THIS year the world’s population reached eight billion and Pakistan’s 230m. The world paused to absorb a major milestone in humanity, an unprecedented and exponential increase largely due to longer survival of the species, major scientific strides, and momentous events in human history. In Pakistan, we barely paused to reflect on what it means to have grown from 33m at Independence to 230m in 75 years.

We have slowly edged towards becoming the fifth largest country in the world. If our economy were thriving and natural resources infinite, then we might be justified in our lack of concern at the rapid population growth in Pakistan.

Given that the multiple crises facing the country are almost all directly related to unabated population growth, why are we so unconcerned about the 230m Pakistanis today and the additional 110m we expect to add by 2050? What does Pakistan have to offer to our current and future generations and why can we not tackle our rapid population growth? We must ask the difficult questions.

Pakistan needs to finally wake up to the apocalypse: 1.4m unwanted births and 2.2m abortions and miscarriages each year that could be avoided through family planning.

Voluntary family planning gives families choices. When we deny these choices, it is because of our callous attitude. After all, these are women and children whose lives will hardly intersect with ours, let alone match the standards we expect for ourselves.

We celebrate the growth rate that has declined this year to 1.9 per cent, but this is a meagre decimal point decline achieved over several years. Above all, our growth rate is double that of Bangladesh, Malawi, Kenya, India, and Iran — all of which stridently pursue national agendas that aspire to rise from poverty, to provide jobs to the youth and to ensure universal health coverage and universal primary education. These are all basic civil rights from which we are deviating wilfully.

Why can we not tackle our rapid population growth?

Last week, more than 3,000 attended the gala international conference on family planning in Pattaya, Thailand, to celebrate women and girls and the power of family planning to not just save but also to empower lives.

What was striking was the fragmented Pakistani delegation of a handful of government officials and hundreds of NGO and independent members, mainly rallied around their own limited and rather unremarkable successes. It was an occasion to laud delegations from African countries with much lower GDPs — countries like Malawi, Rwanda, Senegal — that were there to seriously attend sessions and note innovations in order to improve their family planning programmes and reach for greater success.

Admittedly, the Pakistan delegates had a tough task — to concede that there has hardly been any change in our fertility and family planning indicators since 2007, that this is not just worrying but alarming — and we should have been there to learn how the rest of the world was reaping huge benefits from family planning.

The FP exemplar session, which showed countries that had achieved huge success since 2010, presented Pakistan at the bottom of all possible metrics of performance in family planning.

I realised the community that is entrusted with leadership in family planning needs to bring in the political leadership more, but it also needs to set its house in order and unite on how our family planning efforts could be redoubled to catch up with low-income counterparts.

Nepal, Kenya, Sierra Leone, and Laos are exemplar countries that had much less going in their favour 10 years ago, but just determinedly went about empowering communities, men, women and families to have fewer better-spaced children in order to give them a better future. We need, above all, to unite rather than work in silos, to plan and agree unequivocally on the next steps we will take to change the flatline that is our contraceptive prevalence rate.

At no point in our history were we as culpable for injustice as during the recent floods when 33m people from the poorest districts of Pakistan were swept out of their homes to live as animals.

Women and children suffered the most. And the biggest tragedy was that the scale of the disaster could have been vastly reduced if these underserved, climate-vulnerable districts had received family planning, maternal and childcare services. But the victims lived in neglected areas and faced a tragedy foretold.

The population angle was not brought up at the COP27 conference, and is likely to elude our evolving damages-and-losses approach to climate change. Family planning and balancing population and resources must be ensured as part of our climate rehabilitation and rebuilding strategy.

Miftah Ismail’s recent piece on governance challenges states that the population problem is straightforward, easy to solve; family planning does not require much money, just resolve and competence.

The message for our current and future federal and provincial governments, NGOs and development partners is simple and clear: 1) Do not mystify and complicate a looming high population growth rate accompanied by millions of unwanted pregnancies and babies each year, just to abrogate responsibility; 2) No new policies please, we have enough of those; 3) Start now, plan ambitiously, implement quickly with good technical advice to expand family planning services within the health sector, both static and community-based; 4) No coercion is required for family planning adoption, just common intuition and a general rendering of reproductive justice — by providing information and services for voluntary family planning to couples and women to enable them to have a better balance between children and ensure their full rights; 5) Add innovations and strategies to break the impasse on population indicators, but based on evidence of their effectiveness, potential impact and costs.

Eight billion is a landmark for the world’s population. Let it also be a landmark for Pakistan’s history, as the year we decided we would switch from producing droves of Pakistanis searching for jobs the world over, to a strong nation of educated, healthy and vibrant citizens.

Only then will Pakistan stand up and be counted other than as the wretched disaster of too many with too little to offer humanity.

The writer is Country Director, Population Council.

Published in Dawn, November 26th, 2022