Written by Luisa Antunes.
AbstractToday’s EU pharmaceutical market is unsustainable, due to the fragmentation of EU players and public dependence on private interests. A recent Panel for the Future of Science and Technology (STOA) study proposes a solution involving the creation of a public European medicines infrastructure, a body that would control of the entire drug cycle, from its inception to its delivery.
The forthcoming STOA workshop will discuss how such a structure should be developed. This event is part of a series of STOA activities (including publications and events) addressing the EU health response to the Covid‑19 pandemic, with a view to fostering preparedness to counter future health threats.
Today’s EU public health system is unsustainableThe Covid-19 pandemic exposed gaps in the EU public health system: from non-standardised Member State data reporting and uncoordinated Member State crisis responses, controversial vaccine contracts and slow national vaccine rollouts, to a fragmented network of institutional actors in health.
The EU’s response to Covid-19 improved upon some of these issues. We saw the launch of the EU4Health programme and the pharmaceutical strategy for Europe initiative, the reinforcement of the roles of EU agencies the European Centre for Disease Prevention and Control (ECDC) and European Medicines Agency (EMA), and the creation of two new EU structures, the European Health and Digital Executive Agency (HaDEA) and the Health Emergency Preparedness and Response Authority (HERA), the latter of which has a mission to stockpile and distribute vaccines and other medical countermeasures to the 27 EU Member States.
However, some have argued that these solutions are limited and do not address the root of the problem – the unsustainability of the present EU pharmaceutical system. A STOA study analysing 200 literature sources and interviewing 60 experts identifies the main market and policy failures at the heart of the problem, including:
1. a mismatch between public and private research and development (R&D) priorities;
2. a mismatch between public sector ‘open’ science and private copyright regimes;
3. an excessive flow of public subsidies towards the private sector;
4. private monopoly control over access to and the cost of medicines.
A solution is therefore sought that can repurpose the massive public investment in pharmaceutical R&D for an effective and sustainable public EU ecosystem.
With its resolution of 17 September 2020, the European Parliament called on the Commission and Member States to ‘examine the possibility of creating one or more European non-profit pharmaceutical undertakings which operate in the public interest to manufacture medicinal products of health (…), in order to complete and guarantee security of supply and prevent possible shortages of medicines’.
The December 2021 Council conclusions negotiated under the Slovenian Presidency of the EU and signed off by all 27 EU Health Ministers took note of the importance of Parliament’s resolution to ensure the supply of medicinal products affected by market failures.
In July 2022, an open letter to EU institutions signed by researchers, doctors and by Italian ex-ministers of Health Rosy Bindi and Giulia Grillo, called for the creation of a public European infrastructure that can develop vaccines and other therapeutics, for the common good.
Developing a public European medicines infrastructureAccording to the authors of the STOA study, a European medicines infrastructure would focus on serving public interest by developing effective, affordable and safe medicines that are free from private intellectual property rights and where public funds are reallocated to public-interest projects. Such a structure would allow the development of new antimicrobials and medicines used to cure rare diseases (‘orphan medicines’), areas traditionally left out of private strategies.
Unlike HERA, which does not have the mandate to directly implement pharmaceutical R&D projects, this new structure would have the authority to control the full drug lifecycle, from research to development, production and distribution. It would centralise EU public health R&D in a manner equivalent to other EU structures. It could take inspiration from the United States’ health federal agencies, the National Institutes of Health (NIH) and Biomedical Advanced Research and Development Authority (BARDA), with their reinforced budgets and scope. It would remain open to collaborations with scientific and public health centres at national and EU levels and with pharmaceutical companies, based on transparent contracts.
A European medicines infrastructure could be developed in one of four models, depending on the level of autonomy – from public/private partnerships to fully public – and R&D capacity – and from a focus on infectious diseases to a wider focus on public health.
The upcoming STOA workshopOn 28 September 2022, the European Parliament will organise a roundtable discussion on the purpose and feasibility of creating a European medicines infrastructure. The event will gather experts from research, industry, civil society governmental and non-governmental organisations to discuss the development models for such a structure.
Ahead of the workshop, participants have shared their views. EU research fragmentation is a main contributor to the issue, advises Karin Sipido of KU Leuven. Rolf Apweiler, from EMBL, highlights the importance of ‘open’ science and accessible data sharing for health crisis response. Rosa Castro, from EPHA, supports EU coordination for areas of low commercial profitability, and includes HERA in such a structure. For Salah Dine Chibout, from Novartis, public and private bodies have complementary roles and should continue to collaborate in clinical trial stages. Global vaccine access and distribution remains unequal, due to private monopoly control, notes Els Torreele,in an appeal for new policies and governance rules.
In conclusion, the industry is a key player in pharmaceutical R&D and innovation. However, overwhelming evidence points to a structural disconnect between public health priorities and private strategies, which lead to market and policy failures that do not benefit the public interest. A European medicines infrastructure could offer a new approach to fixing these issues. The forthcoming workshop will contribute to the ongoing public discussion.
Your opinion counts for us. To let us know what you think, get in touch via stoa@europarl.europa.eu.
Le Président de la République, Abdelmadjid Tebboune, a reçu, ce lundi 18 juillet 2022, le président du conseil des ministres d’Italie, Mario Draghi, à la présidence de la République. Avant cela, Mario Draghi a déposé, aujourd’hui lundi, une gerbe au mémorial du sanctuaire du martyr à Alger. Ce dernier est à Alger, pour co-présider avec […]
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Protecting the human rights of trafficking victims must be placed at the heart of all responses to this global crime that particularly targets women and girls, who are even more at risk in situations of armed conflict, OSCE leaders said at the opening of a two-day conference today.
Almost 300 participants from OSCE states, civil society, international organizations and national human rights institutions across the OSCE region registered for the meeting in Vienna, which will provide a forum to discuss the rights of human trafficking victims both in peacetime and during armed conflict.
“The unprovoked Russian aggression against Ukraine has shaken the foundations of international and European security, causing thousands of unnecessary deaths and enormous suffering to the civilian population,” said Ambassador Adam Hałaciński, Permanent Representative of Poland to the OSCE, on behalf of the Polish 2022 OSCE Chairmanship. “It has also caused Europe’s biggest refugee crisis since World War II. The refugee and humanitarian crisis has the potential to turn into a trafficking one, as many experts predict.”
According to UN figures, approximately 40 percent of all global human trafficking cases take place within the OSCE region. The risk of becoming a victim grows during armed conflict, when traffickers are able to plausibly offer rescue and safety or assistance, but in fact with the intention of trafficking them for exploitation. The reach of traffickers has also expanded together with the internet, and the online world offers traffickers anonymity and immediate, global access to individuals and groups with specific profiles. At the same time, new technologies also bring advantages for monitoring and combating trafficking.
Children are especially at risk of becoming victims of trafficking, and the trauma can remain with them far into adulthood. The protection needs of child trafficking victims are significantly different from those of adults, and a dedicated session will therefore focus on child victims of trafficking and ways in which to improve and strengthen child protection systems.
This year ODIHR launched the second edition of a handbook on establishing and strengthening national referral mechanisms to assist OSCE countries in improving their efforts to combat trafficking and support victims. These mechanisms are national frameworks that enable governments to coordinate their efforts to protect and promote the human rights of trafficking victims in strategic partnership with civil society, the private sector, victims, and others working in the field.
“Victims of human trafficking are ripped away from their homes and out of their societies, affecting all those involved for the rest of their lives,” said ODIHR Director Matteo Mecacci. “There are now also new threats that have made individuals and groups already at risk of trafficking even more vulnerable. ODIHR will continue its work with countries across the OSCE to strengthen national frameworks and partnerships with civil society in order to combat human trafficking, and at the same time ensure the voices of victims are heard and their human rights respected.”
Supplementary Human Dimension Meetings are a platform for the OSCE’s participating States and OSCE institutions, as well as international organizations and civil society, to exchange views and good practices to find common solutions for the challenges facing the OSCE region. Today’s discussion is the final SHDM of 2022 and follows meetings dedicated to international cooperation to address violations of international humanitarian law and international human rights law, and the importance of democratic institutions in times of crisis.
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Le Centre de promotion de l'artisanat (CPA) n'existe plus. Le gouvernement à travers un décret en date du 15 juin 2022, et signé du chef de l'Etat Patrice Talon, l'a dissout.
Dissolution de la structure en charge de la promotion de l'artisanat au Bénin. Par décret en date du 15 juin 2022, le gouvernement a dissout le Centre de promotion de l'artisanat (CPA). Un liquidateur a été nommé.
Selon le décret de dissolution, le liquidateur produit lors de sa prise de fonction, une feuille de route de la mission présentant notamment la méthodologie de travail et les modalités d'intervention à soumettre à la validation d'un comité interministériel chargé de la supervision de la liquidation.
La décision de dissolution du CPA a été prise en Conseil des ministres sur proposition du ministre de l'économie et des finances, et son collègue en charge des petites et moyennes entreprises.
Le Centre de promotion de l'artisanat est basé à Cotonou. Il a été créé par le décret N°87-427 du 22 décembre 1987.
F. A. A.
Pinched between two antagonistic blocs, the United Nations was in a deadlock for decades. Credit: United Nations
By Marc Saxer
BERLIN, Jul 18 2022 (IPS)
With the invasion of Ukraine, Russia effectively destroyed the European peace order. Now, Europe needs to find ways to contain its aggressive neighbour, while its traditional protector, the United States, continues its shift of focus to the Indo-Pacific.
This task, however, becomes impossible when China and Russia are driven into each other’s arms because, if anything, the key to end the war in Ukraine lies in Beijing. China hesitates to be dragged into this European war as bigger questions are at stake for the emerging superpower:
Will the silk road be wrecked by a new iron curtain? Shall it stick to its ‘limitless alliance’ with Russia? And what about the territorial integrity of sovereign states? In short: for China, it is about the world order.
The unipolar moment after the triumph of the West in the Cold War is over. The war in Ukraine clearly marks the end of the Pax Americana. Russia and China openly challenge American hegemony. Russia may have proven to be a giant with clay feet, and has inadvertently strengthened the unity of the West.
But the shift of the global balance of power to East Asia is far from over. In China, the United States has encountered a worthy rival for global predominance. But Moscow, Delhi, and Brussels also aspire to become power hubs in the coming multipolar order.
So, we are witnessing the end of the end of history. What comes next? To better understand how world orders emerge and erode, a quick look at history can be helpful.
What is on the menu?
Over the course of the long 19th century, a great power concert has provided stability in a multipolar world. Given the nascent state of international law and multilateral institutions, congresses were needed to carefully calibrate the balance between different spheres of interest.
The relative peace within Europe, of course, was dearly bought by the aggressive outward expansion of its colonial powers.
Marc Saxer
This order was shattered at the beginning of the World War I. What followed were three decades of disorder rocked by wars and revolutions. Not unlike today, the conflicting interests of great powers collided without any buffer, while the morbid domestic institutions could not mitigate the devastating social cost of the Great Transformation.With the founding of the United Nations and the Universal Declaration of Human Rights, the foundations of a liberal order were laid after the end of World War II. However, with the onset of the Cold War, this experiment quickly ran into a quagmire.
Pinched between two antagonistic blocs, the United Nations was in a deadlock for decades. From the Hungarian Revolution over the Prague Spring to the Cuban missile crisis, peace between the nuclear powers was maintained through the recognition of exclusive zones of influence.
After the triumph of the West in the Cold War, American hyperpower quickly declared a new order for a now unipolar world. In this liberal world order, rule-breaking was sanctioned by the world’s policeman.
Proponents of the liberal world order pointed to the rapid diffusion of democracy and human rights around the globe. Critics see imperial motifs at work behind the humanitarian interventions. But even progressives place great hopes in the expansion of international law and multilateral cooperation.
Now that the West is mired in crises, global cooperation is again paralysed by systemic rivalry. From the war in Georgia over the annexation of Crimea to the crackdown in Hong Kong, the recognition of exclusive zones of influence is back in the toolbox of international politics.
After a short heyday, the liberal elements of the world order are jammed again. China has begun to lay the foundations of an illiberal multilateral architecture.
How will great power competition play out?
In the coming decade, the rivalries between great powers are likely to continue with undiminished vigour. The ultimate prize of this great power competition is a new world order. Five different scenarios are conceivable.
First, the liberal world order could survive the end of the unipolar American moment. Second, a series of wars and revolutions can lead to the total collapse of order. Third, a great power concert could bring relative stability in a multipolar world but fail to tackle the great challenges facing humanity.
Fourth, a new cold war may partly block the rule-based multilateral system, but still allow for limited cooperation in questions of common interest. And finally, an illiberal order with Chinese characteristics. Which scenario seems the most probable?
Many believe that democracy and human rights need to be promoted more assertively. However, after the fall of Kabul, even liberal centrists like Joe Biden und Emmanuel Macron have declared the era of humanitarian interventions to be over.
Should another isolationist nationalist like Trump or others of his ilk come to power in Washington, London, or Paris, the defence of the liberal world order would once and for all be off the agenda. Berlin is in danger of running out of allies for its new value-based foreign policy.
In all Western capitals, there are broad majorities across the ideological spectrum that seek to up the ante in the systemic rivalry with China and Russia. The global reaction to the Russian invasion shows, however, that the rest of the world has very little appetite for a new bloc confrontation between democracies and autocracies.
The support for Russia’s attack on the sovereignty and territorial integrity of Ukraine – values especially smaller countries unwaveringly adhere to – should not be read as sympathy for a Russian or Chinese-led order, but as deep frustration over the US empire.
Seen from the Global South, the not-so-liberal world order was merely a pretext for military interventions, structural adjustment programmes, and moral grandstanding. Now, the West comes to realise that in order to prevail geopolitically, it needs the cooperation of undemocratic powers from Turkey to the Gulf monarchies, from Singapore to Vietnam.
The high-minded rhetoric of the systemic rivalry between democracies against autocracies is prone to alienate these much-needed potential allies. But if even the West were to give up on universalism of democracy and human rights, what would be left of the liberal world order?
Are the great power rivalries that play out in the background of the war in Ukraine, the coups in Western Africa and the protests in Hong Kong only the beginning of a new period of wars, coups, and revolutions?
The ancient Greek philosopher Thucydides already knew that the competition between rising and declining great powers can beget great wars. So, are we entering a new period of disorder?
Not only in Moscow and Beijing, but also in Washington, there are thinkers that seek to mitigate these destructive dynamics of the multipolar world through a new concert of great powers. The coordination of great power interests in fora from the G7 to the G20 could be the starting point for this new form of club governance. The recognition of exclusive zones of influence can help to mitigate conflict.
However, there is reason for concern that democracy and human rights will be the first victims of such high-powered horse-trading. This form of minimal cooperation may also be inadequate to tackle the many challenges humankind is facing from climate change over pandemics to mass migration.
The European Union, an entity based on the rule of law and the permanent harmonisation of interests, may have a particularly hard time to thrive in such a dog-eat-dog world.
Not only in Moscow, some fantasize about a revival of imperialism that negates the right to self-determination of smaller nations. This dystopian mix of technologically supercharged surveillance state on the inside and never-ending proxy wars on the outside is eerily reminiscent of George Orwell’s 1984. One can only hope that this illiberal neo-imperialism is shattered in the war in Ukraine.
The Russian recognition of separatist provinces of a sovereign state have rung the alarm bells in Beijing. After all, what if Taiwan follows this model and declares its independence? At least rhetorically, Beijing has returned to its traditional line of supporting national sovereignty and condemning colonialist meddling in internal affairs.
There are debates in Beijing whether China should really side with a weakened pariah state and retreat behind a new iron curtain, or would benefit more from an open and rules-based global order.
So, what is this ‘Chinese Multilateralism’ promoted by the latter school of thought? On the one hand, a commitment to international law and cooperation to tackle the great challenges facing humankind, from climate change over securing trade routes to peacekeeping.
However, China is only willing to accept any framework for cooperation if it is on equal footing with the United States. This is why Beijing takes the United Nations Security Council seriously, but tries to replace the World Bank and the International Monetary Fund with its own institutions such as the Asian Infrastructure Investment Bank.
If Chinese calls for equal footing are rejected, Beijing can still form its own geopolitical bloc with allies across Eurasia, Africa, and Latin America. In such an illiberal order, there would still be rule-based cooperation, but no longer any institutional incentives for democracy and human rights.
Hard choices: what should we strive for?
Alas, with a view of containing an aggressive Russia, a rapprochement with China may have its merits. For many in the West, this would require an about-face. After all, the recently fired German admiral Schönbach was not the only one who wanted to enlist Russia as an ally for a new cold war with China.
Even if Americans and Chinese would bury the hatchet, a post-liberal world order would pose a predicament for Western societies.
Is the price for peace really the right to self-determination of peoples? Is cooperation to tackle the great challenges facing humankind contingent on the rebuttal of the universality of human rights? Or is there still a responsibility to protect, even when the atrocities are committed in the exclusive zone of influence of a great power rival?
These questions go right to the West’s normative foundation.
Which order will prevail in the end will be determined by fierce great power competition. However, who is willing to rally around the banner of each different model differs significantly. Only a narrow coalition of Western states and a handful of Indo-Pacific value partners will come to the defence of democracy and human rights.
If this Western-led alliance of democracies loses the power struggle against the so-called axis of autocracies, the outcome could well be an illiberal world order with Chinese characteristics.
At the same time, the defence of international law, especially the inviolability of borders and the right to self-defence, are generally in the interest of democratic and authoritarian powers alike. An alliance for multilateral cooperation with the United Nations at its core finds supports across the ideological spectrum.
Finally, there could be issue-based cooperation between different centres. If ideological differences are set aside, hybrid partners could cooperate, for instance, in the fight against climate change or piracy, but be fierce competitors in the race for high-tech or energy.
Thus, it would not be surprising if the United States were to replace their ‘alliance of democracies’ with a more inclusive coalition platform.
Politically, Germany can only survive within the framework of a united Europe. Economically, it can only prosper in open world markets. For both, a rules-based, multilateral order is indispensable. Given the intensity of today’s systemic rivalry, some may doubt its feasibility. However, it is worth remembering that even at the heyday of the Cold War, within the framework of a constrained multilateralism, cooperation based on common interests did occur.
From arms control over the ban of the ozone-killer CFC to the Helsinki Accords, the balance sheet of this limited multilateralism was not too bad. In view to the challenges facing humankind, from climate change over pandemics to famines, this limited multilateralism may just be the best among bad options. For what is at stake is the securing of the very foundations of peace, freedom, unity, and prosperity in Europe.
Marc Saxer coordinates the regional work of the Friedrich-Ebert-Stiftung (FES) in the Asia Pacific. Previously, he led the FES offices in India and Thailand and headed the FES Asia Pacific department.
Source: International Politics and Society published by the Global and European Policy Unit of the Friedrich-Ebert-Stiftung, Hiroshimastrasse 28, D-10785 Berlin.
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A half-century of reproduction rights upended by the Supreme Court. Credit: Greenpeace.
By Joseph Chamie
PORTLAND, USA, Jul 18 2022 (IPS)
The 24 June decision of United States Supreme Court to overturn the country’s nearly 50-year constitutional right of a woman to an abortion is being felt worldwide.
In addition to the objections and protests to the court’s landmark decision within the United States, governments, world leaders, and others have expressed their concerns and dissatisfaction about the overturning a woman’s constitutional right to an abortion.
The court’s decision to overturn the constitutional right to an abortion established in 1973 is at odds with the views of a broad majority of the public. No less than two-thirds of U.S. adults did not want the court to overturn the 1973 decision
The European Union’s parliament overwhelmingly condemned the decision ending the constitutional protections of women for abortion in the United States. Fearing the expansion of anti-abortion movements in Europe, the parliament also called for safeguards to abortion rights be enshrined in the EU’s fundamental rights charter and protections be adopted across the EU.
The Director General of the World Health Organization was very disappointed with the decision and the United Nations High Commissioner for Human Rights called the court’s decision a major setback. Access to safe, legal, and effective abortion, the Commissioner stressed, is firmly rooted in international human rights law.
Objections to the decision came from many government leaders worldwide. The Prime Minister of the United Kingdom, for example, saw the decision as a big step backwards. Accusing the court of diminishing the rights of U.S. women, the President of France said that abortion is a fundamental right of all women.
The German Chancellor viewed the decision as a threat to the rights of women, as did New Zealand’s Prime Minister who saw it as a loss for women everywhere. The Belgian Prime Minister expressed concerns about the signal the decision sends to the rest of the world about a woman’s right to an abortion.
Fifty years ago, various U.S. states criminalized a woman having an abortion. In 1973 in the case Roe v. Wade, the Supreme Court’s majority of seven justices established a woman’s constitutional right to an abortion in all 50 states (Table 1).
The justices concluded that state statutes criminalizing abortion in most instances violated a woman’s constitutional right of privacy, which it found to be implicit in the liberty guarantee of the due process clause of the Fourteenth Amendment in the U.S. Constitution.
Thirty years ago, the Supreme Court revisited Roe v. Wade in the 1992 case of Planned Parenthood v. Casey. A majority of five justices reaffirmed a woman’s right to an abortion but imposed a new standard to determine the validity of laws restricting abortions.
The new standard asks whether a state abortion regulation has the purpose or effect of imposing an “undue burden”, which is defined as a substantial obstacle in the path of a woman seeking an abortion before the fetus attains viability.
In June 2022, in the case of Dobbs v. Jackson Women’s Health Organization a majority of six justices concluded that the 1973 and 1992 abortion decisions of a dozen former justices were egregiously wrong in their legal reasoning that led to erroneous decisions concerning the right to an abortion.
After nearly a half century of women having a constitutional right to an abortion enshrined in the 1973 decision and reaffirmed in the 1992 decision, six justices of the current Supreme Court concluded that there is no such constitutional right. In the dissenting opinion, the court’s remaining three justices wrote that the U.S. will become an international outlier after the decision.
The court’s decision to overturn the constitutional right to an abortion established in 1973 is at odds with the views of a broad majority of the public. No less than two-thirds of U.S. adults did not want the court to overturn the 1973 decision.
In addition, a majority of Americans, approximately 60 percent, and President Biden with the backing of many Democratic leaders support Congress passing a law establishing a nationwide right to abortion. Such a law would protect a woman’s right to choose whether or not to have an abortion.
In contrast, a comparatively small minority of Americans, 13 percent in 2022, are opposed to abortion, with some, including Republican leaders, considering a federal abortion ban for all fifty states. Since 1975, the annual proportion of Americans who say abortion should be illegal in all circumstances has varied from a low of 12 percent in 1990 to a high of 22 percent in 2002 (Figure 1).
Source: Gallup Polls.
Following its decision to overturn the Roe v. Wade decision, confidence in the Supreme Court has reached historic lows. A majority of the U.S. public, 58 percent, have an unfavorable view of the Supreme Court. That level of disapproval is now on par with the public’s unfavorable view of Congress.
In addition, the United States has become a patchwork of abortion laws and given rise to a myriad of enforcement regulations, numerous court cases, and challenging legal questions. Abortion is now banned in at least nine states and more bans are expected in the near future. In some states, such as Alabama, Arkansas, Mississippi, Missouri, and South Dakota, abortion is banned with no exceptions for rape or incest.
Also, many state legislatures are considering ways of stopping or criminalizing out of state abortions. They are also proposing banning or tightly restricting the use of abortion medication, which was approved in 2000 by the U.S. Food and Drug Administration and accounted for an estimated 54 percent of the country’s abortions in 2020. In response, other states are advancing legislation and executive orders protecting patients and providers from legal risks outside their borders.
The Supreme Court’s recent decision finding no constitutional right to an abortion has raised concerns that other rights not enumerated in the U.S. Constitution are at risk of being overturned. Among those rights are same-sex marriage, same-sex relationships, and contraceptives.
In a concurring opinion to the recent abortion decision, for example, one of the court’s justices indicated that other precedents should be reconsidered. He also mentioned that future legal cases could curtail other rights not clearly addressed in the U.S. Constitution.
The court’s abortion decision may also embolden abortion opponents, influence policymakers, and affect reproductive health programs in other countries as well. The decision puts U.S. alongside several other countries, including Poland, El Salvador, and Nicaragua, that have backtracked on or restricted abortion policy in recent decades.
However, the court’s abortion decision runs counter to recent global liberalization trends on reproductive rights. During the past three decades about 60 countries have expanded laws and policies relating to reproductive rights, including legal access to abortion.
In sum, the recent decision of the U.S. Supreme Court has not only revoked the nearly 50-year constitutional right of a woman to an abortion, but it is also now out of sync with the increasing worldwide recognition of fundamental reproductive rights, including a woman’s right to an abortion.
Joseph Chamie is a consulting demographer, a former director of the United Nations Population Division and author of numerous publications on population issues, including his recent book, “Births, Deaths, Migrations and Other Important Population Matters.”