UN's family-planning chief will focus on `programs that work'. Global population agency sees demand for services rise as US aid plummets

Attired in a traditional sari, Nafis Sadik comes across as demure. But this image can be deceptive. When it comes to pushing programs for population control and family planning, this demographic expert's colleagues say she is a dynamo. Dr. Sadik has behind her a distinguished medical career that began a quarter-century ago in Pakistan's military hospitals. It reached a milestone in April when she was appointed head of the UN Fund for Population Activities (UNFPA).

As executive director of the sprawling family-planning agency, which she joined in 1971, Sadik faces two immediate and interlocking challenges: an upsurge in demands for the agency's services coupled with the multimillion-dollar loss of funds from its biggest contributor, the United States.

For starters, Sadik met with Gen. Vernon Walters, US ambassador to the UN, about restoring the American contribution of some $35 million a year - about one-fourth of UNFPA's budget. Since 1986, the US has withheld funding because of the agency's family-planning assistance to China, which, critics charge, officially encourages abortion and permits infanticide. Both Peking and the UNFPA deny the accusations.

The ambassador, said Sadik, was ``very helpful and promised to do everything he can'' to restore US funding. On the China issue, she said, Walters made clear that he was very much against abortion. ``I assured him that so was UNFPA.''

Sadik, who moved into UNFPA's top administrative post after years as assistant executive director of field-level programming and planning, says that, under her, UNFPA's emphasis ``will be on field work ... on programs. We should look at what is working and what is not working.''

One of only three women in the UN system to hold the rank of undersecretary-general, Sadik will manage a staff of more than 100 professionals, with some 1,500 programs in 134 countries and territories, and a 1987 budget of $150 million.

UNFPA's key challenge is sub-Saharan Africa, which has the world's fastest-growing population - about 3 percent per year. Women average 6.3 children, compared to 4.1 in other developing nations.

An agency priority in Africa will be to upgrade the status of women through education, mother-and-child health care, and family- planning activities. Among other things, Sadik said ``simple technologies'' would be encouraged as a means of lightening women's domestic burdens. At present, she said, women spend ``an inordinate amount of time fetching wood, looking for water, getting food supplies so that at the end of the day they are too tired to go to a clinic'' for family planning assistance or instruction, even if it is available.

However, Sadik said she is encouraged by an upsurge of interest in family planning throughout sub-Saharan Africa in the past three years. Awareness was awakened ``when they saw the food situation deteriorate'' under the impact of drought, she says. The turning point came when the 1986 special UN General Assembly session on Africa incorporated a population policy in its plan of action for the continent's recovery.

In Latin America, another region with very high birth rates, ``attitudes have certainly changed quite dramatically,'' Sadik said. Argentina and Brazil, which had traditionally opposed family planning, now have asked for UNFPA assistance. In Peru, she added, President Alan Garc'ia P'erez has personally assumed leadership in population planning.

Sadik said that one of her first major undertakings will be to appoint a task force to review UNFPA's two decades of activity ``to see what we have learned,'' and to apply these lessons to avoid mistakes that were made elsewhere.

Among other things, the findings will be used to help determine why South Asian programs are not working, Sadik said. In Pakistan, northern India, Nepal, and Bangladesh - which have had family planning for 25 or 30 years - programs have bogged down. In contrast, many Southeast Asian countries, which began population planning much later, show a continuing decline in birth rates.

Sadik was born in 1929 in Jaunpur, in then-unpartitioned India. Her late father served as Pakistan's finance minister and as vice-president of the World Bank. She earned her Doctor of Medicine degree in Karachi, and served her internship in gynecology and obstetrics at City Hospital in Baltimore. She also studied at Johns Hopkins University and at Queens University, Kingston, Ontario.

In 1954, she was civilian medical officer-in-charge of women's and children's wards in Pakistani armed forces hospitals, directing a staff of some 50 officers.

She entered the government family planning field in 1964 and by 1970 had become director-general of the Central Family Planning Council responsible for the National Population Program.

At present, she is on the governing council of the International Union for the Scientific Study of Population and on the Rockefeller Foundation's Advisory Committee on population sciences. Sadik and her husband, businessman Azhar Sadik, have five children, two of whom are adopted.