conveys an extremely important message about international population trends that have so far received little public attention. For more than 40 years, birth rates in industrialised countries with high economic activity have been below the replacement levels of 2· 1 children per woman. As a result, populations in highly industrialised countries such as Japan, Germany, Switzerland, and Singapore are ageing. Inevitably, these populations will soon decline due to generation turnover. In fact, countries like Germany and Japan have already seen a decline of approximately 50% in the numbers of young adults and children.

Discussing their important findings on global total fertility rates, the investigators focused on economic and social factors and linked economic growth to lower birth rates. However, an important reproductive health perspective was not mentioned. Although the authors referred to reproductive health several times, the term was exclusively used synonymously with contraception throughout the Article. The possibility that industrialisation and economic growth could be closely linked to impaired reproductive capacity due to increased exposures to deleterious environmental pollutants was not discussed at all. According to the 2013 report