VZCZCXRO7990
RR RUEHGI RUEHRN RUEHROV
DE RUEHKM #0955/01 2330857
ZNR UUUUU ZZH
R 210857Z AUG 09
FM AMEMBASSY KAMPALA
TO RUEHC/SECSTATE WASHDC 1702
INFO RUEATRS/DEPT OF TREASURY WASHINGTON DC
RUEHXR/RWANDA COLLECTIVE
RUCNIAD/IGAD COLLECTIVE
RHMFIUU/HQ USAFRICOM STUTTGART GE

UNCLAS SECTION 01 OF 04 KAMPALA 000955 
 
STATE FOR AF/E AND PRM 
FOR USAID/EA (TWAY, KADAMS) 
USAID/GH (LHARLEY, KSTEWART, MBOHRER) 
 
SIPDIS 
SENSITIVE 
 
E.O. 12958:  N/A 
TAGS: ECON EAID PINS PGOV PREL UG
SUBJECT: POPULATION GROWTH: UGANDA'S TICKING TIME BOMB 
 
REF: KAMPALA 1611 
 
¶1. (SBU) Summary: Population trends in Uganda are creating a 
demographic time bomb that is undermining the country's recent gains 
in economic and social development and threatening its longer-term 
political, economic, and environmental viability.  Few countries in 
the world are growing as fast as Uganda.  At current trends, 
Uganda's population will double (from 30 to 60 million) in 20 years 
and reach 130 million by 2050. This surge in population will stress 
the natural environment and strain the government's ability to 
provide basic health and education services, possibly to the 
breaking point, resulting in chronic political instability and 
social unrest.  It's hard to see current trends changing anytime 
soon given the pro-growth sentiments of Ugandan President Yoweri 
Museveni. End Summary. 
 
----------------------------------- 
By the Numbers, Not in Good Company 
----------------------------------- 
 
¶2. (SBU) A rash of recent reports has drawn increased attention to 
Uganda's unchecked population growth. An international study 
commissioned by the British Parliament ominously observes that, "Of 
the top 20 failing states, 17 have populations increasing at close 
to 3% a year. In five of these 17 countries, women have an average 
of nearly seven children each. In all but six of the top 20 failing 
states, at least 40% of the population is under 15." Uganda has 
traveled a long way from failed-state status, but tellingly, it 
still ranks 21st out of 60 in the failed state index, in large part 
due to demographic trends.  Individual country data paint a gloomy 
picture: 
 
-- Uganda's population nearly doubled from 1987 to 2007 and is 
increasing at an annual rate of 3.2%, fifth highest in the world. 
The population is growing by 1.2 million people each year, one of 
the highest absolute increases in the world. 
 
-- Ugandan women have an average of 6.7 children (vs. 2.1 in the 
U.S. and the 5.1 average for sub-Saharan Africa).  Only four 
countries worldwide have higher fertility rates. 
 
-- More than 50% of the population is under the age of 15, and 
according to a report published by the non-governmental Population 
Reference Bureau (PRB), Uganda's ratio of those not in the labor 
force compared to those currently working is the highest in the 
world at 116%. 
 
---------------------------------------- 
The Sheer Pressures of Population Growth 
---------------------------------------- 
 
¶3. (U) Following a period of sustained economic growth over the past 
decade, 31% of the very young Ugandan population still live on less 
than $1 a day and the health of the population remains weak. 
According to "The State of Uganda's Population Report 2008," 
published by the GOU's Population Secretariat with support from the 
United Nations Population Fund (UNFPA), unchecked population growth 
is contributing to an increasingly unhealthy and under-productive 
Ugandan population: 12% of women of reproductive age are 
undernourished, while 38% of children under five years old 
demonstrate stunted growth. 
¶4. (SBU) On July 11, World Population Day was celebrated in Uganda's 
Teso region, an area hit hard by national food shortages.  The sad 
irony of the day was not lost on media outlets or the international 
community, which recognize rapid population growth as a contributing 
factor to the shortages.  This rapid population growth is further 
exacerbating the problem of poverty in Uganda.  While the percentage 
of Ugandans living in extreme poverty has decreased in the past 
decade, absolute numbers have not dropped significantly. Janet 
Jackson, UNFPA Country Director, made the case that, "Development 
gains must not be jeopardized by the challenges and sheer pressures 
of population growth.  Population should be slowed down and 
counterbalanced by an equal pace in growth of other sectors, for 
example health, education, housing, utilities, job creation and food 
production."  There is growing fear, from Ugandans and donors alike, 
that forward strides in these sectors may be negated by 
unsustainable population growth, driven in part by unmet family 
planning needs. 
¶5.  (U) At the current levels of unmet family planning needs and 
population growth, policy makers will face increasingly tough 
decisions on access to land, employment, energy, clean water, 
education, housing, transportation, and health services. Even in the 
unlikely event Uganda experiences a complete fertility transition 
(from high to replacement level fertility) over the course of the 
next 30 years, its population will still double during the same 
 
KAMPALA 00000955  002 OF 004 
 
 
period.  Recent history in Kenya, Madagascar, and Nigeria does not 
bode well for Uganda.  When increasingly scarce resources are spread 
thinly amongst a young, growing population, it only takes a spark 
for violence to erupt, even in a growing economy.  An estimated 80% 
of civil conflict from 1970 to 1999 occurred in countries where at 
least 60% of the population was under age 30.  76% of Uganda's 
population was under age 30 at the time of the 2006 DHS. 
 
------------------------------ 
Economics of Population Growth 
------------------------------ 
¶6. (SBU) The GOU is sending mixed signals about whether it views 
rapid population growth as a fuel for economic growth or as a 
roadblock to its long-term vision of economic success.  The revised 
National Population Policy, whose theme is "Social Transformation 
and Sustainable Development," aims to ensure that all aspects of 
creating a quality population are addressed, including slowing the 
population growth rate that is now too high for the country's 
economy to sustain.  Yet, President Museveni's own comments continue 
to indentify the population boom as a foundation for growth and 
transformation: "The wealth of a nation is not in the soils and 
stones. It is in its people, its population. I do not agree with the 
alarmism over the high rate of population growth...we need to 
educate our children, give them skills and create an enabling 
environment for employment and job creation. That way, we shall 
create wealth, make savings and Ugandans will invest and spur 
economic productivity and growth."  Unfortunately, what Museveni is 
unable to grasp is that while Uganda's economy has grown steadily 
over the last decade, growth would need to increase dramatically to 
generate enough government revenue and new jobs to keep up with the 
ensuing population surge.  Moreover, because the education system is 
underfunded and failing to keep pace with population growth, an 
overwhelming majority of young Ugandans are not acquiring the skills 
and knowledge they need to be competitive, productive, and 
prosperous in the 21st century economy. 
¶7.  (SBU) Ugandan policy-makers often remark on their desire for the 
country to emerge as a strong middle-income economy by emulating the 
performance of the "Asian Tiger" economies of the late 20th century 
(e.g. Thailand, South Korea, and Taiwan).  By 1965, each of the 
Asian Tigers had established family planning programs and by 1995, 
six of the eight Tigers had lower fertility rates than the U.S. The 
resulting demographic shifts led to slower growth in the number of 
school-age children, a lower ratio of dependents to working-age 
adults and a reduced rate of labor force growth.  Left alone, these 
were not enough to create the educated workforce, high wages, 
savings rates, and capital-intensive industries that now 
characterize the Asian Tigers.  But when linked to an innovative 
business sector, sound government investment and an equitable 
education system, demographic shifts soon fostered economic 
opportunity.  Economists credit declining fertility rates as a major 
contributor to sustained economic growth in Asian Tigers, 
attributing up to 50% of their high per capita growth to this 
demographic dividend. 
 
¶8. (SBU) Thus, while Uganda would like to emulate the Tigers' 
success, it ironically appears unwilling or unable to follow the 
formula that led to that success.  To its credit, Uganda is 
committed to sound economic policies, and has made some strides in 
education through its commitment to universal primary education. 
However, in reality, the education sector remains seriously 
underfunded, leaving a surfeit of young people with just enough 
education to get into trouble.  Indeed, Ugandan women with no 
education or only primary education have fertility rates of 7.7 and 
7.2 respectively, while those relative few with a secondary 
education have a rate of 4.4.  Moreover, in sharp contrast to the 
Tigers, the GOU has done little to curb population growth through 
family planning programs. 
 
¶9.  (U) In short, as a 2004 study by Dr. Stephan Klasen argues, per 
capita income will not improve if population growth continues to put 
a "brake on physical and human capital accumulation, the key drivers 
of economic growth." Uganda's current makeup (very young population, 
comparatively few working age people, and even fewer elderly) is a 
"demographic burden." Uganda has the potential to capitalize on its 
demographic make-up, but only if fertility rates are reined in 
quickly during this period of burden.  But after a decade of 
sustained economic growth in Uganda with no change in fertility 
rates, it is clear that the economy and service delivery are 
struggling to keep up, even at current population levels. 
 
------------------------------- 
Family Planning and MDGs: 
More Bang for Your (Donor) Buck 
------------------------------- 
 
 
KAMPALA 00000955  003 OF 004 
 
 
¶10. (SBU) Lack of adequate family planning services in Uganda 
continues to be a key driver of population growth and the numbers 
(dire even by sub-Saharan African standards) tell the story.  One in 
four Ugandan girls will get pregnant before the age of 20; only one 
in four married women use any form of contraception, while "unmet 
need" (women who say they prefer to avoid pregnancy but are not 
currently using a contraceptive method) stands at 40.6%, revealing a 
severe dearth in delivery of and access to family planning services. 
 In contrast, at least 75% of married women use contraception in 
Vietnam, Colombia and Brazil, while only about 7% of women in these 
countries have unmet need. Although poverty in Uganda has been 
reduced considerably from 56% in 1992 to 31% in 2006, infant and 
maternal mortality has remained nearly stagnant with 76 deaths per 
1,000 live births and 435 deaths per 100,000 live births, 
respectively.  These data, when combined with the high levels of 
unintended pregnancies and induced abortions, make it clear that a 
continued lack of family planning services has grave implications 
for the health, and thus the productivity, of Uganda's women and 
children. 
 
¶11. (SBU) A recent USAID study indicates improved family planning 
services in Uganda could help it achieve its Millennium Development 
Goals (MDGs). By fulfilling unmet need for family planning, 450,000 
child deaths and 5,500 maternal deaths could be averted between 2008 
and 2015. In addition, more than 10,000 HIV-positive births per year 
could be averted. Consequently, the MDGs could be achieved faster 
and at a lower cost.  An investment of $1 in family planning would 
yield a $2 savings in reaching goals in other sectors such as 
health, education and environmental sustainability.  These figures 
are particularly eye-catching for donors and aid-recipients who have 
pledged, as the United States and Uganda have, to overcome poverty 
and address many of the most enduring challenges of human 
development. 
 
-------- 
USG Role 
-------- 
 
¶12. (SBU) USAID and UNFPA are the GOU's largest partners in 
supporting programs that provide and strengthen family planning 
services.  After several years of stagnating resources, USAID's 
family planning budget increased to $10 million in FY2008 and to $15 
million in 2009.  USAID expects modest increases in allocations to 
continue in light of the new Global Health Initiative, in which 
family planning figures prominently. In early 2009 USAID awarded a 
$39 million five-year project to focus on improving family planning 
services in terms of access and quality, as well as child survival 
in 15 of Uganda's 80 districts.  USAID also regularly supports the 
procurement of contraceptive commodities.  Together, USAID and UNFPA 
provide the lion's share of Uganda's contraceptive supply.  While 
such donor programming is a step in the right direction, all of 
Uganda's political and economic gains of recent years are in 
jeopardy unless the GOU itself adjusts course and takes action now 
to address its impending demographic disaster. 
 
¶13. (SBU) Comment: The Population Secretariat's report is evidence 
that some GOU officials understand Uganda's demographic challenges, 
but Museveni's own staunch, pro-growth position is probably the 
single greatest obstacle to turning the tide in Uganda.  While the 
GOU has developed policies for reproductive health and family 
planning, in coordination with UNFPA and donors including USAID, 
political commitment to implementation of those policies is lacking. 
 The GOU has not spent funds on contraceptive commodities in the 
past two years, and few high-level officials outside of the 
Population Secretariat have ever made statements contradicting the 
President's position on this issue. Family planning needs to play a 
central role in Uganda's development plans, as it is crucial to 
reducing poverty, improving education, health and the environment, 
safeguarding women's health, and enhancing the standard of living. 
But without an about-face from the country's leadership on this 
issue, we remain pessimistic that family planning will play such a 
role, with potentially dire consequences for the country's long-term 
socio-economic viability. 
 
¶14.  (SBU) Comment continued: Collectively, the USG also needs to 
think seriously about population trends in Uganda (and probably 
elsewhere).  While the USG laudably spends billions of dollars 
saving lives through programs like PEPFAR and the President's 
Malaria Initiative, we are underplaying at best and ignoring at 
worst the fact that the gains made through these programs are being 
simultaneously undermined by runaway population growth.  Moreover, 
it's no coincidence that the Failed State Index takes population 
trends so heavily into account.  Where we now have a relatively 
stable ally in Uganda, the future may bode much worse given current 
population trends.  Perhaps it's time to think about an emergency 
 
KAMPALA 00000955  004 OF 004 
 
 
plan or a presidential initiative for family planning.  End 
comment. 
Hoover