Singapore: Countries across Southeast Asia are mounting a rear-guard action against an alarming decline in fertility rates that pose a major threat to their future sustainability.

Thailand, Malaysia and Vietnam are embracing a unique reform blueprint to advance family friendly policies and arrest falling birth rates with other countries being urged to follow their lead.

Across the world free-falling total fertility rates are expected to see the populations of more than 20 countries shrink by more than 50 per cent by 2100.

In the Asia Pacific region, the average number of children born per woman has dropped threefold since 1960, from 5.4 in 1960 to 1.8 in 2020, with acute population replacement concerns in many countries including Japan, South Korea, Thailand and China.

The Asia Pacific Initiative on Reproduction (ASPIRE) ­ – the peak body representing scientists, doctors, nurses and counsellors in assisted reproduction in the region – is championing the Fertility Counts initiative to address this trend that will have dire economic and social consequences into the future.

In Singapore this week, ASPIRE held a Fertility Counts pre-summit on the issue with medical, economic and public affairs leaders from the Asia Pacific and beyond highlighting the impacts of plunging fertility rates including future labour shortages and growing population age dependency.

ASPIRE President, Dr Clare Boothroyd, said: “This is one of the greatest challenges facing humanity and it will require political and medical resolve over a prolonged period to reverse what is perhaps the most significant threat to life as we know it.”

Fertility Counts has been developed in collaboration with The Economist Update, a global forum that helps advance sustainable strategies to guide governments and corporate leaders.

A key element is the Fertility Policy Toolkit that applies global evidence-based data and resources to guide policy decisions in key categories including childcare, workplace reform, financial incentives for parenthood and improved access to infertility treatment.

It builds on socio-economic and birth rate research conducted in countries including Australia, Indonesia, Japan, Malaysia, the Republic of Korea, Singapore, Taiwan, Thailand and Vietnam.

Dr Boothroyd said the pre-summit in Singapore was a major step forward in helping countries learn from each other about measures to increase birth rates.

“The solutions will vary from country to country because of diverse political, cultural and economic environments, but by health professionals, policy makers and the public engaging on this issue we can build momentum and hopefully effect the necessary changes,” she said.

“One of ASPIRE’s key objectives is to facilitate the dissemination of accurate information about reproduction and fertility to patients and the general public, and we will advance this commitment through the Fertility Counts initiative.

“This will be one of the key issues we will address at the ASPIRE 2024 Congress in Manila in May.”

Keynote speakers at the Fertility Counts pre-summit in Singapore included:

  • Natasha Braumann, Head of Global Policy for Fertility with The Merck Group, which supported the Fertility Counts initiative;
  • Kamthorn Pruksananonda, Professor of Obstetrics and Gynaecology at Chulalongkorn University Hospital, Bangkok, Thailand;
  • Nasuha Yaacob, a specialist in obstetrics and gynaecology and member of the Ministry of Health in National Assisted Reproductive Technology Policy, Malaysia;
  • Tey Nai Peng, Professor Faculty of Economics and Administration at the University of Malaya; and
  • Ho Manh Tuong, Secretary-General of the Ho Chi Minh City Society for Reproductive Medicine.

The speakers emphasised the need for raising public awareness about fertility issues and creating economic supports that encourage people to marry and build families.

“Fertility Counts wants to be evidence-driven in tackling the issue of declining fertility rates to focus on substantive, robust and purpose-driven discussions,” Natasha Braumann said.

“The Fertility Policy toolkit features a menu of policy options that Asian Pacific countries can explore, and to choose actions that will have a positive response on fertility rates and their economies.

“Around the world people are having fewer children than they say is ideal. This is the gap we want to address.”