The international and domestic environments are changing dramatically, writes Zhang Weiqing, minister in charge of the National Population and Family Planning Commission of China, in his article recently published in the Chinese Communist Party journal Seeking Truth (Qiushi). Moreover, with the masses’ awareness rising and their demands increasing, China is encountering some sharp contradictions and problems in the implementation of its population control and family planning programs. 

A look at the problems

Zhang writes that there is still a wide margin between the present birth policies and people’s desires for children. Public concern about overall population issues is low, and both guidance and administrative sanctions are relatively weak. Thus, any unrealistic optimism or slackness in attitude, and any error in making or carrying out policy -- particularly in light of certain adverse influences from outside -- may create the possibility of an upturn in the birth rate.

The population continues to grow. In the next two decades, the national population will have an annual net increase of 10 million. If calculated according to the total fertility rate of 1.8, zero population growth is likely to appear after the population reaches 1.5 billion in 2034. However, performing a more complex calculation that takes certain flexible factors into consideration, and using a total fertility rate of 2.0, China’s population will reach 1.6 billion in 2043, at which point it will attain zero growth. That is an increase of 300 million from today.

Zhang writes that the general quality of the population is low. Birth defects now occur in 4 to 6 percent of the babies born each year, or 800,000 to 1.2 million. Of the 60 million handicapped people in the country, 12 million are mentally retarded. About 60 million patients with regionally prevalent diseases are distributed among 1,800 counties and cities around the country.

Meanwhile, there are obvious problems in overall health, education and mental/emotional conditions. The human development index for China places it 140th in the world, making it a country with low-level human resources.

Contradictions in the population structure are severe. The sex ratio is continuously rising, reaching 117 in the fifth national population census. In the population group aged 0-9, boys outnumber girls by 12.77 million. A number of social problems will arise if the trend continues.

The aging of the population is accelerating as well. Citizens over the age of 65 will account for 11.8 percent of the nation’s total population by 2020, and up to 25 percent by the middle of the century. Notably, the proportion of elderly population in rural areas is higher than in urban districts.

Developed countries in general enter into the “graying society” when per capita GDP reaches US$10,000. China did so when the per capita GDP didn’t amount to US$1,000. As a result, Chinese senior citizens’ health care and social security face crucial challenges.

Employment pressure is quite heavy. In 2020, China’s working-age population will number upward to 900 million, 3 million more than the total labor forces of developed countries. Urban workforces will increase by nearly 10 million annually, and the rural surplus labor forces will be over 200 million. The huge population and disordered growth will create severe employment pressure and social administration difficulties.

Public health, epidemic prevention and health care systems are weak. Eighty percent of China’s health and medical care resources are concentrated in cities; rural per capita expenditure on disease prevention and health care was just 12 yuan (US$1.40) in 2000. About 300 million people do not have access to potable water; timely medical service is not available to 100 million; 120 million are hepatitis B virus carriers; the spread of HIV/AIDS is accelerating. With 80 percent of those who are infected living in villages, and the chance of HIV/AIDS beginning to spread like wildfire is not out of the question.

Now a new type of disadvantaged group is taking shape. Parents of the families that took the lead in practicing family planning are getting old. The lack of a social security system means that those who parented single-child and double-daughter families are likely to encounter hardships.

Contradictions between the population and natural resources and environment are still sharp. The Chinese population is pressing on toward the maximum capacity of its natural environment, even if it develops in a scientific way. The huge population will place severe pressure on resources and the environment in the coming decades.

Spending on population and family planning is far from enough. There is a huge shortfall in funds for grass-roots population and family planning work, which is a side effect of the overall implementation of rural fee and tax reform. Work at the basic level and the 20-year-old service network is in trouble in many localities, particularly in poverty-stricken regions.

Finding solutions

Zhang writes that a number of policies and plans are urgently needed to deal with the challenges that China is facing today.

Strategic research on population control must be conducted. A research group for the state population development strategy has already been established. It will organize academicians, professors, experts, scholars and workers from the front lines of the family planning program to contribute their ideas. The group is trying to complete its research within the year.

China should begin pilot implementation of the policy of rewarding and supporting rural families that practice family planning. The General Office of the State Council has disseminated the information on this plan that was issued by the State Population and Family Planning Commission and the Ministry of Finance.

Under that plan, rural parents having only one child or two daughters will receive a special support allowance from central or local budgetary appropriations when they reach the age of 60. Beginning this year, the policy will be implemented in western China’s Sichuan, Yunnan, Gansu and Qinghai provinces and Chongqing Municipality, in nine prefectures and cities in nine central China provinces, and in Guizhou Province’s Zunyi City. The goal is to launch the program nationwide when the trial period is complete.

The pilot project for poor families with fewer births in poverty-stricken districts should be expanded. This project entails giving the family that volunteers to give up the right to have one more child a lump-sum cash award.

The rising sex ratio in new births must be contained. One measure is to strengthen publicity and give greater visibility to the “caring girls” program to promote gender equality. The other is to improve policies and systems, raising the economic and social status of families having only girls and strictly banning the illegal determination of the sex of a fetus and terminating pregnancy.

After 20 years of effort, a top-to-bottom administration and service system and information network have been established in population and family planning throughout China, made up of administrations, service branches and associations and organizations. They play a vital role in the public health system, and need bolstering. Allowing them to weaken is unthinkable.

Establish a fund input system for population and birth control with financial investment as its main channel. This will ensure that people of childbearing age are provided with free contraception and birth control, that rewards and preferential policies are implemented, and that there are sufficient funds for population and family planning work in central, western and northeast China. 

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