Population trends in Europe and their sensitivity to policy measures
6 October 2004
Social, Health and Family Affairs Committee
Rapporteur : Mrs Christine McCafferty, United Kingdom, Socialist Group
1. The Rapporteur congratulates Mr Brunhart on his report on population trends in Europe and his observations on policy measures aiming to respond to the trends of population ageing and population decrease.
2. A number of issues raised in the report have also been dealt with by the Social, Health and Family Affairs Committee in recent years, namely :
challenges of social policy in Europes ageing societies (Recommendation 1591 (2003))
future of senior citizens : protection, participation and promotion (Recommendation 1428 (1999))
reform of healthcare systems in Europe : reconciling equity, quality and efficiency (Recommendation 1626 (2003))
future of social security in Europe (Recommendation 1661 (2004))
3. In line with Mr Brunharts report, the Committee was of the opinion that reforms necessary to respond to the challenges of ageing societies in Europe ought to be part of a wider political debate in order to: create conditions for active ageing in good health; make pension systems viable while maintaining standards that are enshrined in the legal instruments of the Council of Europe; reform healthcare services while guaranteeing access and quality of care; increase levels of employment of the working age population; improve working conditions in order to reconcile paid work with family life; achieve more equal sharing of paid and unpaid work between men and women; and finally reduce labour costs through a shift in taxation.
4. The Committee also made a number of recommendations with regard to protection of retired and elderly people, their participation in society (active ageing, flexible retirement arrangements, inter-generational exchange of experience; voluntary work, etc.) and with regard to individual dignity and image of the elderly in society (role of media and advertising worlds, vocabulary used particularly in public services, etc.).
5. Persistence of mass unemployment in many member countries and the threat of lessening of social rights through reform of social security systems are of deep concern. Social rights, if effectively guaranteed, are a factor of social cohesion, as well as one of democratic stability. Social security has a price but it can cost still more economically, socially and politically to be without it.
6. In line with the objective of greater social cohesion and solidarity, the main criterion for judging the success of health system reforms in Europe, should be effective access to health care for all without discrimination - a basic human right. Measures undertaken by member states to raise additional revenue and contain costs in health care should be sought without affecting equality of access and greater emphasis should be placed on prevention and primary care.
7. In June this year, the Social, Health and Family Affairs Committee adopted a report on European strategy for the promotion of sexual and reproductive health and rights which is tabled for a debate this week in the Assembly. It coincides with the 10-year review of implementation of the Cairo Programme of Action which was adopted at the International Conference on Population and Development (ICPD) in 1994 and which represents the acknowledgement by the international community and by all signatory countries, including all Council of Europe member states, that the individual must be placed at the heart of all population, demographic and sustainable development policies.
8. The ICPD Programme of Action is often heralded as a paradigm shift away from the purely demographic targets of the 1960s, 70s and 80s towards an approach which recognizes the central and legitimate right for every individual, in this case particularly women, to make their own informed choices about if and when to found a family and the number and spacing of their children.
9. According to The State of World Population 2004 UNFPA report, approximately 150 countries around the world have taken active steps to meet the commitments enshrined in the ICPD Programme of Action since 1994 and an ever increasing number of countries around the world have adopted comprehensive population policies, in Europe, often in the form of legislation on sexual and reproductive health and rights. For example, Armenia adopted such a law a few years ago and Georgia has recently started working on such a piece of legislation.
10. To this day, the ICPD Programme of Action is the only global consensus on what we as the international community must do to tackle population challenges at a global, regional, national and even community level.
11. Population challenges in Europe are different from most other parts of the world, as Mr Brunhart points out in his report, even when compared to other developed regions such as North America where population is increasing. The closest parallel to European population trends can be found in East Asia, particularly those countries which have undergone, as we have, what is called the demographic transition; countries such as Japan, South Korea, Singapore and increasingly Thailand.
12. Looking at demographic decline in Europe, we should consider the following factors:
Precarious living conditions in some countries have brought about a lessened willingness to start a family, especially among child-bearing age women and couples. For example, the high proportion of internally displaced people in the Caucasus region are certain to decrease the willingness and ability of young people to have a family, despite any desire to do so.
The collapse of the health systems and the former inadequacies in the existing health infrastructures of former Soviet countries can account for a significant percentage of the demographic decline. For example, lack of access to affordable and reliable contraception has produced a dependence on abortion as a method of fertility regulation; in the 1990s the average woman in the Russian Federation had between 5 and 7 abortions. Even in the best of conditions, repeated abortions can cause permanent infertility. Lack of access to affordable and reliable contraception also meant a significant increase in sexually transmitted infections, in some countries up to 8 times the average in West European countries. A number of these STIs, if left untreated, can cause permanent infertility.
The looming threat of HIV/AIDS in Central and Eastern Europe, where UNAIDS declared in 2002 and again this year that the Russian Federation was one of five countries around the world where, unless decisive action was taken immediately, the HIV/AIDS virus would reach epidemic proportions in that country.
When looking at the impact of the same virus on countries where it has reached epidemic proportions, for example in sub-Saharan Africa, we can see the effects on population decline, negative growth, social fracture and collapse of social systems that the epidemic can cause.
13. With this in mind, when considering future population policies in Europe, we should first of all be inspired by the internationally agreed consensus and objectives in the field of population, particularly this year as the UN General Assembly meets on 14 October to commemorate the ICPD Programme of Action.
14. In concrete terms, this should mean that :
we address health challenges which inhibit people to have the number of children they desire
improve health conditions to allow people to remain fertile
address looming health challenges which can negatively impact demographic trends, such as HIV/AIDS
15. Finally, in addressing population and demographic trends we must also recognize that many people may not wish to have more children or found a family. In this respect, we must give particular attention to the need to adapt social systems to conform to this new reality.
to the report of the Committee on Migration, Refugees and Population (Doc. 10182)
Amendment N° 1
In the draft recommendation, after paragraph 6, introduce a new paragraph as follows:
The Programme of Action adopted at the International Conference on Population and Development (ICPD) in Cairo by 179 countries in 1994 represented the acknowledgement by the international community and by all signatory countries, including all Council of Europe member states, that the individual must be placed at the heart of all population, demographic and sustainable development policies. The ICPD Programme of Action, which marks ten years of implementation this year in 2004, is often heralded as a paradigm shift away from the purely demographic targets of the 1960s, 70s and 80s towards an approach which recognized the central and legitimate right for every individual, in this case particularly women, to make their own informed choices about if and when to found a family and the number and spacing of their children.
Amendment N° 2
In the draft recommendation, in paragraph 9 vii, at the end of sub-paragraph a. add :
in line with the ICPD Programme of Action (Cairo, 1994);
Amendment N° 3
In the draft recommendation, in paragraph 9 vii, after sub-paragraph c. add a new sub-paragraph. as follows:
recognise that many people may not wish to have more children or found a family and in this respect adapt social systems to conform to this new reality;
Amendment N° 4
In the draft recommendation, in paragraph 9.vii.f.A., introduce a new sub-paragraph as follows:
address health challenges which inhibit people to have the number of children they desire, improve health conditions to allow people to remain fertile and respond to looming health challenges which can negatively impact demographic trends, such as HIV/AIDS;
Reporting Committee : Committee on Migration, Refugees and Population (Doc. 10182)
Committee for opinion : Social, Health and Family Affairs Committee
Reference to committee : Doc. 9805, Ref. No. 2842 of 27.05.03
Opinion adopted by the committee on 5 October 2004
Secretaries to the committee : Mr Mezei, Mrs Nollinger, Mrs Meunier and Mrs Karanjac
 See Doc. 10182 tabled by the Committee on Migration, Refugees and Population.
 The Cairo Consensus at Ten: Population, Reproductive Health and the Global Effort to End Poverty, UNFPA, 15 September 2004.