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<div class="WordSection1">
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><a href="https://www.bbc.com/news/health-46118103">https://www.bbc.com/news/health-46118103</a><o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal" style="background:white;vertical-align:baseline"><span style="font-size:12.0pt;font-family:"Helvetica",sans-serif;color:#1E1E1E">GLOBAL DECLINE IN FERTILITY RATES
<o:p></o:p></span></p>
<p class="MsoNormal" style="background:white;vertical-align:baseline"><span style="font-size:10.5pt;font-family:inherit;color:#404040;border:none windowtext 1.0pt;padding:0in"><o:p> </o:p></span></p>
<p class="MsoNormal" style="background:white;vertical-align:baseline"><img border="0" width="494" height="278" id="Picture_x0020_5" src="cid:image009.jpg@01D48051.2E6CB710" alt="_104217216_gettyimages-923032034"><span style="font-size:10.5pt;font-family:inherit;color:#404040;border:none windowtext 1.0pt;padding:0in"><o:p></o:p></span></p>
<p class="MsoNormal" style="background:white;vertical-align:baseline"><span style="font-size:10.5pt;font-family:inherit;color:#404040;border:none windowtext 1.0pt;padding:0in">GE</span><span style="font-size:10.5pt;font-family:inherit;color:#0D0D0D;text-transform:uppercase;letter-spacing:.2pt;border:none windowtext 1.0pt;padding:0in">TTY
IMAGES<o:p></o:p></span></p>
<p class="MsoNormal" style="background:white;vertical-align:baseline"><span style="font-size:10.5pt;font-family:inherit;color:#0D0D0D;text-transform:uppercase;letter-spacing:.2pt;border:none windowtext 1.0pt;padding:0in"><o:p> </o:p></span></p>
<p class="MsoNormal" style="background:white;vertical-align:baseline"><span style="font-size:10.5pt;font-family:inherit;color:#404040;border:none windowtext 1.0pt;padding:0in">By James Gallagher -
</span><span style="font-size:10.5pt;font-family:inherit;color:#5A5A5A;border:none windowtext 1.0pt;padding:0in">Health and Science Correspondent, BBC News</span><span style="font-size:10.5pt;font-family:inherit;color:#5A5A5A"><o:p></o:p></span></p>
<p class="MsoNormal" style="mso-margin-top-alt:21.0pt;margin-right:3.0pt;margin-bottom:1.5pt;margin-left:0in;text-indent:-.25in;mso-list:l1 level1 lfo2;background:white;vertical-align:baseline">
<![if !supportLists]><span style="font-size:10.0pt;font-family:Symbol;color:#404040"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:10.5pt;font-family:inherit;color:#5A5A5A">9 November 2018 -
</span><b><span style="font-size:10.5pt;font-family:inherit;color:#404040">There has been a remarkable global decline in the number of children women are having, say researchers.<o:p></o:p></span></b></p>
<p class="MsoNormal" style="margin-top:17.25pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">Their report found fertility rate falls meant nearly half of countries were now facing a "baby bust" - meaning there are insufficient children to maintain their population size.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">The researchers said the findings were a "huge surprise".<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">And there would be profound consequences for societies with "more grandparents than grandchildren".<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:14.0pt;font-family:inherit;color:#1E1E1E">How big has the fall been?<o:p></o:p></span></p>
<p class="MsoNormal" style="background:white;vertical-align:baseline"><span style="font-size:10.5pt;font-family:inherit;color:#404040"><o:p> </o:p></span></p>
<p class="MsoNormal" style="background:white;vertical-align:baseline"><span style="font-size:10.5pt;font-family:inherit;color:#404040">The study, <a href="https://www.thelancet.com/gbd"><b><span style="color:#222222;border:none windowtext 1.0pt;padding:0in;text-decoration:none">published
in the Lancet,</span></b></a> followed trends in every country from 1950 to 2017.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">In 1950, women were having an average of 4.7 children in their lifetime. The fertility rate all but halved to 2.4 children per woman by last year.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">But that masks huge variation between nations.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">The fertility rate in Niger, west Africa, is 7.1, but in the Mediterranean island of Cyprus women are having one child, on average.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">In the UK, the rate is 1.7, similar to most Western European countries.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:14.0pt;font-family:inherit;color:#1E1E1E">How high does the fertility rate need to be?<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">The total fertility rate is the average number of children a woman gives birth to in their lifetime (it's different to the birth rate which is the number of children born per thousand people each
year).<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">Whenever a country's rate drops below approximately 2.1 then populations will eventually start to shrink (this "baby bust" figure is significantly higher in countries which have high rates of
death in childhood).<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">At the start of the study, in 1950, there were zero nations in this position.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">Prof Christopher Murray, the director of the Institute for Health Metrics and Evaluation at the University of Washington, told the BBC: "We've reached this watershed where half of countries have
fertility rates below the replacement level, so if nothing happens the populations will decline in those countries.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">"It's a remarkable transition.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">"It's a surprise even to people like myself, the idea that it's half the countries in the world will be a huge surprise to people."<o:p></o:p></span></p>
<p class="MsoNormal" style="background:white;vertical-align:baseline"><span style="font-size:10.5pt;font-family:inherit;color:#404040;border:none windowtext 1.0pt;padding:0in"><img border="0" width="481" height="412" id="Picture_x0020_2" src="cid:image010.jpg@01D48051.2E6CB710" alt="Graph showing global fertility rate"></span><span style="font-size:10.5pt;font-family:"Helvetica",sans-serif;color:#404040"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:24.0pt;background:white;vertical-align:baseline">
<span style="font-size:14.0pt;font-family:inherit;color:#1E1E1E">Which countries are affected?<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">More economically developed countries including most of Europe, the US, South Korea and Australia have lower fertility rates.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">It does not mean the number of people living in these countries is falling, at least not yet as the size of a population is a mix of the fertility rate, death rate and migration.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">It can also take a generation for changes in fertility rate to take hold.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">But Prof Murray said: "We will soon be transitioning to a point where societies are grappling with a declining population."<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">Half the world's nations are still producing enough children to grow, but as more countries advance economically, more will have lower fertility rates.<o:p></o:p></span></p>
<p class="MsoNormal" style="background:white;vertical-align:baseline"><span style="font-size:10.5pt;font-family:inherit;color:#404040;border:none windowtext 1.0pt;padding:0in"><img border="0" width="640" height="2" id="Picture_x0020_3" src="cid:image011.jpg@01D48051.2E6CB710" alt="Presentational grey line"></span><span style="font-size:10.5pt;font-family:"Helvetica",sans-serif;color:#404040"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:24.0pt;background:white;vertical-align:baseline">
<span style="font-size:14.0pt;font-family:inherit;color:#1E1E1E">'We'd rather give our daughter the best of everything'<o:p></o:p></span></p>
<p class="MsoNormal" style="background:white;vertical-align:baseline"><span style="font-size:10.5pt;font-family:inherit;color:#404040;border:none windowtext 1.0pt;padding:0in">Rachael Jacobs, 38, of Kent UK who had her first and only child seven years ago</span><span style="font-size:10.5pt;font-family:inherit;color:#404040"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">I'd always focused on my career. When I was pregnant I was still focusing on my career.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">I know now that we can survive on what we earn as a family and still go on holiday every year. If we had more than one child we couldn't go on holiday.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">We'd rather give our daughter the best of everything than have multiple children that we can just about feed and clothe.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">My partner and I are also thinking about the future. We want to be in a position where we can help her financially with university or housing. I don't want to ever have to say that she can't go
to a party or have a new Christmas jumper.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:14.0pt;font-family:inherit;color:#1E1E1E">Why is the fertility rate falling?<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">The fall in fertility rate is not down to sperm counts or any of the things that normally come to mind when thinking of fertility.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-top:13.5pt;background:white;vertical-align:baseline">
<span style="font-size:10.5pt;font-family:inherit;color:#404040">Instead it is being put down to three key factors:<o:p></o:p></span></p>
<p class="MsoNormal" style="mso-margin-top-alt:13.5pt;margin-right:0in;margin-bottom:0in;margin-left:15.0pt;margin-bottom:.0001pt;text-indent:-.25in;mso-list:l0 level1 lfo4;background:white;vertical-align:baseline">
<![if !supportLists]><span style="font-size:10.0pt;font-family:Wingdings;color:#404040"><span style="mso-list:Ignore">§<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:10.5pt;font-family:inherit;color:#404040">Fewer deaths in childhood meaning women have fewer babies<o:p></o:p></span></p>
<p class="MsoNormal" style="mso-margin-top-alt:13.5pt;margin-right:0in;margin-bottom:0in;margin-left:15.0pt;margin-bottom:.0001pt;text-indent:-.25in;mso-list:l0 level1 lfo4;background:white;vertical-align:baseline">
<![if !supportLists]><span style="font-size:10.0pt;font-family:Wingdings;color:#404040"><span style="mso-list:Ignore">§<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:10.5pt;font-family:inherit;color:#404040">Greater access to contraception<o:p></o:p></span></p>
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</span></span></span><![endif]><span style="font-size:10.5pt;font-family:inherit;color:#404040">More women in education and work<o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:inherit;color:#404040">In many ways, falling fertility rates are a success story.<o:p></o:p></span></p>
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<img border="0" width="516" height="443" id="Picture_x0020_7" src="cid:image012.jpg@01D48051.2E6CB710" alt="_104243244_top_10_fertility_bar_chart-nc"><b><span style="font-size:14.0pt;font-family:inherit;color:#1E1E1E"><o:p></o:p></span></b></p>
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<img border="0" width="516" height="443" id="Picture_x0020_8" src="cid:image015.jpg@01D48051.2E6CB710" alt="_104244230_bottom_10_fertility_bar_chart-nc"><b><span style="font-size:14.0pt;font-family:inherit;color:#1E1E1E"><o:p></o:p></span></b></p>
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<span style="font-size:14.0pt;font-family:inherit;color:#1E1E1E">What will the impact be?<o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:inherit;color:#404040">Without migration, countries will face ageing and shrinking populations.<o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:inherit;color:#404040">Dr George Leeson, director of the Oxford Institute of Population Ageing, says that does not have to be a bad thing, as long as the whole of society adjusts to the massive demographic change.<o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:inherit;color:#404040">He told the BBC: "Demography impacts on every single aspect of our lives, just look out of your window at the people on the streets, the houses, the traffic, the consumption, it is all driven
by demography.<o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:inherit;color:#404040">"Everything we plan for is not just driven by the numbers in the population, but also the age structure and that is changing, so fundamentally we haven't got our heads around it."<o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:inherit;color:#404040">He thinks workplaces are going to have to change and even the idea of retiring at 68, the current maximum in the UK, will be unsustainable.<o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:inherit;color:#404040">The report, part of the Global Burden of Diseases analysis, says affected countries will need to consider increasing immigration, which can create its own problems, or introducing policies to
encourage women to have more children, which often fail.<o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:inherit;color:#404040">Report author Prof Murray argues: "On current trends there will be very few children and lots of people over the age of 65 and that's very difficult to sustain global society.<o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:inherit;color:#404040">"Think of all the profound social and economic consequences of a society structured like that with more grandparents than grandchildren.<o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:inherit;color:#404040">"I think Japan is very aware of this, they're facing declining populations, but I don't think it's hit many countries in the West, because low fertility has been compensated with migration.<o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:inherit;color:#404040">"At a global level there is no migration solution," Prof Murray says.<o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:inherit;color:#404040">But while the change may challenge societies, it may also have environmental benefits given the impact of our species.<o:p></o:p></span></p>
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<span style="font-size:14.0pt;font-family:inherit;color:#1E1E1E">What about China?<o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:inherit;color:#404040">China has seen huge population growth since 1950, going from around half a billion inhabitants to 1.4 billion.<o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:inherit;color:#404040">But it too is facing the challenge of fertility rates, which stood at only 1.5 in 2017, and has recently moved away from its famous one child policy.<o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:inherit;color:#404040">The reason developed countries need a fertility rate of 2.1 is because not all children survive to adulthood and babies are ever so slightly more likely to be male than female.<o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:inherit;color:#404040">But in China, the report shows for every 100 girls born there were 117 boys which "imply very substantial sex-selective abortion and even the possibility of female infanticide". That means even
more children need to be born to have a stable population.<o:p></o:p></span></p>
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