Pakistan is adding five to six million people annually. The 2023 Census recorded 241.5 million people, an increase of 33.8 million in six years. The annual growth rate of 2.55% reversed a decades-long decline. At this pace, Pakistan could approach 400 million people by 2050.

Our predicament is particularly disturbing when compared with our peers. In the 1970s, Pakistan, Bangladesh, India, Indonesia and Iran faced broadly similar demographic challenges. Today, fertility rates have fallen to approximately 2.1 children per woman in Bangladesh, 2.0 in India, 2.1 in Indonesia and 1.7 in Iran. Pakistan remains at 3.6.

The consequences are everywhere. Approximately 20 million children aged five to sixteen are out of school. Public health expenditure is below 1% of GDP. Per capita water availability has fallen below the scarcity threshold of 1,000 cubic metres. The economy must create roughly 2.5 to 3 million jobs annually for new labour-market entrants. Housing, food supplies and urban infrastructure are under relentless pressure. Population growth is not the sole cause of these problems, but it magnifies every one of them. Even improvements in economic growth and public investment are diluted by rapid population growth.

Pakistan recognised the challenge early, launching a national family planning programme in 1965. Since then, successive governments have established ministries, departments, welfare centres, mobile units and national action plans. Billions of rupees, supplemented by international assistance, have been spent. Yet the results remain deeply disappointing.

The last consolidated national inventory recorded 3,439 Family Welfare Centres, 261 Reproductive Health-A Centres and 295 Mobile Service Units, supported by thousands of personnel.........

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