A story from McClatchy News­pa­pers today claims that poli­cies under the US Bush admin­is­tra­tion helped to fuel the pop­u­la­tion boom in Africa.

Dur­ing the Bush years the PEPFAR ini­tia­tive began to pro­vide drugs to those who are HIV-positive in Africa. How­ever, the pro­gram did noth­ing to pro­vide con­tra­cep­tives to help slow the spread of the virus. Fur­ther, fund­ing for fam­ily plan­ning slowed dur­ing the Bush years.

The story makes the case that even though PEPFAR saved lives, the pop­u­la­tion boom made resources scarce for those lives to survive.

From McClatchy News­pa­pers, writer Shashank Ben­gali explains what effect the pol­icy shift had on Africa’s population.

Under Pres­i­dent George W. Bush, the United States with­drew from its decades-long role as a global leader in sup­port­ing fam­ily plan­ning, dri­ven by a con­ser­v­a­tive ide­ol­ogy that favored absti­nence and shied away from pro­vid­ing con­tra­cep­tive devices in devel­op­ing coun­tries, even to mar­ried women.

Bush’s mam­moth global anti-AIDS ini­tia­tive, the President’s Emer­gency Plan for AIDS Relief, poured bil­lions of dol­lars into Africa but pro­hib­ited groups from spend­ing any of it on fam­ily plan­ning ser­vices or coun­sel­ing pro­grams, whose bud­gets flat-lined.

The restric­tions flew in the face of research by inter­na­tional aid agen­cies, the U.N. World Health Orga­ni­za­tion and the U.S. government’s own experts, all of whom touted con­tra­cep­tion as a cru­cial method of pre­vent­ing births of babies being infected with HIV, the virus that causes AIDS.

The restric­tions flew in the face of research by inter­na­tional aid agen­cies, the U.N. World Health Orga­ni­za­tion and the U.S. government’s own experts, all of whom touted con­tra­cep­tion as a cru­cial method of pre­vent­ing births of babies being infected with HIV, the virus that causes AIDS.

The Bush pro­gram is widely hailed as a suc­cess, hav­ing sup­plied life­sav­ing anti-retroviral drugs to more than 2 mil­lion HIV patients worldwide.

How­ever, researchers, Africa experts and vet­eran U.S. health offi­cials now think that PEPFAR also con­tributed to Africa’s epi­demic pop­u­la­tion growth by under­min­ing efforts to help women in some of the world’s poor­est coun­tries exer­cise greater con­trol over their fertility.

“It was a huge missed oppor­tu­nity to inte­grate HIV/AIDS and repro­duc­tive health in ways that made sense,” said Jotham Musin­guzi, a Ugan­dan physi­cian who heads the Africa office of Part­ners in Pop­u­la­tion and Devel­op­ment, an inter­gov­ern­men­tal group that pro­motes sex­ual health in devel­op­ing countries.

In some coun­tries that received sub­stan­tial PEPFAR fund­ing, such as Uganda and Kenya, health sur­veys have found that fer­til­ity rates remained con­stant or even rose slightly over the past decade. In Uganda, where many men want large fam­i­lies and abor­tion is ille­gal except to save a woman’s life, the aver­age woman bears 6.7 chil­dren, one of the high­est rates in the world.

This small nation of rolling hills and banana trees is at the epi­cen­ter of Africa’s demo­graphic boom. Uganda is roughly the size of Nebraska, but in 40 years its pop­u­la­tion is pro­jected to triple to 96 mil­lion, sur­pass­ing Japan, accord­ing to the Pop­u­la­tion Ref­er­ence Bureau, a Wash­ing­ton research center.

Stanch­ing that tidal wave will require a dra­matic increase in con­tra­cep­tive use, cur­rently prac­ticed by only 18 per­cent of mar­ried women.

“There hasn’t been a coun­try in the world where the birth rate came down with­out it,” said Carl Haub, a senior demog­ra­pher with the pop­u­la­tion bureau.

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