Pakistan stands at a critical demographic juncture. With over 241 million people and counting, we are adding more than five million individuals to our population each year. If current trends persist, the country will surpass 386 million by 2050. This is not a distant projection-it is a challenge unfolding in real time. And it demands a level of policy attention and urgency we have yet to demonstrate.
Over the past decade, my experience within the demographic policy and research space has made it abundantly clear: we will not meet our economic, environmental, or human development goals without grappling honestly with the scale and implications of our population growth. This is not about alarmism. It is about aligning our development vision with demographic realities.
Pakistan’s development trajectory over the next 25 years will be shaped-perhaps more than by any other single factor-by how we respond to population growth.
The young age structure of our population-nearly two-thirds are under 30-has often been described as a demographic dividend. But dividends require investment. Without significant improvements in education, employment, and health, our youth bulge will exacerbate social pressures rather than drive growth. Already, 26 million children are out of school. Millions of young people, including university graduates, struggle to find decent work. Meanwhile, one in three children under five is stunted, a staggering indicator of long-term deprivation.
Fertility levels remain high. While there is some variation across regions, the average number of children per woman still ranges between 3.2 and 3.6, far above the replacement level. Access to modern contraceptives has remained stubbornly low, with usage rates hovering around 34% and significant unmet needs among women, particularly in underserved areas. This stagnation is not due to lack of demand alone. It reflects systemic issues-underfunded services, uneven quality, and a fragmented institutional response.
Since the devolution of population planning to the provinces, progress has been mixed. Some regions have made commendable strides, but overall, we lack the coherence needed to steer national outcomes. The current structure of the National Finance Commission award-where a major share of resources is distributed based on population size-creates a paradox. Provinces, in effect, have a fiscal incentive to grow their populations. This structural misalignment undermines efforts at stabilisation and must be addressed through serious fiscal reform.
The consequences of inaction are not abstract. They are visible in overcrowded hospitals, in schools with one teacher for fifty students, and in urban centres straining under unplanned expansion. They are reflected in worsening air quality, shrinking per capita water availability, and growing vulnerability to climate shocks. These pressures will not ease unless we stabilise the growth curve, and that can only happen with deliberate policy and investment.
What is needed now is political clarity and institutional resolve. First, we must restore national coordination through a National Council on Population and Development with cross-sectoral representation and direct linkage to federal policy. The Council must not be symbolic. It must be resourced, staffed with technical expertise, and embedded in the broader development planning framework.
Second, family planning must be treated as a development necessity, not a donor-funded sideline. Public funding must rise. Service delivery must be integrated into primary health systems, and frontline providers must be equipped and supported. Community outreach-particularly in peri-urban and rural areas-should be expanded through partnerships with civil society, faith leaders, and local governments.
Third, we must tackle the structural roots of high fertility: lack of education for girls, early marriage, and women’s limited access to economic opportunities. We cannot expect fertility rates to decline when millions of girls are out of school and only a quarter of women participate in the formal labour market. Empowering women is not only a matter of equity-it is central to demographic transition.
We also need to recognise that this issue cuts across sectors. Urban planning, climate resilience, water management, and fiscal policy all intersect with population dynamics. A siloed approach will not work. Each development ministry must integrate demographic analysis into its planning processes.
Pakistan is not alone in facing this challenge. Countries with far fewer resources have turned the tide through strategic action. Bangladesh, for example, dramatically lowered fertility through sustained investments in reproductive health and girls’ education. Iran, during the 1990s, integrated family planning into health services nationwide with remarkable results. The lessons are there. We must choose to apply them.
As we mark World Population Day, we should resist the temptation to treat it as a ceremonial occasion. The stakes are too high. Pakistan’s development trajectory over the next 25 years will be shaped-perhaps more than by any other single factor-by how we respond to population growth. If we fail to act, the pressure on our institutions, our environment, and our people will become unmanageable. But with foresight and leadership, we can build a future where every child is planned, every mother is safe, and every young person has the chance to thrive.
This is not a technical issue. It is a matter of national survival.
The writer is Member (Social Sector & Devolution, Ministry of Planning, Development and Special Initiatives)