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ASSUMPTIONS UNDERLYING THE RESULTS OF THE
2008 REVISION OF WORLD POPULATION PROSPECTS
The preparation of each new revision of the official population
estimates and projections of the United Nations involves two
distinct processes: (a) the incorporation of all new and relevant
information regarding the past demographic dynamics of the
population of each country or area of the world; and (b) the
formulation of detailed assumptions about the future paths of
fertility, mortality and international migration. The data sources
used and the methods applied in revising past estimates of
demographic indicators (i.e., those referring to 1950-2010) are
presented
online and in volume III of World Population Prospects: The 2008
Revision (forthcoming).
The future population of each country is projected starting with an
estimated population for 1 July 2010. Because population data are
not necessarily available for that date, the 2010 estimate is
derived from the most recent population data available for each
country, obtained usually from a population census or a population
register, projected to 2010 using all available data on fertility,
mortality and international migration trends between the reference
date of the population data available and 1 July 2010. In cases
where data on the components of population change relative to the
past 5 or 10 years are not available, estimated demographic trends
are projections based on the most recent available data. Population
data from all sources are evaluated for completeness, accuracy and
consistency, and adjusted as necessary.1
To project the population until 2050, the United Nations Population
Division uses assumptions regarding future trends in fertility,
mortality and international migration. Because future trends cannot
be known with certainty, a number of projection variants are
produced. The following paragraphs summarize the main assumptions
underlying the derivation of demographic indicators for the period
starting in 2010 and ending in 2050. A more detailed description of
the different assumptions will be available in volume III of World
Population Prospects: The 2008 Revision (forthcoming)
The 2008 Revision includes eight projection variants. The
eight variants are: low; medium; high; constant-fertility;
instant-replacement-fertility; constant-mortality; no change
(constant-fertility and constant-mortality); and zero-migration. The
World Population Prospects Highlights focuses on the medium
variant of the 2008 Revision, and results from the first four
variants are available on-line and are published in volume I of
World Population Prospects (forthcoming). The full set of
results for all variants and scenarios are available only on CD-ROM.
The first five variants, namely, the low, medium, high,
constant-fertility and instant-replacement-fertility, differ among
themselves exclusively in the assumptions made regarding the future
path of fertility. The sixth variant, named “constant-mortality”,
differs from the medium variant only with regard to the path
followed by future mortality. The seventh variant, denominated “no
change”, has constant mortality and constant fertility and thus
differs from the medium variant with respect to both fertility and
mortality. The eight variant, denominated “zero-migration”, differs
from the medium variant only with regard to the path followed by
future international migration. Generally, variants differ from each
other only over the period 2010-2050.
To describe the different projection variants and scenarios, the
various assumptions made regarding fertility, mortality and
international migration are presented below.
A. Fertility assumptions: convergence toward total fertility below
replacement level
The fertility assumptions are described in terms of the following
groups of countries:
-
High-fertility countries: Countries that until 2010 had
no fertility reduction or only an incipient decline;
-
Medium-fertility countries: Countries where fertility has
been declining but whose level was still above 2.1 children per
woman in 2005-2010;
-
Low-fertility countries: Countries with total fertility
at or below 2.1 children per woman in 2005-2010.
1. Medium-fertility assumption:
Total fertility in all countries is assumed to converge eventually
toward a level of 1.85 children per woman. However, not all
countries reach this level during the projection period, that is, by
2045-2050. Projection procedures differ slightly depending on
whether a country had a total fertility above or below 1.85 children
per woman in 2005-2010.
-
Total fertility in all countries is assumed to converge
eventually toward a level of 1.85 children per woman. However,
not all countries reach this level during the projection period,
that is, by 2045-2050. Projection procedures differ slightly
depending on whether a country had a total fertility above or
below 1.85 children per woman in 2005-2010.
Fertility in high- and medium-fertility countries is assumed to
follow a path derived from models of fertility decline
established by the United Nations Population Division on the
basis of the past experience of all countries with declining
fertility during 1950-2010. The models relate the level of total
fertility during a period to the average expected decline in
total fertility during the next period. If the total fertility
projected by a model for a country falls to 1.85 children per
woman before 2050, total fertility is held constant at that
level for the remainder of the projection period (that is, until
2050). Therefore, the level of 1.85 children per woman
represents a floor value below which the total fertility of
high- and medium-fertility countries is not allowed to drop
before 2050. However, it is not necessary for all countries to
reach the floor value by 2050. If the model of fertility change
produces a total fertility above 1.85 children per woman for
2045-2050, that value is used in projecting the population.
In all cases, the projected fertility paths yielded by the
models are checked against recent trends in fertility for each
country. When a country’s recent fertility trends deviate
considerably from those consistent with the models, fertility is
projected over an initial period of 5 or 10 years in such a way
that it follows recent experience. The model projection takes
over after that transition period. For instance, in countries
where fertility has stalled or where there is no evidence of
fertility decline, fertility is projected to remain constant for
several more years before a declining path sets in.
-
Fertility in low-fertility countries is generally assumed to
remain below 2.1 children per woman during most of the
projection period and reach 1.85 children per woman by
2045-2050. For countries where total fertility was below 1.85
children per woman in 2005-2010, it is assumed that over the
first 5 or 10 years of the projection period fertility will
follow the recently observed trends in each country. After that
transition period, fertility is assumed to increase linearly at
a rate of 0.05 children per woman per quinquennium. Thus,
countries whose fertility is currently very low need not reach a
level of 1.85 children per woman by 2050.
2. High-fertility assumption:
-
Under the high variant, fertility is projected to remain 0.5
children above the fertility in the medium variant over most of
the projection period. By 2045-2050, fertility in the high
variant is therefore half a child higher than that of the medium
variant. That is, countries reaching a total fertility of 1.85
children per woman in the medium variant have a total fertility
of 2.35 children per woman in the high variant at the end of the
projection period.
3. Low-fertility assumption:
-
Under the low variant, fertility is projected to remain 0.5
children below the fertility in the medium variant over most of
the projection period. By 2045-2050, fertility in the low
variant is therefore half a child lower than that of the medium
variant. That is, countries reaching a total fertility of 1.85
children per woman in the medium variant have a total fertility
of 1.35 children per woman in the low variant at the end of the
projection period.
4. Constant-fertility assumption:
-
For each country, fertility remains constant at the level
estimated for 2005-2010.
5. Instant-replacement-fertility assumption:
-
For each country, fertility is set to the level necessary to
ensure a net reproduction rate of 1 starting in 2010-2015.
Fertility varies over the rest of the projection period in such
a way that the net reproduction rate always remains equal to
unity thus ensuring, over the long-run, the replacement of the
population.
B. Mortality assumptions: increasing life expectancy
except when affected by HIV/AIDS
1. Normal mortality assumption:
-
Mortality is projected on the basis of models of change of life
expectancy produced by the United Nations Population Division.
These models produce smaller gains the higher the life
expectancy already reached. The selection of a model for each
country is based on recent trends in life expectancy by sex. For
countries highly affected by the HIV/AIDS epidemic, the model
incorporating a slow pace of mortality decline has generally
been used to project a certain slowdown in the reduction of
general mortality risks not related to HIV/AIDS.
2. The impact of HIV/AIDS on mortality:
-
In the 2008 Revision, countries where HIV prevalence
among persons aged 15 to 49 was ever equal to or greater than
one per cent during 1980-2007 are considered as affected by the
HIV/AIDS epidemic and their mortality is projected by modelling
explicitly the course of the epidemic and projecting the yearly
incidence of HIV infection. Also considered among the affected
countries are those where HIV prevalence has always been lower
than one per cent but whose population is so large that the
number of people living with HIV in 2007 surpasses 500,000
(i.e., Brazil, China, India, the Russian Federation and the
United States of America). In total, 58 countries are considered
to be affected by the HIV/AIDS epidemic in the 2008 Revision.
The model developed by the UNAIDS Reference Group on Estimates,
Modelling and Projections2,3
is used to fit past estimates of HIV prevalence provided by
UNAIDS
for each of the affected countries4
so as to derive the parameters determining the past dynamics of
the epidemic for each of
them. For most countries, the model is fitted assuming that the
relevant parameters have remained constant in the past.
Beginning in 2007, the parameter PHI, which reflects the rate of
recruitment of new individuals into the high-risk or susceptible
group, is projected to decline by half every twenty years. The
parameter R, which represents the force of infection, is
projected to decline by half every thirty years. The reduction
in R reflects the assumption that changes in behaviour among
those subject to the risk of infection, along with increases in
access to treatment for those infected, will reduce the chances
of HIV transmission.
-
In the 2008 Revision, interventions to prevent the
mother-to-child transmission of HIV are modelled on the basis of
estimated country-specific coverage levels that, in 2007,
averaged 36 per cent among the 58 affected countries, but varied
from 0 to 99 per cent among them (with 22 countries having less
than 20 per cent coverage of pregnant women in 2007, and only 8
countries with more than 75 per cent coverage). These coverage
levels are projected to reach 60 per cent on average by 2015,
varying between 40 per cent and 99 per cent among the affected
countries.5
After 2015, the coverage of interventions to prevent
mother-to-child transmission of HIV is assumed to remain
constant until 2050 at the level reached in each of the affected
countries in 2015. Among women receiving treatment, the
probability of transmission from mother to child is assumed to
vary between 2 per cent and 19 per cent depending on the
particular combination of breastfeeding practices (mixed
breastfeeding, replacement feeding, exclusive breastfeeding),
its duration in the population and the type of treatment
available (single-dose nevirapine, dual-prevention, or
triple-prevention antiretroviral treatment). These assumptions
produce a reduction in the incidence of HIV infection among
children born to HIV-positive women, but the size of the
reductions varies from country to country depending on the level
of coverage that treatment reaches in each country.6
-
The survivorship of infected children2 takes account of varying
access to paediatric treatment.6
In the 2008 Revision, HIV-infected children are divided into two
groups: (i) those infected in-utero, among whom the disease
progresses rapidly and whose average survival is set at 1.3
years, and (ii) those infected through breastfeeding after
birth, among whom the disease progresses slowly and whose
average survival is set at 15.2 years without treatment.7
Explicit inclusion of paediatric treatment is done via
country-specific coverage levels which average 34 per cent in
2007 but vary between 0 and 99 per cent among the 58 affected
countries (with 15 countries having less than 10 per cent
coverage in 2007 and only 12 countries having a coverage level
above 75 per cent). By 2015, the projected coverage is expected
to reach 60 per cent on average in the 58 affected countries,
varying from 40 per cent to 100 per cent.8
Coverage levels are assumed to remain constant from 2015 to 2050
at the level reached in each country by 2015. The annual
survival of children receiving treatment is 80 per cent during
the first year, 90 per cent the second year, and 95 per cent
thereafter, so that their mean survival time is 31.1 years and
the median survival time is 20.5 years in the absence of other
causes of death.6
-
The 2008 Revision incorporates a longer survival for persons
receiving treatment with highly active antiretroviral therapy
(ART).2,6
The proportion of the HIV-positive population
receiving treatment in each country is consistent with estimates
prepared by the World Health Organization,8
which averaged 36 per cent in 2007 among the 58 affected
countries, but varied between 8 per cent and 99 per cent.
Coverage is projected to reach between 40 per cent and 100 per
cent by 2015, averaging 60 per cent for the affected countries.
Between 2015 and 2050, coverage levels are assumed to remain
constant at the level reached in each country by 2015. It is
assumed that adults receiving treatment have, on average, an 85
per cent chance of surviving on the first year of treatment, and
a 95 per cent chance of surviving each year thereafter in the
absence of other causes of death. Under this assumption, mean
survival time after the initiation of therapy is 19.3 years and
the median survival time is 10.9 years, in the absence of other
causes of death. Therapy is assumed to start at the time
full-blown AIDS develops. Without treatment, infected adults
have a mean survival time of 3.2 years (and a median survival
time of 3.0 years) after the onset of full-blown AIDS.2,6
3. Constant-mortality assumption:
-
Under this assumption, mortality is maintained constant in each
country at the level estimated for 2005-2010.
C. International migration assumptions
1. Normal-migration assumption:
- Under the normal migration assumption, the future path of
international migration is set on the basis of past
international migration estimates and consideration of the
policy stance of each country with regard to future
international migration flows. Projected levels of net migration
are generally kept constant over most of the projection period.
Zero-migration assumption:
- Under this assumption, for each country, international
migration is set to zero starting in 2010-2015.
D. Eight Projections Variants
The 2008 Revision includes eight different projection
variants or scenarios (table 1). Five of those variants differ among
themselves only with respect to the level of fertility in each, that
is, they share the assumptions made with respect to mortality and
international migration. The five fertility variants are: low,
medium, high, constant-fertility and instant-replacement fertility.
A comparison of their results allows an assessment of the effects
that different fertility paths have on other demographic parameters.
In addition to the five fertility variants, a constant-mortality
variant, a zero-migration variant and a no change variant
(constant-fertility and constant-mortality) have been prepared. The
constant-mortality variant and the zero-migration variant both have
the same fertility assumption (i.e. medium fertility). Furthermore,
the constant-mortality variant has the same international migration
assumption as the medium variant. Consequently, the results of the
constant-mortality variant can be compared with those of the medium
variant to assess the effect that changing mortality has on other
demographic parameters. Similarly, the zero-migration variant
differs from the medium variant only with respect to the underlying
assumption regarding international migration. Therefore, the
zero-migration variant allows an assessment of the effect that
non-zero net migration has on other demographic parameters. Lastly,
the no change variant has the same international migration as the
medium variant but differs from the latter by having constant
fertility and constant mortality. When compared to the medium
variant, therefore, its results shed light on the effects that
changing fertility and mortality have on the results obtained.
Table 1. Projection variants or scenarios in terms of
assumptions for fertility, mortality and international migration
|
Assumptions
|
|
Projection variant |
Fertility |
Mortality |
International
migration |
| |
|
|
|
|
Low |
Low
|
Normal*
|
Normal
|
|
Medium |
Medium
|
Normal*
|
Normal
|
|
High |
High |
Normal*
|
Normal
|
|
Constant-fertility |
Constant as of 2005-2010 |
Normal* |
Normal |
|
Instant-replacement-fertility |
Instant-Replacement
as of 2005-2010 |
Normal* |
Normal |
|
Constant-mortality |
Medium |
Constant as of 2005-2010 |
Normal |
|
No-change |
Constant as of 2005-2010 |
Constant as of 2005-2010 |
Normal |
|
Zero-migration |
Medium |
Normal* |
Zero as of
2010-2015 |
* Including the impact of HIV/AIDS in 58 countries, as described
in section B.2.
E. Methodological Changes Introduced in the 2008 Revision
The following changes and adjustments were made in the 2008 Revision
in relation to procedures followed in the 2006 Revision.
-
The base year, that is, the year where the projections start
changed from 2005 to 2010.
-
In the 2008 Revision, the impact of HIV/AIDS on mortality is
modelled explicitly for all countries where HIV prevalence among
persons aged 15 to 49 was ever equal to or greater than one per
cent during 1980-2007.
-
The models of the incidence of HIV infection by age have been
revised to take into account newly available data from
nationally representative population surveys. Three new regional
models, one for each Africa, Asia and the Caribbean, have been
estimated by the United Nations Population Division for each sex
using adult HIV prevalence rates by age and sex from 24 DHS
surveys (covering 21 countries between 2001 and 2007).9 In the
new models, mean age at infection is lower than in the models
used in previous revisions, particularly for males. The mean age
of infection for female varies between 25.0 (Asia) and 26.9
(Africa) years while for male it varies between 27.9 (Asia) and
31.9 (Africa).
-
The survival of HIV-positive children receiving treatment
increased with respect to that used in the 2006 Revision.
-
For HIV-positive adults, the asymptomatic period (i.e., the
period between the time of initial infection and full-blown
AIDS) decreased on to 8 years on average for males and 9 years
on average for females (with median values of 7.5 and 8.5 years,
respectively).
-
The survival time of HIV-positive adults after developing
full-blown AIDS increased with respect to that in models used
previously, both for those receiving treatment and for
HIV-positive persons not receiving treatment.
1 For a general description of the
procedures used in revising estimates of population dynamics, see "Chapter
VI. Methodology of the United Nations population estimates and
projections" (pp. 100-104) in
World Population Prospects: The
2004 Revision, Volume III: Analytical Report.
2 Ghys P.D., Walker N., McFarland W.,
Miller R., Garnett G.P. (2008).
Improved
data, methods and tools for the 2007 HIV and AIDS estimates and
projections. Sexually Transmitted Infections. August
2008, Volume 84, Supplement 1, pp. i1-i4 ;
doi:10.1136/sti.2008.032573 -
http://sti.bmj.com/cgi/content/full/84/Suppl_1/i1
3 Brown T., Salomon J.A., Alkema L.,
Raftery A.E., Gouws E. (2008).
Progress
and challenges in modelling country-level HIV/AIDS epidemics: the
UNAIDS Estimation and Projection Package 2007. Sexually
Transmitted Infections. August 2008, Volume 84, Supplement 1,
pp. i5–i10. doi:10.1136/sti.2008.030437 -
http://sti.bmj.com/cgi/content/full/84/Suppl_1/i5
4 UNAIDS/WHO. (2008).
2008 Report on the global AIDS epidemic. UNAIDS/08.25E /
JC1510E. Geneva. Aug. 2008. 362 p. -
http://www.unaids.org/en/KnowledgeCentre/HIVData/GlobalReport/2008/2008_Global_report.asp
- See online table: “Adult
(15-49) HIV prevalence percent by country, 1990-2007 (with 95%
confidence intervals)”:
http://data.unaids.org/pub/GlobalReport/2008/080813_gr08_prev1549_1990_2007_en.xls
5 UNAIDS, UNICEF, WHO (2008).
Children and AIDS - Third Stocktaking Report. (with
Statistical Annexes). Dec. 2008. See Table 1. Preventing
mother-to-child transmission of HIV (pp. 33-35) and Table 2.
Providing paediatric treatment (pp. 36-38). URL:
www.unicef.org/uniteforchildren -
http://www.uniteforchildren.org/uniteforchildren/knowmore/files/StocktakingReport08_Full_110708.pdf
6 Stover J, Johnson P, Zaba B, Zwahlen
M., Dabis F., Ekpini R.E. (2008).
The
Spectrum projection package: improvements in estimating mortality,
ART needs, PMTCT impact and uncertainty bounds. Sexually
Transmitted Infections. August 2008, Volume 84, Supplement 1,
pp. i24-i30. doi:10.1136/sti.2008.029868 -
http://sti.bmj.com/cgi/content/full/84/Suppl_1/i24
7 Marston M., Zaba B., Salomon J.A., Brahmbhatt H., Bagenda D. (2005) -
Estimating the Net Effect of HIV on Child Mortality in African Populations Affected by Generalized HIV Epidemics.
JAIDS Journal of Acquired Immune Deficiency Syndromes. Volume 38, Number 2, February 1 2005. pp. 219–227 ; Newell, M-L. Coovadia H., Cortina-Borja M., Rollins N., Gaillard P., Dabis F. (2004).
Mortality of infected and uninfected infants born to HIV-infected mothers in Africa: a pooled analysis.
Lancet. Vol 364. October 2, 2004, pp: 1236–43.
8 WHO/UNAIDS/UNICEF.
Towards universal access: scaling up priority HIV/AIDS interventions in the health sector, progress report 2008. Geneva, WHO, June 2008.
http://www.who.int/entity/hiv/pub/towards_universal_access_report_2008.pdf
9 The approach is based on methodology presented at the
UNAIDS Reference Group on Estimates, Modelling and Projections January 2008 meeting (London, UK) by Ray W. Shiraishi, Abhijeet Anand, R.W. Shiraishi, M. Morgan, W. Hladik, R. Bunnell, L.H. Marum, J. Aberle-Grasse, G. Bello, T. Diaz on "Using Population-based HIV Surveys to Estimate HIV Incidence in Kenya, Malawi and Uganda”.
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