Albanian Daily News had a talk with Manuela Bello, Head of Office, UNFPA Albania, about depopulation issues, specifically focusing on Albania. “In the 1960s Albania had a demographic regime with high fertility, 7 children per woman. The figure was halved in the 90s to 3 children per woman. The more years passed after the 90s, the more the number of births per woman decreased until it went from 3 to 1.65 in 2011, to 1.32 in 2021 and most recently with the new census data to 1.2 in 2023,” Ms. Manuela Bello said in the following interview: 

Albanian Daily News: 2024 is coming to an end and this is an opportunity for ADN readers to learn something more about the activity of UNFPA in Albania, especially in a year when all the world is passing through a global crisis among which depopulation.

Manuela Bello, Head of Office, UNFPA Albania: The world population has reached the 8 billion mark and it will continue to grow for decades to come. However, the global trend masks the greatest demographic diversity that the world has ever seen. While some of the least developed countries continue to be at a relatively early stage of the demographic transition, characterized by high fertility and high population growth, some of the more developed countries are at a more advanced stage of the demographic transition, characterized by low fertility and slow, or even negative, population growth. According to the latest population estimates by the United Nations, 60 percent of the world population is already living in countries where the fertility rate is at or below replacement level of 2.1 children per woman.

- Which are the perspectives of the activity of your agency especially regarding depopulation and the focus of your work?

-In the 1960s Albania had a demographic regime with high fertility, 7 children per woman. The figure was halved in the 90s to 3 children per woman. The more years passed after the 90s, the more the number of births per woman decreased until it went from 3 to 1.65 in 2011, to 1.32 in 2021 and most recently with the new census data to 1.2 in 2023. But demography has not changed its conditions, when looking for the level of population replacement point it is still 2.1 children per woman. From 53,000 births in 2001, to 34,000 in 2011. Low, but favorable as long as the number of deaths was at levels of about 20,000 deaths per year. History changed its shape in the years 2020-2021 where the number of deaths exceed births, 30 thousand deaths per year (due to Covid19, too). A turning point marked 2023, where births were 2 thousand more than deaths. A child missing at birth in 2011 would now be a 13-year-old returning to the active workforce in a few years. Yes, there are at least 7,000 such missing births, from 2011 to 202 and while they are missing from the population pyramid, this is not the case with the older persons.

In Albania, the average life expectancy continues to increase up to 80 years. Census 2023 data show that one in five individuals (19.7 percent) are 65 or older, compared to one in nine individuals (11.3 percent) in the 2011 Census and 7.5 percent in the 2001 Census. The aging of the population is also observed in the dependence ratios between the number of young people and that of the elderly. If we compare measurements from the 2023 census and measurements from the 2011 census, the youth dependency ratio decreased to 24.0 percent from 30.4 while the elderly dependency ratio increased to 30.4 percent from 16.7. The average age of the population is 42.5 years, from 35.3 years that was in the 2011 Census. In other words, the number of young people is decreasing and the number of older persons is increasing. According to INSTAT, the number of children and teenagers is likely to drop from 656,000 in 2020 to around 350,000 in 30 years. If the number of the general population, children, adolescents and people of working age, decreases rapidly, the growth of the number of older persons will be intense during the first two decades. Its share of the total population is likely to increase steadily from 15.2% at the end of 2020 to almost 29% in 2050.

- Which are the areas of Albania where your activity is concentrated and which are the expected projects of your Agency for 2025?

- Against this background, UNFPA, as the go-to agency of the UN on population matters, is collaborating with the government to assist in preparation and to cope with these challenges. In response, UNFPA has launched work on the demographic resilience – including all Western Balkans -- and in consultation and cooperation with a wide range of public and private partners, UNFPA has developed its Demographic Resilience Programme. The overarching goal of demographic resilience is that societies can weather and thrive amidst demographic change, which is critically dependent on the capacity of governments to understand, plan for and shape demographic change.

UNFPA is raising awareness among policy makers and the public at large. It is essential that policy makers know how many people live within their jurisdiction, how old they are and where they reside, and how population numbers, the age structure and the spatial distribution of the population are changing. Without this “demographic intelligence” they cannot understand the changing needs of their population, and the ambition to ensure evidence-based and people- centered policies will be a matter of chance rather than principle. Hence, UNFPA works closely with INSTAT to collect such data. Furthermore, if the government sets out to manage the demographic future, they must understand the factors that influence fertility, life expectancy and migration – these are generally rooted in the social and economic realities of societies – and they must be prepared to address these factors through a comprehensive set of measures.

These include efforts to address the reasons for why women and men have fewer children than they hope for. The reasons for the difference between actual and desired fertility vary widely, but in all instances these differences suggest an inability of women and men to freely decide on the number, timing and spacing of children, and also suggests a space for rights-based population- policies aimed at helping women and men realize their fertility preferences.

- To be more concrete, how does depopulation in Albania impact social structures and community life of this small country in the Western Balkans?

- The analysis of demographic change often focuses on changes in the dependency ratios. In the course of the demographic transition, the total dependency ratio will fall, mostly because fewer children are born per woman (i.e., young-age dependency falls), and at a later stage of the demographic transition, the dependency ratio will rise again, mostly because the baby boomers are going into retirement age (i.e., old-age dependency increases). The fall in the dependency ratio can open up a window of opportunity for countries to realize a first demographic dividend, and therefore this fall in the dependency ratio is often a welcome moment in the demographic transition. However, the realization of the demographic dividend is not an automatic process, and the focus on the dependency ratio can be highly misleading. This is because many people who are in working age might not have productive or remunerative work, which would enable them to effectively support dependents -- indeed, a notable share of the working-age population does not have adequate income to support themselves -- and many older people who are outside working age are not suddenly or necessarily dependent on others. Thus, some conditions necessary to achieve the demographic dividend, such as productive and remunerative work, might not be met, and therefore a mere decline in the demographic dependency ratio does not necessarily mean that countries will benefit from accelerated growth, which is the key characteristic of the demographic dividend, just like an increase in the dependency does not necessarily mean that countries will inevitably see economic challenges.

-In the meantime, what policies have been effective in mitigating the effects of depopulation, taking into consideration the contribution of UNFPA?

-Much more important for the development of societies than the sheer number of people, or abstract demographic dependency ratios, is the productive engagement of people in the society. This calls for a focus on the engagement of younger persons (some countries have a relatively high share of young persons who are neither in education nor employment), the engagement of women (some countries have a comparatively low share of women who actively participate in labor markets), and the integration of immigrants (some countries have a relatively large share of immigrants who are de jure or de facto excluded from the world of work). More can also be done to support healthy and active ageing, mostly through investment in health and education throughout the life course. Yet, a focus on the demographic dependency ratio is common, and it commonly leads to anxieties about demographic changes. At the core, such policies need to understand the economic, social, cultural, political and environmental factors that explain the difference between actual and desired fertility, and help women and men address these complex and interrelated factors. Population policies to this end are fundamentally different from population policies of the past.

And that’s what UNFPA is supporting and assisting Albania with. Furthermore, the focus on sexual and reproductive healthcare and services needs to be complemented by a focus on the broader societal factors. The ability to achieve desired fertility levels is closely related to the empowerment and education of women, and to whether women have an equal say in relationships, for example. In countries that have low and falling fertility levels, like Albania, it is particularly apparent that in addition to gender equality, decisions about children are also influenced by two further balances: The work-life balance and flexi working arrangements, which determines the ability of women and men to combine work and child bearing, and the income-cost balance. While a disposable household income can compensate for relatively high costs of child care, health care, education and/ or housing, many will crucially depend on the availability and affordability of services. Furthermore, decisions about children are linked to the future outlook of parents. Among others, worries about the state of the economy, adequacy of their future income, the reliability of social security, the inclusiveness of politics, or the degradation of the environment, can influence decisions about child bearing.

-How does an aging population impact the healthcare systems, especially in a country which has already had a debilitated health infrastructure?

-The diverse demographic realities have caused anxieties about their social and economic implications, and encouraged diverse and diverting policy responses. Whereas the development literature has long focused on the challenges associated with rapid population growth – notably the ambition to foster economic development, create jobs, raise productivity, and expand access to education and other essential services -- more recent literature has begun to focus on the challenge of population ageing. Indeed, population ageing has been termed by some as the “new population bomb”, threatening to undermine economic and social progress. These anxieties are fueled by narratives of negative implication of population ageing for pensions and healthcare, and arguing that population ageing might result in skills shortages or outright labor shortages, and that population ageing will undermine innovation and productivity growth and thereby result in a slowdown of economic activity with potentially devastating social consequences.

While some of these worries are real, others are exaggerated or unsubstantiated. In any case, many of these worries are increasingly omnipresent. The United Nations Population Division runs recurrent surveys of governments about their perception of, and responses to demographic change, and these surveys have shown that an increasing number of governments has “major concerns” about population ageing. Furthermore, they show that a growing number of the countries that worry about demographic change are pursuing policies to halt or reverse fertility decline. Although population ageing and population decline are shaped by three factors – fertility, life expectancy and migration – efforts to slow population ageing and population decline largely focus on fertility alone. This is attributable to the fact that there is only one desirable and acceptable direction of change as regards mortality— an increase in life expectancy -- and that policy makers see any effort to address migration, and potentially increase immigration, as politically too sensitive. In short, for fear that they cannot cater to a growing number of people, some of the countries that have high population growth have sought to promote lower fertility levels. By contrast, for fear of a shrinking number of people some of the more advanced countries are now seeking to encourage higher fertility levels.

- As we already mentioned, depopulation combined with immigration is a global issue. As such, could you tell how much you cooperate with regional countries to help each other to reduce its impact?

-When we talk about the Albanian population, the dividing and comparative line remains the year 1990. After this year, the population of Albania fell drastically from 3.2 million to 2.6 million. In the first years after democracy, the only factor that affected the population decrease was immigration. According to INSTAT data, Albania counts 50,000 less people who emigrate in a year. Today, more than a third of the population of 1990 has immigrated. Before the 90s, the immigration factor was zero. Therefore, the population knew only growth, adding here also the birth boom promoted by the policies of the communist era to increase the population. But everything was turned upside down, with the change of the system.

Albanians who immigrate are between the ages of 20 and 39, and this age group has remained unchanged in three decades. And it is precisely this reproductive age that could bear children and that can afford to work.

In terms of collaboration with other countries, there are more specialized UN agencies like IOM, UNHCR that are working with the governments and international bodies to cope with immigration and ensuring respect for fundamental human rights are observed for all.

- To conclude, which are the fields you cooperate with the central and local governments to cope with this phenomenon?

-The planned interventions support government authorities in their efforts to strengthen public literacy on demographic change and possible and necessary policy responses, consistent with the evidence base and the human rights imperative. Together with central and local authorities, academia, civil society, the media, influencers and other stakeholders, UNFPA is offering spaces for conversations about demographic futures, with an emphasis on comprehensive solutions based on evidence and human rights.

Building demographically resilient societies is at its core about a commitment to systematically consider the evidence base, as well as a commitment to pursue rights-based policy responses

in an effort to manage demographic futures. Without either, efforts to influence demographic trends such as fertility, life expectancy or migration will not be successful, and might undermine respect for fundamental human rights.

The efforts to build demographic resilient societies will help to ensure better governance and more inclusive economies and are intrinsically linked to the broader effort to promote sustainable development. Without the systematic consideration of population data and projections, countries will not be able to ensure evidence-based and people-centered policies. Furthermore, efforts to build resilience to demographic change through investment in human capital, and the timely adaptation of social policy systems are essential for the creation of more inclusive societies and economies. These will help the country to promote an increase in labor productivity, and ensure that social protection measures and social policies cater to the people who need them are financially viable and effective at the same time.