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C h a p t e r 2 Policy for a Better Future: A Focus on Girls and Women Ruth Levine The world over, sound public policy requires a very specific type of vision—the vision to see into the future. Public policymakers need to anticipate how the actions they take today will make the people and institutions they serve either more vulnerable to both predictable and unknown future challenges or more resilient to those very same challenges . This is no easy task, in large measure because the pressures of the present—political, financial, and otherwise—often prevent attention to the middle distance and constrain the willingness to invest in the sorts of policies and programs that bring the greatest future benefits . But when long-term conditions and consequences are considered, we inevitably come to an understanding of the importance of appropriate , high-impact investments in the lives and livelihoods of the girls and young women of today. Thinking about the future brings to mind an insightful metaphor held by the Aymara Indians of the Andean highlands. The Aymara refer to the future not as most other cultures do, which is as something in front of us that we look toward. Instead, they think of the future as being in back of them, hidden from sight; what they can see before their eyes is the past. So they have an image of walking backward into the future. That notion—which we might call 20/20 hindsight—is a fascinating challenge to our own notion that we face the future with a clear view of what is ahead. If we think more like the Aymara, then we realize how carefully we must walk: taking clues from what we can see based on past trends, but with the realization that there are vast uncertainties that we cannot see. Those who are responsible throughout the world for major decisions about the laws, regulations, and use of public funds can make the best Policy for a Better Future 29 choices for the future by orienting their actions based on four major trends: changes in the size and age structure of populations (including population movement, particularly urbanization); changes in the type of distribution of health threats; environmental dynamics, especially climate change; and long-term economic trends. Unlike other important and headline-grabbing influences on national and global prospects, such as elections and the eruption of conflict, these four trends have remarkably predictable features, in some cases for decades into the future. Through them, we can look out twenty or even thirty years and have a good sense of how different the world will look. We can see the type of world for which the young people of today must be prepared. At the same time, there are limits to inevitability. Within each of these trends we can identify a set of changes that are certain to occur, and then a range of scenarios that reflect uncertainty. So, for example, although we know that the average global temperature is rising, we are unsure about the pace and magnitude—variables that are a function, in part, of today’s actions to control greenhouse gas emissions. Although we can play out demographic scenarios, social changes such as age at marriage and desired family size over the next decade influence the long-term prospects. In many cases, the potential variation and uncertainty hold clues to near-term policy actions that can influence what scenario plays out in reality. In this chapter, I highlight what these large-scale trends tell us about what the world is likely to look like ten to fifty years hence. And I identify some of the ways in which a recognition of these trends should inform public policy, particularly with respect to policies that affect adolescent girls and women. The Size and Structure of Populations Let’s look at the first trend, demographic change. Over the past forty years, almost all of the major developing regions of the world have witnessed a dramatic fall in the number of children born to each woman, along with significant improvements in life expectancy with the reduction of preventable childhood mortality, improved living conditions , and improvements in health among older adults. Those shifts, of course, came later to the developing countries than similar declines in fertility and mortality in the countries that now have relatively high average incomes. Given the population momentum—the echoes of high-fertility periods through subsequent cohorts—we can predict with confidence that between 2005...


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