively against outbreaks has been strengthened since June 2007, when the revised International Health Regulations came into force.

3. Strengthening health systems

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For health improvement to operate as a poverty-reduction strategy, health services must reach poor and underserved populations. Health systems in many parts of the world are unable to do so, making the strengthening of health systems a high priority for WHO. Areas being addressed include :the provision of adequate numbers of appropriately trained staff, sufficient financing, suitable systems for collecting vital statistics, and access to appropriate technology including essential drugs.

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4. Harnessing research, information and evidence

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Evidence provides the foundation for setting priorities, defining strategies, and measuring results. WHO generates authoritative health information, in consultation with leading experts, to :set norms and standards, articulate evidence-based policy options and monitor the evolving global heath situation.

5. Enhancing partnerships
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WHO carries out its work with the support and collaboration of many partners, including UN agencies and other international organizations, donors, civil society and the private sector. WHO uses the strategic power of evidence to encourage partners implementing programmes within countries to align their activities with best technical guidelines and practices, as well as with the priorities established by countries.

6. Improving performance
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WHO participates in ongoing reforms aimed at improving its efficiency and effectiveness, both at the international level and within countries. WHO aims to ensure that its strongest asset its staff - works in an environment that is motivating and rewarding. WHO plans its budget and activities through results-based management, with clear expected results to measure performance at country, regional and international levels.

Data and statistics

A new estimate shows that close to half a million women died of maternal causes in 2005. About 99% of these deaths occurred in developing countries. Despite the global commitment to reduce the maternal mortality ratio by 5.5%, the current rate of decline is about less than 0.4% per annum.

The World Health Report

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The World Health Report, first published in 1995, is WHO's leading publication. Each year the report combines an expert assessment of global health, including statistics relating to all countries, with a focus on a specific subject. The main purpose of the report is to provide countries, donor agencies, international organizations and others with the information they need to help them make policy and funding decisions. The report is also offered to a wider audience, from universities, teaching hospitals and schools, to journalists and the public at large - anyone, in fact, with a professional or personal interest in international health issues.

World Health Report 2007

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The World Health Report 2007 - A safer future: global public health security in the 21st century Marks a turning point in the history of public health, and signals what could be one of the biggest advances in health security in half a century. It shows how the world is at increasing risk of disease outbreaks, epidemics, industrial accidents, natural disasters and other health emergencies which can rapidly become threats to global public health security. The report explains how the revised International Health Regulations (2005), which came into force this year, helps countries to work together to identify risks and act to contain and control them. The regulations are needed because no single country, regardless of capability or wealth, can protect itself from outbreaks and other hazards without the cooperation of others. The report says the prospect of a safer future is within reach - and that this is both a collective aspiration and a mutual responsibility.

Alma Ata Declaration

The Declaration of Alma-Ata was adopted at the International Conference on Primary Health Care,Almaty, presently in Kazakhtan, 6-12 September 1978. y It expressed the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world. y It was the first international declaration underlining the importance of primary health care. y The primary health care approach has since then been accepted by member countries of WHO as the key to achieving the goal of "Health for All".
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Primary health care, often abbreviated as PHC, is "essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and the country can afford to maintain at every stage of their development in the spirit of self-determination"(Alma Ata international conference definition) It was a new approach to health care that came into existence following this international conference in Alma Ata in 1978 organized by the World Health Organisation and the UNICEF. Primary health care was accepted by the member countries of WHO as the key to achieving the goal of Health for all.

Primary health care is essential health care made universally accessible to individuals and families in the community by means acceptable to them, through their full participation and at a cost that the community and country can afford. It forms an integral part both of the country's health system of which it is the nucleus and of the overall social and economic development of the community - WHO