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In October 2011, Earth’s population reaches 7 billion. This global milestone is both a great opportunity and a great challenge. Although people are living longer and healthier lives, and couples worldwide are choosing to have fewer children, huge inequities persist. The current pace of growth is adding about 78 million more people every year-the population of Canada , Australia , Greece and Portugal combined [1] Nearly all that growth-97 of every 100 people is occurring in less developed countries, some of which already struggle to meet their people’s needs. Gaps between rich and poor are growing. And more people than ever are vulnerable to food insecurity, water shortages, and weather-related disasters. Meanwhile, many rich and middle-income countries are concerned about low fertility, declining populations and ageing. Whether we can live together on a healthy planet will depend on the decisions we make.