Breaking out or breaking down.

A new kind of challenge looms in several regions of the world, where the historic trend toward longer life expectancy has been sharply reversed. There are three clearly identifiable trends that are causing death rates to increase. The first is the spread of the HIV virus, which causes AIDS. As illustrated by the case of sub-Saharan Africa, the growth of the HIV epidemic damages a nation's social infrastructure, producing lingering demographic and economic effects. It reinforces conditions like poverty, illiteracy, and malnutrition. Second, the depletion of aquifers has become a major threat, particularly in India, where water tables are falling in almost every region. Water shortage leads to such problems as infectious diseases, waterborne microbes, and weakened water irrigation for farmers, which in turn leads to a diminishment of the food supply. The third threat that hangs over the future of nearly all countries where rapid population growth continues is the decline in the amount of cropland per person; this is a threat arising as a consequence of population growth and of the conversion of cropland to other uses. Land scarcity readily translates into malnutrition, hunger, rising mortality, and migration. In order to face all of these threats, leaders all over the world will need to understand that universal access to family planning is not only important for coping with resource scarcity and the spread of HIV/AIDS but is also likely to improve the quality of life for citizens of their countries.