National Security Study Memorandum NSSM 200

Implications of Worldwide Population Growth For U.S. Security and Overseas Interests

(THE KISSINGER REPORT)

December 10, 1974

CLASSIFIED BY Harry C. Blaney, III

SUBJECT TO GENERAL DECLASSIFICATION SCHEDULE OF EXECUTIVE ORDER 11652 AUTOMATICALLY DOWNGRADED AT TWO YEAR INTERVALS AND DECLASSIFIED ON DECEMBER 31, 1980.

This document can only be declassified by the White House.

Declassified/Released on 7/3/89 under provisions of E.O. 12356 by F. Graboske, National Security Council LINK

This entire article is excerpts taken directly from the 200 page report. Comments I make will be in [brackets – G.C.] All highlighting is mine. I am not going to put this monster in quotes.

TABLE OF CONTENTS …. Pages
Executive Summary 4-17
Part One — Analytical Section Chapter I World Demographic Trends 19-34
Chapter II Population and World Food Supplies 34-39
Chapter III Minerals and Fuel 40-49
Chapter IV Economic Development and Population Growth 50-55
Chapter V Implications of Population Pressures for National Security 56-65
Chapter Vl World Population Conference 66-72

Part Two — Policy Recommendations 73
Section I A U.S. Global Population Strategy 74-84
Section II Action to Create Conditions for Fertility Decline: Population and a Development Assistance Strategy 85-105

A. General Strategy and Resource for A.I.D. 85-91
Assistance B. Functional Assistance Programs to Create 92-102
Conditions for Fertility Decline C. Food for Peace Program and Population 103-105
Section III International Organizations and other Multilateral Population Programs 106-107

A. UN Organization and Specialized Agencies

B. Encouraging Private Organizations
Section IV Provision and Development of Family Planning Services, information and Technology 108-120
A. Research to Improve Fertility Control Technology
B. Development of Low-Cost Delivery Systems

C. Utilization of Mass Media and Satellite Communications System for Family Planning Section V Action to Develop Worldwide Political and Popular Commitment to Population Stability 121-123

……..

…General Goals and Requirements for Dealing With Rapid Population Growth

23. The central question for world population policy in the year 1974, is whether mankind is to remain on a track toward an ultimate population of 12 to 15 billion — implying a five to seven-fold increase in almost all the underdeveloped world outside of China — or whether (despite the momentum of population growth) it can be switched over to the course of earliest feasible population stability — implying ultimate totals of 8 to 9 billions and not more than a three or four-fold increase in any major region.

24. What are the stakes? We do not know whether technological developments will make it possible to feed over 8 much less 12 billion people in the 21st century. We cannot be entirely certain that climatic changes in the coming decade will not create great difficulties in feeding a growing population, especially people in the LDCs who live under increasingly marginal and more vulnerable conditions. There exists at least the possibility that present developments point toward Malthusian conditions for many regions of the world. 25. But even if survival for these much larger numbers is possible, it will in all likelihood be bare survival…

28. World policy and programs in the population field should incorporate two major objectives:

(a) actions to accommodate continued population growth up to 6 billions by the mid-21st century without massive starvation or total frustration of developmental hopes; and (b) actions to keep the ultimate level as close as possible to 8 billions rather than permitting it to reach 10 billions, 13 billions, or more.

29. While specific goals in this area are difficult to state, our aim should be for the world to achieve a replacement level of fertility, (a two- child family on the average), by about the year 2000. This will require the present 2 percent growth rate to decline to 1.7 percent within a decade and to 1.1 percent by 2000 compared to the U.N medium projection, this goal would result in 500 million fewer people in 2000 and about 3 billion fewer in 2050. Attainment of this goal will require greatly intensified population programs. A basis for developing national population growth control targets to achieve this world target is contained in the World Population Plan of Action. 30. The World Population Plan of Action is not self-enforcing and will require vigorous efforts by interested countries, U.N. agencies and other international bodies to make it effective. U.S. leadership is essential….

[World Population 1950-2023 shows this goal was achieved -G.C.]

37. There is an alternative view which holds that a growing number of experts believe that the population situation is already more serious and less amenable to solution through voluntary measures than is generally accepted. It holds that, to prevent even more widespread food shortage and other demographic catastrophes than are generally anticipated, even stronger measures are required and some fundamental, very difficult moral issues need to be addressed. These include, for example, our own consumption patterns, mandatory programs, tight control of our food resources. In view of the seriousness of these issues, explicit consideration of them should begin in the Executive Branch, the Congress and the U.N. soon….

Thus, barring both large-scale birth control efforts (greater than implied by the medium variant) or economic or political upheavals, the next twenty-five years offer non-communist LDCs little respite from the burdens of rapidly increasing humanity. Of course, some LDCs will be able to accommodate this increase with less difficulty than others. Moreover, short of Draconian measures there is no possibility that any LDC can stabilize its population at less than double its present size. For many, stabilization will not tee short of three times their present size….

Rapid population growth and lagging food production in developing countries, together with the sharp deterioration in the global food situation in 1972 and 1973, have raised serious concerns about the ability of the world to feed itself adequately over the next quarter century and beyond.

There is great uncertainty whether the conditions for achieving food balance in the LDCs can in fact be realized. Climatic changes are poorly understood, but a persistent atmospheric cooling trend since 1940 has been established. [REMEMBER in 1972 Strong in his Stockholm speech warned urgently about global warming, the devastation of forests, the loss of biodiversity, polluted oceans, the population time bomb. …Strong was Secretary General of the first United Nations Conference on the Environment and Population in 1972, President of the Rockefeller Foundation, head of the World Bank, head of the United Nations Environmental Program, a member of the Foundation Board of the World Economic Forum and a committed socialist and globalist…. He was also one of Klaus Schwab’s mentors. – G.C.] One respectable body of scientific opinion believes that this portends a period of much wider annual frosts, and possibly a long-term lowering of rainfall in the monsoon areas of Asia and Africa. Nitrogen fertilizer will be in world short supply into the late 1970s, at least; because of higher energy prices, it may also be more costly in real terms than in the 1960s….

Even if massive famine can be averted, the most optimistic forecasts of food production potential in the more populous LDCs show little improvement in the presently inadequate levels and quality of nutrition. … The problem is clear. The solutions, or at least the directions we must travel to reach them are also generally agreed. What will be required is a genuine commitment to a set of policies that will lead the international community, both developed and developing countries, to the achievement of the objectives spelled out above….

… the focal point of the World Population Conference (WPC) at Bucharest, Romania, in August 1974, was the World Population Plan of Action (WPPA) ….

Despite the initial attack and continuing efforts to change the conceptual basis of the world Population Plan of Action, the Conference adopted by acclamation (only the Holy See staking a general reservation) a complete World Population Plan of Action….

[“Declaration on Procured Abortion” (1974), by the Vatican – Ratified on 28 June 1974 by Pope Paul VI. Was this declaration against ANY abortion why Pope Paul was removed on August 6, 1978? – G.C.]

The Plan of Action lays down several important principles, some for the first time in a U.N. document….

…for the first time, a U.N. document links the responsibility of child-bearers to the community [Para 13(f) continued]: The responsibility of couples and individuals in the exercise of this right takes into account the needs of their living and future children, and their responsibilities towards the community….

The growing interdependence of countries makes the adoption of measures at the international level increasingly important for the solution of problems of development and population problems….

The U.N. low variant projection used in these paragraphs is close to the goals proposed by the United States and other ECAFE nations: – For developed countries – replacement levels of fertility by 1985; stationary populations as soon as practicable. – For developing countries – replacement levels in two or three decades. – For the world – a 1.7% population growth rate by 1985 with 2% average for the developing countries and 0.7% average for developed countries; replacement level of fertility for all countries by 2000. The dangerous situation evidenced by the current food situation and projections for the future make it essential to press for the realization of these goals….

In addition, the U.S. strategy should support in these LDC countries general activities (e.g. bio-medical research or fertility control methods) capable of achieving major breakthroughs in key problems which hinder reductions in population growth….

Two main advances are required for providing safe and effective fertility control techniques in the developing countries:

1. Expansion and further development of efficient low-cost systems to assure the full availability of existing family planning services, materials and information to the 85% of LDC populations not now effectively reached. In developing countries willing to create special delivery systems for family planning services this may be the most effective method. In others the most efficient and acceptable method is to combine family planning with health or nutrition in multi-purpose delivery systems.

2. Improving the effectiveness of present means of fertility control, and developing new technologies which are simple, low cost, effective, safe, long- lasting and acceptable to potential users. This involves both basic developmental research and operations research to judge the utility of new or modified approaches under LDC conditions.
   • Two main advances are required for providing safe and effective fertility control techniques in the developing countries:

Expansion and further development of efficient low-cost systems to assure the full availability of existing family planning services, materials and information to the 85% of LDC populations not now effectively reached. In developing countries willing to create special delivery systems for family planning services this may be the most effective method. In others the most efficient and acceptable method is to combine family planning with health or nutrition in multi-purpose delivery systems.

Improving the effectiveness of present means of fertility control, and developing new technologies which are simple, low cost, effective, safe, long- lasting and acceptable to potential users. This involves both basic developmental research and operations research to judge the utility of new or modified approaches under LDC conditions. It is clear that the availability of contraceptive services and information is not a complete answer to the population problem….

[THIS PUTS A WHOLE OTHER TWIST ON THE LAWS AND ROE vs WADE]

The U.S. strengthened its credibility as an advocate of lower population growth rates by explaining that, while it did not have a single written action population policy, it did have legislation, Executive Branch policies and court decisions that amounted to a national policy and that our national fertility level was already below replacement and seemed likely to attain a stable population by 2000….

The U.S. further offered to collaborate with other interested donor countries and organizations (e.g., WHO, UNFPA, World Bank, UNICEF) to encourage further action by LDC governments and other institutions to provide low-cost, basic preventive health services, including maternal and child health and family planning services, reaching out into the remote rural areas…

We should also appeal to potential leaders among the younger generations in developing countries, focusing on the implications of continued rapid population growth for their countries in the next 10-20 years, when they may assume national leadership roles…. [Think London School of Economics — G.C.]

… increased emphasis on mass media and other population education and motivation programs by the U.N., USIA, and USAID. We should give higher priorities in our information programs world-wide for this area and consider expansion of collaborative arrangements with multilateral institutions in population education programs….

An Alternative View The above basic strategy assumes that the current forms of assistance programs in both population and economic and social development areas will be able to solve the problem. There is however, another view, which is shared by a growing number of experts. It believes that the outlook is much harsher and far less tractable than commonly perceived. This holds that the severity of the population problem in this century which is already claiming the lives of more than 10 million people yearly, is such as to make likely continued widespread food shortage and other demographic catastrophes, and, in the words of C.P. Snow, we shall be watching people starve on television.

The conclusion of this view is that mandatory programs may be needed and that we should be considering these possibilities now. This school of thought believes the following types of questions need to be addressed:
— Should the U.S. make an all out commitment to major limitation of world population with all the financial and international as well as domestic political costs that would entail?
— Should the U.S. set even higher agricultural production goals which would enable it to provide additional major food resources to other countries? Should they be nationally or internationally controlled?
— On what basis should such food resources then be provided? Would food be considered an instrument of national power? Will we be forced to make choices as to whom we can reasonably assist, and if so, should population efforts be a criterion for such assistance?
— Is the U.S. prepared to accept food rationing to help people who can’t/won’t control their population growth?
— Should the U.S. seek to change its own food consumption patterns toward more efficient uses of protein? [Crickets Anyone? G.C.]
— Are mandatory population control measures appropriate for the U.S. and/or for others?
— Should the U.S. initiate a major research effort to address the growing problems of fresh water supply, ecological damage, and adverse climate?….

Should the choice be made that the recommendations and the options given below are not adequate to meet this problem, consideration should be given to a further study and additional action in this field as outlined above….

Conclusion:
The overall strategy above provides a general approach through which the difficulties and dangers of population growth and related problems can be approached in a balanced and comprehensive basis. No single effort will do the job. Only a concerted and major effort in a number of carefully selected directions can provide the hope of success in reducing population growth and its unwanted dangers to world economic will-being and political stability. There are no “quick-fixes” in this field.

Below are specific program recommendations which are designed to implement this strategy. Some will require few new resources; many call for major efforts and significant new resources. We cannot simply buy population growth moderation for nearly 4 billion people “on the cheap”….

Since inception of the program in 1965, AID has obligated nearly $625 million for population activities. …Since the Fund’s establishment, AID has been the largest single contributor. Moreover, with assistance from AID a number of private family planning organizations (e.g., Pathfinder Fund, International Planned Parenthood Foundation, Population Council) have significantly expanded their worldwide population programs. Such organizations are still the main supporters of family planning action in many developing countries…

[Discussion of funding -G.C.]

There are three major factors to consider in judging the seriousness of the problem: — The first is the country’s contribution to the world’s population problem, which is determined by the size of its population, its population growth rate, and its progress in the “demographic transition” from high birth and high death rates to low ones.
— The second is the extent to which population growth impinges on the country’s economic development and its financial capacity to cope with its population problem.
— The third factor is the extent to which an imbalance between growing numbers of people and a country’s capability to handle the problem could lead to serious instability, international tensions, or conflicts. Although many countries may experience adverse consequences from such imbalances, the trouble making regional or international conditions might not be as serious in some places as they are in others.

[Discussion of direct intervention and the use of NGOs – G.C.]

…U.S. assistance is limited either by the nature of political or diplomatic relations with those countries (e.g. India, Egypt), or by the lack of strong government interest in population reduction programs (e.g. Nigeria, Ethiopia, Mexico, Brazil)…

In addition, the U.S. strategy should support general activities capable of achieving major breakthroughs in key problems which hinder attainment of fertility control objectives. For example, the development of more effective, simpler contraceptive methods through big-medical research will benefit all countries which face the problem of rapid population growth… Some major actions in the area of creating conditions for fertility decline, as described in Section JIB, can be funded from AID resources available for the sectors in question (e.g., education, agriculture). Other actions come under the purview of population (“Title X”) funds. In this latter category, increases in projected budget requests to the Congress on the order of $35-50 million annually through FY 1980 — above the $137.5 million requested by FY 1975 — appear appropriate at this time. Such increases must be accompanied by expanding contributions to the worldwide population effort from other donors and organizations …

Our objective should be to assure that developing countries make family planning information, educational and means available to all their peoples by 1980. Our efforts should include:

— Increased A.I.D. bilateral and centrally-funded programs, consistent with the geographic priorities cited above.

— Expanded contributions to multilateral and private organizations that can work effectively in the population area.

— Further research on the relative impact of various socio-economic factors on desired family size, and experimental efforts to test the feasibility of larger-scale efforts to affect some of these factors.

— Additional big-medical research to improve the existing means of fertility control and to develop new ones which are safe, effective, inexpensive, and attractive to both men and women.

— Innovative approaches to providing family planning services, such as the utilization of commercial channels for distribution of contraceptives, and the development of low-cost systems for delivering effective health and family planning services to the 85% of LDC populations not now reached by such services.

— Expanded efforts to increase the awareness of LDC leaders and publics regarding the consequences of rapid population growth and to stimulate further LDC commitment to actions to reduce fertility….

… the need to assure that new projects involve sensible, effective actions that are likely to reduce fertility….

It is clear that the availability of contraceptive services and information, important as that is, is not the only element required to address the population problems of the LDCs. Substantial evidence shows that many families in LDCs (especially the poor) consciously prefer to have numerous children for a variety of economic and social reasons. For example, small children can make economic contributions on family farms, children can be important sources of support for old parents where no alternative form of social security exists, and children may be a source of status for women who have few alternatives in male-dominated societies….

…how much does it cost to educate a girl to the point where her fertility will be reduced (which occurs at about the fourth-grade level)? What specific programs in female education are most cost-effective (e.g., primary school, non-formal literacy training, or vocational or pre-vocational training)?

… laws that raise the minimum marriage age, where politically feasible and at least partially enforceable, can over time have a modest effect on fertility at negligible cost. Similarly, there have been some controversial, but remarkably successful, experiments in India in which financial incentives, along with other motivational devices, were used to get large numbers of men to accept vasectomies….

(4). AID should help develop capacity in a few existing U.S. and LDC institutions to serve as major centers for research and policy development in the areas of fertility-affecting social or economic measures, direct incentives, household behavior research, and evaluation techniques for motivational approaches….

High infant and child mortality rates, evident in many developing countries, lead parents to be concerned about the number of their children who are likely to survive. Parents may over compensate for possible child losses by having additional children. Research to date clearly indicates not only that high fertility and high birth rates are closely correlated but that in most circumstances low net population growth rates can only be achieved when child mortality is low as well….

Considerable reduction in infant and child mortality is possible through improvement in nutrition, inoculations against diseases, and other public health measures if means can be devised for extending such services to neglected LDC populations on a low-cost basis. It often makes sense to combine such activities with family planning services in integrated delivery systems in order to maximize the use of scarce LDC financial and health manpower resources…

[World Health Organization began working on an anti-fertility vaccine, led by Dr. G.P. Talwar in New Delhi, India, in the 1970s – G.C.]

….local medical communities tend to favor relatively expensive quality health care, even at the cost of leaving large numbers of people (in the LDC’s generally over two-thirds of the people) virtually uncovered by modern health services. (So involve World Bank low cost loans)…

As offered at Bucharest, the U.S. should join donor countries, WHO, UNFPA, UNICEF and the World Bank to create a consortium to offer assistance to the more needy developing countries to establish their own low-cost preventive and curative public health systems reaching into all areas of their countries and capable of national support within a reasonable period. Such systems would include family planning services as an ordinary part of their overall services.

– The WHO should be asked to take the leadership in such an arrangement and is ready to do so. Apparently at least half of the potential donor countries and the EEC’s technical assistance program are favourably inclined. So is the UNFPA and UNICEF. The U.S., through its representation on the World Bank Board, should encourage a broader World Bank initiative in this field, particularly to assist in the development of inexpensive, basic health service infrastructures in countries wishing to undertake the development of such systems….

3. Expanding Wage Employment Opportunities, Especially for Women

Employment is the key to access to income, which opens the way to improved health, education, nutrition, and reduced family size. Reliable job opportunities enable parents to limit their family size and invest in the welfare of the children they have. The status and utilization of women in LDC societies is particularly important in reducing family size. For women, employment outside the home offers an alternative to early marriage and childbearing, and an incentive to have fewer children after marriage. The woman who must stay home to take care of her children must forego the income she could earn outside the home. Research indicates that female wage employment outside the home is related to fertility reduction….

3. AID should enlarge pre-vocational and vocational training to involve women more directly in learning skills which can enhance their income and status in the community (e.g. paramedical skills related to provision of family planning services).

4. AID should encourage the development and placement of LDC women as decision-makers in development programs, particularly those programs designed to increase the role of women as producers of goods and services, and otherwise to improve women’s welfare (e.g. national credit and finance programs, and national health and family planning programs)….

4 . Developing Alternatives to the Social Security Role Provided By Children to Aging Parents

In most LDCs the almost total absence of government or other institutional forms of social security for old people forces dependence on children for old age survival. The need for such support appears to be one of the important motivations for having numerous children… (discussion of possible alternatives])

AID should encourage governments to consider such measures, and should provide financial and technical assistance where appropriate. [Is this why the USA is paying Ukrainian old age pensions??? -G.C.]

5. Pursuing Development Strategies that Skew Income Growth Toward the Poor, Especially Rural Development Focusing on Rural Poverty

…AID should continue its efforts to focus not just on agriculture and rural development but specifically on small farmers…

6. Concentration on Education and Indoctrination of The Rising Generation of Children Regarding the Desirability of Smaller Family Size

Present efforts at reducing birth rates in LDCs, including AID and UNFPA assistance, are directed largely at adults now in their reproductive years. Only nominal attention is given to population education or sex education in schools and in most countries none is given in the very early grades which are the only attainment of 2/3-3/4 of the children….The great necessity is to convince the masses of the population that it is to their individual and national interest to have, on the average, only three and then only two children. …Without diminishing in any way the effort to reach these adults, the obvious increased focus of attention should be to change the attitudes of the next generation, those who are now in elementary school or younger. If this could be done, it would indeed be possible to attain a level of fertility approaching replacement in 20 years and actually reaching it in 30.

Because a large percentage of children from high-fertility, low income groups do not attend school, it will be necessary to develop means to reach them for this and other educational purposes through informal educational programs…..

Recommendation

1. That U.S. agencies stress the importance of education of the next generation of parents, starting in elementary schools, toward a two-child family ideal.

2. That AID stimulate specific efforts to develop means of educating children of elementary school age to the ideal of the two-child family and that UNESCO be asked to take the lead through formal and informal education.

General Recommendation for UN Agencies

As to each of the above six categories State and AID should make specific efforts to have the relevant UN agency, WHO, ILO, FAO, UNESCO, UNICEF, and the UNFPA take its proper role of leadership in the UN family with increased program effort, citing the world Population Plan of Action. II. C. Food for Peace Program and Population Discussion: One of the most fundamental aspects of the impact of population growth on the political and economic well-being of the globe is its relationship to food. Here the problem of the interrelationship of population, national resources, environment, productivity and political and economic stability come together when shortages of this basic human need occur. USDA projections indicate that the quantity of grain imports needed by the LDCs in the 1980s will grow significantly, both in overall and per capita terms. In addition, these countries will face year-to-year fluctuations weather and other factors. This is not to say that the LDCs need face starvation in the next two decades, for the same projections indicate an even greater increase in production of grains in the developed nations. It should be pointed out, however, that these projections assume that such major problems as the vast increase in the need for fresh water, the ecological effects of the vast increase in the application of fertilizer, pesticides, and irrigation, and the apparent adverse trend in the global climate, are solved. At present, there are no solutions to these problems in sight. The major challenge will be to increase food production in the LDCs themselves and to liberalize the system in which grain is transferred commercially from producer to consumer countries…..

In the longer run, LDCs must both decrease population growth and increase agricultural production significantly. At some point the “excess capacity” of the food exporting countries will run out. Some countries have already moved from a net food exporter to a net importer of food….

In the longer run, LDCs must both decrease population growth and increase agricultural production significantly. At some point the “excess capacity” of the food exporting countries will run out. Some countries have already moved from a net food exporter to a net importer of food….

In particular, we believe that population growth may have very serious negative consequences on food production in the LDCs including over-expectations of the capacity of the land to produce, downgrading the ecological economics of marginal areas, and over-harvesting the seas. All of these conditions may affect the viability of the world’s economy and thereby its prospects for peace and security.

Recommendations: Since NSC/CIEP studies are already underway we refer the reader to them. However the following, we believe, are minimum requirements for any strategy which wishes to avoid instability and conflict brought on by population growth and food scarcity:

(1) High priority for U.S. bilateral and multilateral LDC Agricultural Assistance; including efforts by the LDCs to improve food production and distribution with necessary institutional adjustments and economic policies to stimulate efficient production. This must include a significant increase in financial and technical aid to promote more efficient production and distribution in the LDCs.
(2) Development of national food stocks *( including those needed for emergency relief – ) within an internationally agreed framework sufficient to provide an adequate level of world food security;
(3) Expansion of production of the input elements of food production (i.e., fertilizer, availability of water and high yield seed stocks) and increased incentives for expanded agricultural productivity. In this context a reduction n the real cost of energy (especially fuel) either through expansion in availability through new sources or decline in the relative price of oil or both would be of great importance;
(4) Significant expansion of U.S. and other producer country food crops within the context of a liberalized and efficient world trade system that will assure food availability to the LDCs in case of severe shortage. New international trade arrangements for agricultural products, open enough to permit maximum production by efficient producers and flexible enough to dampen wide price fluctuations in years when weather conditions result in either significant shortfalls or surpluses. We believe this objective can be achieved by trade liberalization and an internationally coordinated food reserve program without resorting to price-oriented agreements, which have undesirable effects on both production and distribution;
(5) The maintenance of an adequate food aid program with a clearer focus on its use as a means to make up real food deficits, pending the development of their own food resources, in countries unable to feed themselves rather than as primarily an economic development or foreign policy instrument; and (6) A strengthened research effort, including long term, to develop new seed and

• Department of Agriculture favours U.S. commercial interests holding any national stocks in an international network of stockpiles farming technologies, primarily to increase yields but also to permit more extensive cultivation techniques, particularly in LDCs
  [Clinton in his infinite wisdom signed the “Freedom to Fail Farm Bill” of 1996 that wiped out the US Strategic Grain Storage System and by 2008 the USDA reported “The cupboard is bare” just in time for the 2008 food crisis. – G.C.]
• III. International Organizations and other Multilateral Population Programs
• A. UN Organization and Specialized Agencies Discussion In the mid-sixties the UN member countries slowly began to agree on a greater involvement of the United Nations in population matters. In 1967 the Secretary-General created a Trust Fund to finance work in the population field. In 1969 the Fund was renamed the United Nations Fund for Population Activities (UNFPA) and placed under the overall supervision of the United Nations Development Program. During this period, also, the mandates of the Specialized Agencies were modified to permit greater involvement by these agencies in population activities.
• UNFPA’s role was clarified by an ECOSOC resolution in 1973:
• (a) to build up the knowledge and capacity to respond to the needs in the population and family planning fields;
• (b) to promote awareness in both developed and developing countries of the social, economic, and environmental implications of population problems;
• (c) to extend assistance to developing countries; and
• (d) to promote population programs and to coordinate projects supported by the UNFPA. Most of the projects financed by UNFPA are implemented with the assistance of organizations of the United Nations system, including the regional Economic Commission, United Nations Children’s Fund (UNICEF), International Labour Organization (ILO), Food and Agriculture Organization (FAO), United Nations Educational Scientific and Cultural Organization (UNESCO), the World Health Organization (WHO). Collaborative arrangements have been made with the International Development Association (IDA), an affiliate of the World Bank, and with the World Food Programme. Increasingly the UNFPA is moving toward comprehensive country programs negotiated directly with governments. This permits the governments to select the implementing (executing) agency which may be a member of the UN system or a non-government organization or company. With the development of the country program approach it is planned to level off UNFPA funding to the specialized agencies….
• B. Encouraging Private Organizations Discussion The cooperation of private organizations and groups on a national, regional and world-wide level is essential to the success of a comprehensive population strategy. These groups provide important intellectual contributions and policy support, as well as the delivery of family planning and health services and information. In some countries, the private and voluntary organizations are the only means of providing family planning services and materials.
• Recommendations: AID should continue to provide support to those private U.S. and international organizations whose work contributes to reducing rapid population growth, and to develop with them, where appropriate, geographic and functional divisions of labor in population assistance.
• Provision and Development of Family Planning Services, Information and Technology In addition to creating the climate for fertility decline, as described in a previous section, it is essential to provide safe and effective techniques for controlling fertility. There are two main elements in this task:
• (a) improving the effectiveness of the existing means of fertility control and developing new ones; and
• (b) developing low-cost systems for the delivery of family planning technologies, information and related services to the 85% of LDC populations not now reached.
• Legislation and policies affecting what the U.S. Government does relative to abortion in the above areas is discussed at the end of this section.
• A. Research to Improve Fertility Control Technology
• Discussion The effort to reduce population growth requires a variety of birth control methods which are safe, effective, inexpensive and attractive to both men and women. The developing countries in particular need methods which do not require physicians and which are suitable for use in primitive, remote rural areas or urban slums by people with relatively low motivation. Experiences in family planning have clearly demonstrated the crucial impact of improved technology on fertility control. None of the currently available methods of fertility control is completely effective and free of adverse reactions and objectionable characteristics. The ideal of a contraceptive, perfect in all these respects, may never be realized. A great deal of effort and money will be necessary to improve fertility control methods.
• The research to achieve this aim can be divided into two categories:
• Short-term approaches:
• These include applied and developmental work which is required to perfect further and evaluate the safety and role of methods demonstrated to be effective in family planning programs in the developing countries. Other work is directed toward new methods based on well established knowledge about the physiology of reproduction. Although short term pay-offs are possible, successful development of some methods may take 5 years and up to $15 million for a single method.
• Long-term approaches:
• The limited state of- fundamental knowledge of many reproductive processes requires that a strong research effort of a more basic nature be maintained to elucidate these processes and provide leads for contraceptive development research. For example, new knowledge of male reproductive processes is needed before research to develop a male “pill” can come to fruition. Costs and duration of the required research are high and difficult to quantify. With expenditures of about $30 million annually, a broad program of basic and applied big-medical research on human reproduction and contraceptive development is carried out by the Center for Population Research of the National Institute of Child Health and Human Development. The Agency for International Development annually funds about $5 million of principally applied research on new means of fertility control suitable for use in developing countries. Smaller sums are spent by other agencies of the U.S. Government. Coordination of the federal research effort is facilitated by the activities of the Interagency Committee on Population Research. This committee prepares an annual listing and analyses of all government supported population research programs. The listing is published in the Inventory of Federal Population Research. A variety of studies have been undertaken by non-governmental experts including the U.S. Commission on Population Growth and the American Future. Most of these studies indicate that the United States effort in population research is insufficient. Opinions differ on how much more can be spent wisely and effectively but an additional $25-50 million annually for bio-medical research constitutes a conservative estimate….
• Short-term approaches:
• These approaches include improvement and field testing of existing technology and development of new technology. It is expected that some of these approaches would be ready for use within five years. Specific short term approaches worthy of increased effort are as follows:
• a. Oral contraceptives have become popular and widely used; yet the optimal steroid hormone combinations and doses for LDC populations need further definition. Field studies in several settings are required. Approx. Increased Cost: $3 million annually.
• b. Intra-uterine devices of differing size, shape, and bioactivity should be developed and tested to determine the optimum levels of effectiveness, safety, and acceptability. Approx. Increased Cost: $3 million annually.
• c. Improved methods for ovulation prediction will be important to those couples who wish to practice rhythm with more assurance of effectiveness than they now have. Approx. Increased Cost: $3 million annually.
• d. Sterilization of men and women has received wide-spread acceptance in several areas when a simple, quick, and safe procedure is readily available. Female sterilization has been improved by technical advances with laparoscopes, culdoscopes, and greatly simplifies abdominal surgical techniques. Further improvements by the use of tubal clips, trans-cervical approaches, and simpler techniques can be developed. For men several current techniques hold promise but require more refinement and evaluation. Approx. Increased Cost $6 million annually.
• e. Injectable contraceptives for women which are effective for three months or more and are administered by pare-professionals undoubtedly will be a significant improvement. Currently available methods of this type are limited by their side effects and potential hazards. There are reasons to believe that these problems can be overcome with additional research. Approx. Increased Cost: $5 million annually.
• f. Leuteolytic and anto-progesterone approaches to fertility control including use of prostaglandins are theoretically attractive but considerable work remains to be done. Approx. Increased Cost: $7 million annually.
• g. Non-Clinical Methods. Additional research on non-clinical methods including foams, creams, and condoms is needed. These methods can be used without medical supervision. Approx. Increased Cost; $5 million annually.
• h. Field studies. Clinical trials of new methods in use settings are essential to test their worth in developing countries and to select the best of several possible methods in a given setting. Approx. Increased Cost: $8 million annually.
• Long-term approaches:
• Increased research toward better understanding of human reproductive physiology will lead to better methods of fertility control for use in five to fifteen years. A great deal has yet to be learned about basic aspects of male and female fertility and how regulation can be effected. For example, an -effective and safe male contraceptive is needed, in particular an injection which will be effective for specified periods of time. Fundamental research must be done but there are reasons to believe that the development of an injectable male contraceptive is feasible. Another method which should be developed is an injection which will assure a woman of regular periods. The drug would be given by pare-professionals once a month or as needed to regularize the menstrual cycle. Recent scientific advances indicate that this method can be developed. Approx. Increased Cost: $20 million annually.
• 
  B. Development of Low-cost Delivery Systems Discussion
  Exclusive of China, only 10-15% of LDC populations are currently effectively reached by family planning activities. If efforts to reduce rapid population growth are to be successful it is essential that the neglected 85- 90% of LDC populations have access to convenient, reliable family planning services. Moreover, these people — largely in rural but also in urban areas — not only tend to have the highest fertility, they simultaneously suffer the poorest health, the worst nutritional levels, and the highest infant mortality rates.
• Family planning services in LDCs are currently provided by the following means:
• Government-run clinics or centers which offer family planning services alone;
• Government-run clinics or centers which offer family planning as part of a broader based health service;
• Government-run programs that emphasize door to door contact by family planning workers who deliver contraceptives to those desiring them and/or make referrals to clinics;
• Clinics or centres run by private organizations (e.g., family planning associations);
• Commercial channels which in many countries sell condoms, oral contraceptives, and sometimes spermicidal foam over the counter;
• Private physicians. Two of these means in particular hold promise for allowing significant expansion of services to the neglected poor:
• Integrated Delivery Systems. This approach involves the provision of family planning in conjunction with health and/or nutrition services, primarily through government-run programs. There are simple logistical reasons which argue for providing these services on an integrated basis. Very few of the LDCs have the resources, both in financial and manpower terms, to enable them to deploy individual types of services to the neglected 85% of their populations. By combining a variety of services in one delivery mechanism they can attain maximum impact with the scarce resources available. In addition, the provision of family planning in the context of broader health services can help make family planning more acceptable to LDC leaders and individuals who, for a variety of reasons (some ideological, some simply humanitarian) object to family planning. Family planning in the health context shows a concern for the well-being of the family as a whole and not just for a couple’s reproductive function.
• Finally, providing integrated family planning and health services on a broad basis would help the U.S. contend with the ideological charge that the U.S. is more interested in curbing the numbers of LDC people than it is in their future and well-being. While it can be argued, and argued effectively, that limitation of numbers may well be one of the most critical factors in enhancing development potential and improving the chances for well-being, we should recognize that those who argue along ideological lines have made a great deal of the fact that the U.S. contribution to development programs and health programs has steadily shrunk, whereas funding for population programs has steadily increased.
• While many explanations may be brought forward to explain these trends, the fact is that they have been an ideological liability to the U.S. in its crucial developing relationships with the LDCs. A.I.D. currently spends about $35 million annually in bilateral programs on the provision of family planning services through integrated delivery systems. Any action to expand such systems must aim at the deployment of truly low- cost services. Health-related services which involve costly physical structures, high skill requirements, and expensive supply methods will not produce the desired deployment in any reasonable time. The basic test of low- cost methods will be whether the LDC governments concerned can assume responsibility for the financial, administrative, manpower and other elements of these service extensions. Utilizing existing indigenous structures and personnel (including traditional medical practitioners who in some countries have shown a strong interest in family planning) and service methods that involve simply-trained personnel, can help keep costs within LDC resource capabilities.
• 2. Commercial Channels. In an increasing number of LDCs, contraceptives
• Commercial Channels. In an increasing number of LDCs, contraceptives (such as condoms, foam and the Pill) are being made available without prescription requirements through commercial channels such as drugstores.* The commercial approach offers a practical, low-cost means of providing family planning services, since it utilizes an existing distribution system and does not involve financing the further expansion of public clinical delivery facilities. Both A.I.D. and private organizations like the IPPF are currently testing commercial distribution schemes in various LDCs to obtain further information on the feasibility, costs, and degree of family planning acceptance achieved through this approach. A.I.D. is currently spending about $2 million annually in this area.
• In order to stimulate LDC provision of adequate family planning services, whether alone or in conjunction with health services, A.I.D. has subsidized contraceptive purchases for a number of years…. These costs must ultimately be borne by LDC governments and/or individual consumers. Therefore, A.I.D. will increasingly focus on developing contraceptive production and procurement capacities by the LDCs themselves. A.I.D. must, however, be prepared to continue supplying large quantities of contraceptives over the next several years to avoid a detrimental hiatus in program supply lines while efforts are made to expand LDC production and procurement actions. A.I.D. should also encourage other donors and multilateral organizations to assume a greater share of the effort, in regard both to the short-term actions to subsidize contraceptive supplies and the longer-term actions to develop LDC capacities for commodity production and procurement.
• Recommendations:
• A.I.D. should aim its population assistance program to help achieve adequate coverage of couples having the highest fertility who do not now have access to family planning services.
• The service delivery approaches which seem to hold greatest promise of reaching these people should be vigorously pursued. For example:
  a. The U.S. should indicate its willingness to join with other donors and organizations to encourage further action by LDC governments and other institutions to provide low-cost family planning and health services to groups in their populations who are not now reached by such services. In accordance with Title X of the AID Legislation and current policy, A.I.D. should be prepared to provide substantial assistance in this area in response to sound requests.
  b. The services provided must take account of the capacities of the LDC governments or institutions to absorb full responsibility, over reasonable time-frames, for financing and managing the level of services involved.
  c. A.I.D. and other donor assistance efforts should utilize to the extent possible indigenous structures and personnel in delivering services, and should aim at the rapid development of local (community) action and sustaining capabilities.
  d. A.I.D. should continue to support experimentation with commercial distribution of contraceptives and application of useful findings in order to further explore the feasibility and replicability of this approach. Efforts in this area by other donors and organizations should be encouraged. Approx. U.S. Cost: $5-10 million annually.
• In conjunction with other donors and organizations, A.I.D. should actively encourage the development of LDC capabilities for production and procurement of needed family planning contraceptives.
• Special Footnote: While the agencies participating in this study have no specific recommendations to propose on abortion the following issues are believed important and should be considered in the context of a global population strategy.
• Abortion
• Worldwide Abortion Practices Certain facts about abortion need to be appreciated:
• — No country has reduced its population growth without resorting to abortion.
• — Thirty million pregnancies are estimated to be terminated annually by abortion throughout the world. The figure is a guess. More precise data indicate about 7 percent of the world’s population live in countries where abortion is prohibited without exception and 12 percent in countries where abortion is permitted only to save the life of the pregnant woman. About 15 percent live under statutes authorizing abortion on broader medical grounds, that is, to avert a threat to the woman’s health, rather than to her life, and sometimes on eugenic and/or juridical grounds (rape, etc.) as well. Countries where social factors may be taken into consideration to justify termination of pregnancy account for 22 percent of the world’s population and those allowing for elective abortion for at least some categories of women, for 36 percent. No information is available for the remaining 8 percent; it would appear, however, that most of these people live in areas with restrictive abortion laws.
• — The abortion statutes of many countries are not strictly enforced and some abortions on medical grounds are probably tolerated in most places. It is well known that in some countries with very restrictive laws, abortions can be obtained from physicians openly and without interference from the authorities. Conversely, legal authorization of elective abortion does not guarantee that abortion on request is actually available to all women who may want their pregnancies terminated. Lack of medical personnel and facilities or conservative attitudes among physicians and hospital administrators may effectively curtail access to abortion, especially for economically or socially deprived women.
• U.S. Legislation and Policies Relative to Abortion
• Although the Supreme Court of the United States invalidated the abortion laws of most states in January 1973, the subject still remains politically sensitive. U.S. Government actions relative to abortion are restricted as indicated by the following Federal legislation and the resultant policy decisions of the concerned departments and agencies.
• a. A.I.D. Program The predominant part of A.I.D.’s population assistance program has concentrated on contraceptive or foresight methods. A.I.D. recognized, however, that under developing country conditions foresight methods not only are frequently unavailable but often fail because of ignorance, lack of preparation, misuse and non-use. Because of these latter conditions, increasing numbers of women in the developing world have been resorting to abortion, usually under unsafe and often lethal conditions. Indeed, abortion, legal and illegal, now has become the most widespread fertility control method in use in the world today. Since, in the developing world, the increasingly widespread practice of abortion is conducted often under unsafe conditions, A.I.D. sought through research to reduce the health risks and other complexities which arise from the illegal and unsafe forms of abortion. One result has been the development of the Menstrual Regulation Kit, a simple, inexpensive, safe and effective means of fertility control which is easy to use under LDC conditions.
• Section 114 of the Foreign Assistance Act of 1961 (P.L. 93-189), as amended in 1974, adds for the first time restrictions on the use of A.I.D. funds relative to abortion. The provision states that “None of the funds made available to carry out this part (Part I of the Act) shall be used to pay for the performance of abortions as a method of family planning or to motivate or coerce any person to practice abortions.” In order to comply with Section 114, A.I.D. has determined that foreign assistance funds will not be used to:
• (i) procure or distribute equipment provided for the purpose of inducing abortions as a method of family planning.
• (ii) directly support abortion activities in LDCs. However, A.I.D. may provide population program support to LDCs and institutions as long as A.I.D. funds are wholly attributable to the permissible aspects of such programs. A.I.D. funds may continue to be used for research relative to abortion since the Congress specifically chose not to include research among the prohibited activities. A major effect of the amendment and policy determination is that A.I.D. will not be involved in further development or promotion of the Menstrual Regulation Kit. However, other donors or organizations may become interested in promoting with their own funds dissemination of this promising fertility control method.
• b. DHEW Programs Section 1008 of the Family Planning Services and Population Research Act of 1970 (P.L. 91-572) states that “None of the funds appropriated under this title shall be used in programs where abortion is a method of family planning.” DHEW has adhered strictly to the intent of Congress and does not support abortion research. Studies of the causes and consequences of abortion are permitted, however. The Public Health Service Act Extension of 1973 (P.L. 9345) contains the Church Amendment which establishes the right of health providers (both individuals and institutions) to refuse to perform an abortion if it conflicts with moral or religious principles.
• c. Proposed Legislation on Abortion Research There are numerous proposed Congressional amendments and bills which are more restrictive on abortion research than any of the pieces of legislation cited above.
• It would be unwise to restrict abortion research for the following reasons:
• The persistent and ubiquitous nature of abortion.
• Widespread lack of safe abortion technique.
• Restriction of research on abortifacient drugs and devices would:
  a. Possibly eliminate further development of the IUD.
  b. Prevent development of drugs which might have other beneficial uses. An example is methotrexate (R) which is now used to cure a hitherto fatal tumour of the uterus — choriocarcinoma. This drug was first used as an abortifacient.
• C. Utilization of Mass Media and Satellite Communications Systems for Family Planning
• Utilization of Mass Media for Dissemination of Family Planning Services and Information. The potential of education and its various media is primarily a function of
  (a) target populations where socio-economic conditions would permit reasonable people to change their behavior with the receipt of information about family planning and
  (b) the adequate development of the substantive motivating context of the message. While dramatic limitations in the availability of any family planning related message are most severe in rural areas of developing countries, even more serious gaps exist in the understanding of the implicit incentives in the system for large families and the potential of the informational message to alter those conditions.
• Nevertheless, progress in the technology for mass media communications has led to the suggestion that the priority need might lie in the utilization of this technology, particularly with large and illiterate rural populations. While there are on-going efforts they have not yet reached their full potential. Nor have the principal U.S. agencies concerned yet integrated or given sufficient priority to family planning information and population programs generally. Yet A.I.D.’s work suggests that radio, posters, printed material, and various types of personal contacts by health/family planning workers tend to be more cost-effective than television except in those areas (generally urban) where a TV system is already in place which reaches more than just the middle and upper classes.
• There is great scope for use of mass media, particularly in the initial stages of making people aware of the benefits of family planning and of services available; in this way mass media can effectively complement necessary interpersonal communications. In almost every country of the world there are channels of communication (media) available, such, as print media, radio, posters, and personal contacts, which already reach the vast majority of the population. For example, studies in India – with only 30% literacy, show that most of the population is aware of the government’s family planning program. If response is low it is not because of lack of media to transmit information. A.I.D. believes that the best bet in media strategy is to encourage intensive use of media already available, or available at relatively low cost. For example, radio is a medium which in some countries already reaches a sizeable percentage of the rural population; a recent A.I.D. financed study by Stanford indicates that radio is as effective as television, costs one-fifth as much, and offers more opportunities for programming for local needs and for local feedback.
• Recommendations USAID and USIA should encourage other population donors and organizations to develop comprehensive information and educational programs dealing with population and family planning consistent with the geographic and functional population emphasis discussed in other sections. Such programs should make use of the results of AID’s extensive experience in this field and should include consideration of social, cultural and economic factors in population control as well as strictly technical and educational ones.
• Use of U.S. broadcast satellites for dissemination of family planning and health information to key LDC countries
• Discussion One key factor in the effective use of existing contraceptive techniques has been the problem of education. In particular, this problem is most severe in rural areas of the developing countries. There is need to develop a cost-effective communications system designed for rural areas which, together with local direct governmental efforts, can provide comprehensive health information and in particular, family planning guidance. One new supporting technology which has been under development is the broadcast satellite. NASA and Fairchild have now developed an ATS (Applied Technology Satellite), now in orbit, which has the capability of beaming educational television programs to isolated areas via small inexpensive community receivers. NASA’s sixth Applications Technology Satellite was launched into geosynchronous orbit over the Galapagos Islands on May 30, 1974. It will be utilized for a year in that position to deliver health and educational services to millions of Americans in remote regions of the Rocky Mountain States, Alaska and Appalachia. During this period it will be made available for a short time to Brazil in order to demonstrate how such a broadcast satellite may be used to provide signals to 500 schools in their existing educational television network 1400 miles northeast of Rio de Janeiro in Rio Grande do Norte.
• In mid-1975, ATS-6 will be moved to a point over the Indian Ocean to begin beaming educational television to India. India is now developing its broadcast program materials. Signals picked up from one of two Indian ground transmitters will be rebroadcast to individual stations in 2500 villages and to ground relay installations serving networks comprising 3000 more. This operation over India will last one year, after which time India hopes to have its own broadcast satellite in preparation. Eventually it will be possible to broadcast directly to individual TV sets in remote rural areas. Such a “direct broadcast satellite,” which is still under development, could one day go directly into individual TV receivers.
• At present, broadcast satellite signals go to ground receiving stations and are relayed to individual television sets on a local or regional basis. The latter can be used in towns, villages and schools. The hope is that these new technologies will provide a substantial input in family planning programs, where the primary constraint lies in informational services. The fact, however, is that information and education does not appear to be the primary constraint in the development of effective family planning programs. AID itself has learned from costly intensive inputs that a supply oriented approach to family planning is not and cannot be fully effective until the demand side – incentives and motivations are both understood and accounted for.
• Leaving this vast problem aside, AID has much relevant experience in the numerous problems encountered in the use of modern communications media for mass rural education. First, there is widespread LDC sensitivity to satellite broadcast, expressed most vigorously in the Outer Space Committee of the UN. Many countries don’t want broadcasts of neighbouring countries over their own territory and fear unwanted propaganda and subversion by hostile broadcasters. NASA experience suggests that the U.S. must tread very softly when discussing assistance in program content. International restrictions may be placed on the types of proposed broadcasts and it remains technically difficult to restrict broadcast area coverage to national boundaries. To the extent programs are developed jointly and are appreciated and wanted by receiving countries, some relaxation in their position might occur.
• Agreement is nearly universal among practitioners of educational technology that the technology is years ahead of software or content development. Thus cost per person reached tend to be very high. In addition, given the current technology, audiences are limited to those who are willing to walk to the village TV set and listen to public service messages and studies show declining audiences over time with large audiences primarily for popular entertainment. In addition, keeping village receivers in repair is a difficult problem. The high cost of program development remains a serious constraint, particularly since there is so little experience in validifying program content for wide general audiences. With these factors it is clear that one needs to proceed slowly in utilization of this technology for the LDCs in the population field.
• Recommendations:
• The work of existing networks on population, education, ITV, and broadcast satellites should be brought together to better consolidate relative priorities for research, experimentation and programming in family planning. Wider distribution of the broad AID experience in these areas would probably be justified. This is particularly true since specific studies have already been done on the experimental ATS-6 programs in the U.S., Brazil, and India and each clearly documents the very experimental character and high costs of the effort. Thus at this point it is clearly inconsistent with U.S. or LDC population goals to allocate large additional sums for a technology which is experimental.
• Limited donor and recipient family planning funds available for education/motivation must be allocated on a cost-effectiveness basis. Satellite TV may have opportunities for cost-effectiveness primarily where the decision has already been taken ── on other than family planning grounds ── to undertake very large-scale rural TV systems. Where applicable in such countries satellite technology should be used when cost-effective. Research should give special attention to costs and efficiency relative to alternative media. 3. Where the need for education is established and an effective format has been developed, we recommend more effective exploitation of existing and conventional media: radio, printed material, posters, etc., as discussed under part I above.
• V. Action to Develop World-Wide Political and Popular Commitment to Population Stability
• Discussion: A far larger, high-level effort is needed to develop a greater commitment of leaders of both developed and developing countries to undertake efforts, commensurate with the need, to bring population growth under control. In the United States, we do not yet have a domestic population policy despite widespread recognition that we should — supported by the recommendations of the remarkable Report of the Commission on Population Growth and the American Future. Although world population growth is widely recognized within the Government as a current danger of the highest magnitude calling for urgent measures, it does not rank high on the agendas of conversations with leaders of other nations. Nevertheless, the United States Government and private organizations give more attention to the subject than any donor countries except, perhaps, Sweden, Norway and Denmark.
• France makes no meaningful contribution either financially or verbally. The USSR no longer opposes efforts of U.S. agencies but gives no support. In the LDCs, although 31 countries, including China, have national population growth control programs and 16 more include family planning in their national health services ── at least in some degree — the commitment by the leadership in some of these countries is neither high nor wide. These programs will have only modest success until there is much stronger and wider acceptance of their real importance by leadership groups. Such acceptance and support will be essential to assure that the population information, education and service programs have vital moral backing, administrative capacity, technical skills and government financing.
• Recommendations:
• Executive Branch
  a. The President and the Secretary of State should make a point of discussing our national concern about world population growth in meetings with national leaders where it would be relevant.
  b. The Executive Branch should give special attention to briefing the Congress on population matters to stimulate support and leadership which the Congress has exercised in the past. A program for this purpose should be developed by S/PM with H and AID.
• World Population Conference
  a. In addition to the specific recommendations for action listed in the preceding sections, U.S. agencies should use the prestige of the World Population Plan of Action to advance all of the relevant action recommendations made by it in order to generate more effective programs for population growth limitation. AID should coordinate closely with the UNFPA in trying to expand resources for population assistance programs, especially from non-OECD, non-traditional donors. The U.S. should continue to play a leading role in ECOSOC and General Assembly discussions and review of the WPPA.
• Department of State
  a. The State Department should urge the establishment at U.N. headquarters of a high level seminar for LDC cabinet and high level officials and non-governmental leaders of comparable responsibility for indoctrination in population matters. They should have the opportunity in this seminar to meet the senior officials of U.N. agencies and leading population experts from a variety of countries.
  b. The State Department should also encourage organization of a UNFPA policy staff to consult with leaders in population programs of developing countries and other experts in population matters to evaluate programs and consider actions needed to improve them.
  c. A senior officer, preferably with ambassadorial experience, should be assigned in each regional bureau dealing with LDCs or in State’s Population Office to give full-time attention to the development of commitment by LDC leaders to population growth reduction.
  d. A senior officer should be assigned to the Bureau of International Organization Affairs to follow and press action by the Specialized Agencies of the U.N. in population matters in developing countries.
  e. Part of the present temporary staffing of S/PM for the purposes of the World Population Year and the World Population Conference should be continued on a permanent basis to take advantage of momentum gained by the Year and Conference. Alternate View on 3.c. b. The Department should expand its efforts to help Ambassadorial and other high-ranking U.S.G. personnel understand the consequences of rapid population growth and the remedial measures possible. c. The Department would also give increased attention to developing a commitment to population growth reduction on the part of LDC leaders. Adequate manpower should be provided inS/PM and other parts of the Department as appropriate to implement these expanded efforts.
• A I D. should expand its programs to increase the understanding of LDC leaders regarding the consequences of rapid population growth and their commitment to undertaking remedial actions. This should include necessary actions for collecting and analyzing adequate and reliable demographic data to be used in promoting awareness of the problem and in formulating appropriate policies and programs.
• USIA. As a major part of U.S. information policy, the improving but still limited programs of USIA to convey information on population matters should be strengthened to a level commensurate with the importance of the subject.