UNFPA - Country Profiles

Asia and Pacific

No other region illustrates the diversity of nations as does Asia and the Pacific. From Iran to the small islands of the Pacific, the region encompasses countries at vastly differing stages of the demographic transition, and of social and health status. The region is home to approximately 3.7 billion people, and a large share of the world's poorest citizens. In the past two decades, motivated by the ICPD Programme of Action and the MDGs, great progress has been made regionally on both the social and economic fronts. But, while hundreds of millions of its people have been lifted out of poverty, comparable millions still struggle to survive in conditions of extreme poverty. Southern Asia, from Iran to Bangladesh, is second only to sub-Saharan Africa in the proportion of the population living in extreme poverty (defined as less than US$1.25 per day), although extreme poverty ranges from less than 2 per cent in Iran to 55 per cent in Nepal. While considerable progress has been made on MDG 1 to halve the number of people living in extreme poverty by 2015, it will be difficult to achieve the MDG target in Southern Asia by 2015. The area's two other large regions, Eastern and Southeastern Asia, have already reached and surpassed MDG 1. The proportions of their citizens living in extreme poverty had dropped to 16 and 19 per cent, respectively, by 2005. Asia and the Pacific is home to nearly 60 per cent of the world's total population. China, with 1.3 billion people, is the world's largest country. India, with 1.2 billion people, is currently projected to pass China as the world's largest in population at some point between 2020 and 2025. The potential for rapid population growth in India continues as total fertility rates (TFR) remain high in many of its most populous states, such as Bihar, Rajasthan and Uttar Pradesh. The possibility of India reaching 2 billion in population cannot be ruled out. Gross gender disparities persist, especially in Southern and West Asia, where traditional gender norms
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and harmful cultural practices allow for discrimination, son preference, prenatal sex selection, forced marriage, gender-based violence and social and economic exclusion. In many countries, access to high-quality health services is uneven, and there is a large unmet need for family planning and reproductive health services. While the region has the widest range of total fertility rates in the world, from 1.7 births per woman in Iran to 6.4 in both Afghanistan and Timor-Leste, overall, region-wide, fertility has fallen to 2.3 births per woman. Excluding China, which has below-replacement fertility, the regional average TFR is 2.6 births per woman. Some countries in the region established population policies to reduce fertility decades ago, contributing to a current regional annual population growth rate of 1.1 per cent, slightly below the global rate of 1.2 per cent. Outside of China, where contraceptive use has reached 90 percent, more than half of women in the region are using a method of contraction. In Eastern Asia, the intrauterine device (IUD) is the predominant method, while the use of female sterilization is most prevalent in South Asia. In Southeast Asia, hormonal methods including injectables, implants and the oral pill are most commonly used. More than half of the world's 1.8 billion young people between the ages of 10 and 24 live in the region. One of the region's major demographic challenges will be to provide for the social and economic wellbeing of this huge cohort of future workers and parents. If properly educated and trained, this group could provide great benefits for national development. Investments made to realize the potential of this "Youth bulge" must be made soon so that a healthy and educated group of new labour force entrants can look forward to meaningful and rewarding employment. India has recently mandated compulsory education for all through the 12th grade, as well as improved health and reproductive heath services in the poorest and underserved states though its National Rural Health Mission. While expensive, this programme serves as an example of an intelligent, focused, approach to investing in the nation's future. Asia is also home to the majority of the world's elderly. People over the age of 60 made up nearly 10 per cent of the region's population in 2009 and are projected to account for almost 17 per cent by 2025. The emerging issue of ageing has major ramifications, as the majority of developing countries in Asia and the Pacific do not have systems of social protection in place, particularly old age security and health insurance for the elderly. Urbanization is occurring at an unprecedented pace, bringing both problems and possibilities. By 2009,

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42 per cent of the regional population lived in urban areas and the proportion is expected to pass 50 per cent by 2025, an increase of 700 million urban residents. Urban migration is most often motivated by a lack of economic opportunities, population pressures on the land in rural areas, and the hope of a better life in the city. While it is easier for governments to provide health services and education to urban populations, migrants to the city frequently live in urban slums where they lack access to such public health necessities as clean water supply and sanitation. Within the next 15 years, 13 of the projected 22 global megacities (urban areas with more than 10 million people) will be in Asia, and over half of the people will live in slums and informal settlements characterized by a lack of basic services. Although empowering and educating women and improving their reproductive health are keys to achieving the ICPD targets and the MDGs, regional gender disparities persist in health, literacy, education, political participation, income and employment. Asia is the region in which a strong preference for sons is the most widespread. Due to illegal sex-selective abortions, there were 120 male births for every 100 female births in China in 2009. The skewed sex ratio at birth is nearly as high in Armenia and Azerbaijan. In some states of India, where fertility is comparatively low and populations are of relatively high income and thus able to afford an ultrasound test, the sex ratio at birth is similarly skewed in favor of male births. This imbalance in the sex ratio is anticipated to have serious consequences, e.g., for the availability of marriage partners in the future. UNAIDS estimates that 5 million adults and children were living with HIV and AIDS in the region in 2007, a number that has stabilized in South and Southeast Asia but is still rising in East Asia and the Pacific. Just over 3 million HIV infected persons live in China and India. The spread of the epidemic from highrisk groups, such as commercial sex workers and intravenous needle-sharing drug users, has been addressed with some success in a few countries. The number of newly infected people is estimated to have declined from 2001 to 2007 in Cambodia, India, Myanmar and Thailand. At the same time, treatment is enabling a growing number of people to live with HIV. Obstacles to fighting the disease include stigma and discrimination against HIV-infected people, a lack of knowledge of how HIV spreads, a reluctance to be tested and sex trafficking of women. The UNFPA Global and Regional Programme is helping the Asia and the Pacific region to overcome a wide range of challenges, including the insufficient attention that has been paid to women's health issues and the large unmet need for family planning and reproductive health services. UNFPA will provide support through regional and national networks of specialized institutions and expertise to: ensure that reproductive health is addressed in development frameworks, policies and plans; develop effective approaches to create demand for services among excluded and marginalized

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populations; reach vulnerable groups with integrated services to prevent HIV and sexually transmitted infections; link reproductive health and HIV prevention services aimed at young people to other sectors, especially education and employment; integrate gender-sensitive reproductive health and life-skills education into school curricula; and support analyses of health-sector reform.

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