Abidjan – Côte d’Ivoire

Monday, june 30 ,2025

By Roselyne Kandel

The world is in crisis. Not just militarily, climatically or economically, but also in terms of food and health. In many countries, people are worried about the increase in the mortality rate compared to the low birth rate. Questions are being asked about the reasons for the cascade of deaths and the relative sterility of young couples. We investigate, we try to understand, we look for answers to this phenomenon, inexplicable a priori. We’re worried about the future. Is this a recent phenomenon? What do the official figures say? How can the trend be reversed? What about Côte d’Ivoire? A number of hypotheses and proposals are being put forward. (Read the full article)

What’s does the data tell us ?

According to data from the United Nations (UN), in 2022 the global fertility rate will be around 2.4 children per woman, compared with 5 in the 1960s. In low-income countries, the birth rate remains high, but it is falling rapidly. Reports from the World Health Organisation (WHO) show that global mortality has been disrupted by the pandemic, with around 15 million excess deaths between 2020 and 2021. These trends vary greatly from region to region. Sub-Saharan Africa is maintaining a high birth rate, while East Asia and Eastern Europe are experiencing record declines.

Is it a recent phenomenon ?

The increase in deaths linked to the Covid-19 pandemic is a recent phenomenon (2020-2023), but the gradual rise due to ageing has been a trend for several decades in developed countries. In developing countries, crises (conflicts, famines) may cause occasional increases. As for the decline in the birth rate, this has been a structural phenomenon in industrialised countries since the 1970s, as in Japan and Europe. However, a more marked decline has been observed post-Covid in certain countries (e.g. China, South Korea, the United States), amplifying pre-existing trends.

What are the assumptions behind the rise in mortality?

The ageing of the world’s population is the first hypothesis put forward to explain this increase in mortality worldwide. In developed countries, longer life expectancy and fewer births are leading to an older population, mechanically increasing the mortality rate. Health crises, particularly the Covid-19 pandemic (2020-2022), have led to significant excess mortality, particularly among the elderly and vulnerable. Long-term sequelae and disruptions to healthcare systems (delays in care) have also played a role. The increase in lifestyle-related chronic diseases (obesity, diabetes, cardiovascular disease) is contributing to mortality, particularly in industrialised countries. Environmental factors such as pollution, climatic challenges and natural or provoked disasters (heat waves, floods, volcanic eruptions, earthquakes) have an impact on health. Socio-economic crises such as poverty, inequalities in access to healthcare, armed conflict and mass and forced migration all increase mortality in certain regions. Finally, some studies have shown that the medical side-effects of vaccines or post-Covid mass treatment have an impact on the increase in mortality. However, the data on medical side-effects remains debated and not consensual.

What are the assumptions behind the fall in the birth rate?

As far as the falling birth rate is concerned, urbanisation, women’s education, access to contraception and the priority given to career and leisure over family are the main reasons in industrialised countries. This is a demographic transition. Economic factors such as the high cost of living, economic instability, lack of affordable housing and financial uncertainties prevent many young couples from having children. Social norms are also changing, with an emphasis on individualism, childfree relationships and reduced social pressure to procreate. Studies point to a decline in sperm quality and fertility problems due to pollution (endocrine disruptors), stress and lifestyle. Unsurprisingly, the Covid-19 pandemic has heightened economic and psychological uncertainty, leading to the postponement or abandonment of parenthood plans in some countries.

Birth and death rates in the United States

In the United States, the birth rate continues to be influenced by economic and social factors. Fertility is below the replacement level (2.1 children per woman), although not as low as in Europe or Asia. It has been declining steadily since the 2010s. In 2023, 3.36 million babies will be born, slightly fewer than in 2022 (3.68 million) and a far cry from the 3.8 million a year before the 2010s. However, the natural balance has rebounded since 2022, reaching 53,400 in 2023, thanks to a reduction in deaths. Specific mortality data for 2024-2025 are less detailed, but the end of the Covid-19 pandemic has reduced the number of deaths compared with 2020-2021. Life expectancy is tending to stabilise, although regional disparities persist. The United States stands out from other developed countries with a slight demographic rebound, but the demographic transition is underway.

Birth and death rates in France

In France, the birth rate has also been in steady decline since 2010. In 2024, 663,000 babies were born, down 2.2% on 2010, marking the lowest level since 1945. The Total Fertility Rate (TFR) fell to 1.62 children per woman (1.59 in mainland France), the lowest since the end of the First World War. This fall was mainly due to a reduction in the fertility rate, despite a stable number of women of childbearing age. As for mortality, in 2024, 646,000 deaths were recorded. This is 1.1% higher than in 2023. Life expectancy remains high and stable at 85.6 years for women and 80 years for men. However, the natural balance (births – deaths) is very low. It will be +17,000 cases in 2024. The lowest since the Second World War. If current trends continue, deaths could exceed births as early as 2027, making demographic growth dependent on migratory flows.

Births and deaths in sub-Saharan Africa, particularly in Côte d’Ivoire

In sub-Saharan Africa, in general, the fertility rate, although high, is falling. In 2021, the GSI will be above 3 in many regions, and above 5 in the Sahel, Central Africa and the Horn of Africa. This decline, although rapid compared with Europe historically, is held back by cultural and religious factors and limited access to contraception. In Côte d’Ivoire, the fertility rate has fallen significantly, from almost 8 children per woman in 1975-1980 to around 5 in 2010. This decline can be explained by an increase in the age at marriage, better schooling for girls and greater access to contraception. The birth rate among teenage girls remains high. There are 111 births for every 1,000 women aged between 15 and 19 in West Africa, compared with 43 worldwide.

Infant mortality remains high, with 91 deaths per 1,000 live births among children under 5, compared with 78 on average in sub-Saharan Africa. Life expectancy at birth is lower than the sub-Saharan average, affected by the challenges of infectious diseases and limited access to healthcare. Strong demographic growth (population multiplied by 4 by 2100 in some West African countries) poses environmental and social challenges, particularly in Côte d’Ivoire, where rapid urbanisation threatens biodiversity and natural resources such as water. The Covid-19 pandemic has also exacerbated early pregnancies, temporarily increasing the teenage birth rate.

 

Why worry ?

These alarming demographic trends for the future of humanity raise economic, social and political concerns, as they affect population structure, the workforce, pension systems and economic growth. Globally, fertility has fallen from 5.1 children per woman in 1965 to 2.3 in 2021. This is all the more worrying given that 63% of the world’s population lives in areas where the GSI is below the generation replacement threshold (2.1 children per woman). This decline is particularly marked in Europe, Japan and South Korea. The situation is similar in China, India and Brazil. Even in Africa, where fertility remains higher, it is gradually declining.

The falling birth rate is a cause for concern, as it leads to an ageing population, reducing the workforce available to support the pension and healthcare systems. Some see this as a threat to “national security” or economic sustainability. In some countries, the urgency of the situation is even pushing back the retirement age. This is because, despite the medical advances that have reduced mortality, successive specific health crises, notably Covid-19, have led to localised excess mortality. Significant losses have been recorded from 2020 to 2022. This decline is alarming for industrialised countries, reflecting public health problems and socio-economic inequalities. In developing countries such as Côte d’Ivoire, despite the progress made between 1990 and 2015, the persistence of infant and maternal mortality remains a challenge and is holding back development.

Reasons for the falling birth rate

According to specialists, the fall in the birth rate is due to three main factors. The first is the economic factor (cost of parenthood, female employment). Housing, education and healthcare are expensive, especially in developed countries. In the United States and France, rising property prices are limiting the number of large families. Countries such as Côte d’Ivoire are unfortunately following the same path, albeit with some nuances. The increased participation of women in the labour market, in support of family welfare, is delaying the age of first birth and reducing family size. In Côte d’Ivoire, urbanisation and women’s education are contributing to this trend.

The second factor is socio-cultural (changing values, social norms). Young people prioritise self-fulfilment and are reluctant to have children in a context of crises (health, job market, agriculture, economy, climate). In countries such as South Korea and Italy, high expectations of parents and gender inequalities are holding back the birth rate. This is beginning to emerge in Côte d’Ivoire. The third factor is demographics (ageing, access to contraception). There are fewer women of childbearing age in developed countries. In France, the fall in births is linked to lower fertility among 18-34 year olds. The widespread use of contraception in developed countries and its increasing use in sub-Saharan Africa, particularly in Côte d’Ivoire, are reducing the number of unplanned births.

Reasons for the rise in death rate

The rise in mortality is linked to health crises, an ageing population and inequalities in access to healthcare. Covid-19 caused excess mortality between 2020 and 2022, particularly in France and the United States. In addition, overdoses (drug or drug-related), obesity and cardiovascular disease are increasing significantly in all countries. The ageing of the population is a constant phenomenon, with the gap between births and deaths narrowing. Inequalities in access to healthcare are real, especially in rural areas and particularly in sub-Saharan African countries such as Côte d’Ivoire. The rise in mortality is also linked to environmental factors. Extreme heat, natural disasters or disasters caused by geo-engineering exacerbate mortality.

How can we reverse the falling the falling birth rate ?

 

Effectively tackling the falling birth rate and rising mortality (or their stagnation) are major concerns worldwide, with some differences depending on the context. While in the United States and France ageing and health crises dominate, in sub-Saharan Africa and Côte d’Ivoire the demographic transition and access to healthcare are central. The solutions lie in family policies, economic reforms, better crisis management and investment in health and education in all countries. These measures must, however, be adapted to the cultural and economic realities of each country if they are to be effective.

Implementing encouraging policies in countries

Specifically, on family policies (parental leave, childcare, financial aid, economic reforms, economic stability, immigration), it is a good idea to strengthen aid such as crèches and paid leave could encourage births. The OECD notes that reconciling work and family increases fertility. Incentives such as family allowances or tax reductions can help. In Côte d’Ivoire, promoting women’s education while supporting families in the areas can be a solution. In the United States and France, policies to reduce property costs would enable young couples to have children. Stable jobs and decent wages reduce financial insecurity, which is a brake on the birth rate. In countries with low birth rates, such as France and the United States, immigration can compensate for demographic decline. However, this requires effective integration policies.

In Côte d’Ivoire, regional immigration could support the workforce, but it is less relevant given the birth rate. The most important thing in all this family policy is to promote standards that value parenthood, without compromising women’s autonomy. We need to balance modernisation with family traditions. The family remains a central institution, and having several children is often seen as a source of social wealth and a guarantee for the future. Any policy on the birth rate should avoid denigrating these values, for example by proposing campaigns that emphasise the quality of life of children rather than their number. Striking a balance between modernisation and family traditions requires a nuanced approach that respects Ivorian identity, while responding to demographic and economic challenges. This requires an inclusive dialogue between modern and traditional players to build solutions accepted by all.

How do we reverse the rise in mortality ?

To act on the rise in mortality and bring it down, it is important to improve healthcare systems. In the United States, strengthening the prevention of overdoses and chronic diseases through public health campaigns is one solution that is being exploited. In France, it is necessary to invest in the care of the elderly and the resilience of the population in the face of crises (heat waves, epidemics). In Côte d’Ivoire, it is important to extend access to primary care, especially in rural areas, to reduce infant and maternal mortality. Generally speaking, we need to be better prepared for pandemics and climatic challenges. On a global scale, improving preparedness for pandemics (vaccines, hospital infrastructure) and natural or provoked climatic disasters must be taken into consideration.

In France and the United States, infrastructures should be adapted to heat waves, flu vaccinations stepped up and the racial and economic inequalities that exacerbate mortality reduced. In sub-Saharan Africa and Côte d’Ivoire, investment in education and infrastructure is needed to reduce the disparities between rural and urban areas. As for technological progress in agriculture to ensure food security, this is essential to reduce mortality linked to malnutrition.

Long term impact of policy

The fall in the birth rate and the rise in the death rate can be explained mainly by structural and socio-economic factors. However, it must be recognised that public policies are not neutral. They can amplify or attenuate these trends, sometimes with ideological or economic ulterior motives, rather than an explicit demographic agenda as such.

Thus, specific policies put in place can influence the birth rate and/or mortality, but their motivations are generally linked to ideological objectives, as in the United States with the annulment of Roe v. Wade (decision of the Supreme Court of the United States abolishing the constitutional right to abortion) or in France, with the modulation of family allowances or even in Côte d’Ivoire with the reduction in USAID funds for HIV/AIDS. The effects observed by the policies implemented are often indirect, albeit predictable, consequences of decisions taken by the authorities for either ideological (United States), economic (France) or budgetary and geopolitical (Côte d’Ivoire) reasons, rather than a deliberate desire to manipulate demographics or a blatant desire to “control” the population.

Conspiracy theories or hidden realities?

None of the policies implemented support the idea of an intentional agenda to bring about a fall in the birth rate and a rise in the death rate. But, there have been various accusations regarding Bill Gates and George Soros around population control and public health policies. Some critics claim that Gates’ involvement in global health initiatives, such as vaccination programs and reproductive health efforts, is part of a broader agenda to reduce birth rates. Similarly, Soros has been accused of influencing political and social movements in ways that some believe align with population control strategies. These claims are widely disputed about lack of credible and scientific evidences. Formally, Gates’ foundation has focused on improving healthcare access, reducing child mortality, and combating diseases like malaria and polio. While some of his initiatives involve reproductive health, they are generally framed as efforts to provide voluntary family planning resources rather than coercive population control measures. Soros’ work, officially, through the Open Society Foundations, has primarily been centered on democracy, human rights, and social justice, rather than direct involvement in birth rate or mortality policies. In any case, all the elements mentioned taken together highlight the importance of analysing the secondary impacts and long term of decisions taken in crisis an contexts that are sometimes cyclical.

Roselyne Kandel