There is an alternative to this bleak prospect, and that is to help countries that want to slow their population growth to do so quickly. This brings with it what economists call the demographic bonus. When countries move quickly to smaller families, growth in the number of young dependents—those who need nurturing and educating—declines relative to the number of working adults. In this situation, productivity rises, savings and investment climb, and economic growth accelerates.

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Although the U.S. government does not have explicit export subsidies, production subsidies provided to farmers enable them to export cotton at low prices. These subsidies to just 25,000 cotton farmers exceed U.S. financial aid to all of sub-Saharan Africa’s 750 million people. And since the United States is the world’s leading cotton exporter, its subsidies depress prices for all cotton exporters.

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For many developing countries, farm subsidies in aid-giving countries and debt relief may be even more important. A successful export-oriented farm sector—taking advantage of low-cost labor and natural endowments of land, water, and climate to boost rural incomes and to earn foreign exchange—often offers a path out of poverty. Sadly, for many developing countries this path is blocked by the self-serving farm subsidies of affluent countries. Overall, the farm subsidies in the affluent countries at $279 billion are roughly four times the development assistance flows from these governments

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Treating those with HIV infections is costly, but ignoring the need for treatment is a strategic mistake simply because treatment strengthens prevention efforts. Africa is paying a heavy cost for its delayed response to the epidemic.

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Some leading sources of premature death are lifestyle-related. Cigarettes take a particularly heavy toll. The World Health Organization (WHO) estimates that 4.9 million people died in 2000 of tobacco-related illnesses, more than from any infectious disease. Today there are some 25 known diseases that are linked to tobacco use, including heart disease, stroke, respiratory illness, several forms of cancer, and male impotence. Cigarette smoke kills more people each year than all other air pollutants combined—nearly 5 million versus 3 million.

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