Unsustainable rise

PAKISTAN’S population debate has seen moments of concern, followed by long stretches of inaction.

The health minister has recently warned that the country could become the world’s fourth most populous nation within five years. This projection has huge implications and should dispel any remaining complacency. Already home to over 255m people, Pakistan is adding roughly 6.2m individuals every year, a figure larger than the entire population of some countries.

It is not simply a question of size, it is also a question of pace, planning and political will. The consequences of unchecked growth are plain to see. Hospitals are stretched thin, struggling to meet rising demand with limited resources. Schools are overcrowded, while millions of children remain out of education. Urban centres expand in an unplanned sprawl, straining water supplies, sanitation systems and transport networks. Meanwhile, the economy fails to generate enough jobs for a rapidly expanding youth population. These pressures are already being felt, deepening inequality and straining social stability.

Yet other countries, including Bangladesh, Indonesia and Iran, have shown that fertility rates can be reduced through sustained, coordinated policy interventions. The lesson is clear: population outcomes are shaped not by fate, but by governance. Our difficulty has been less about recognising the problem and more about delivering solutions. At the heart of the issue lies access — or the lack of it. Millions of women still cannot obtain reliable family planning services. Cultural barriers, misinformation and weak primary healthcare systems continue to limit informed reproductive choices.

Expanding these services, particularly in underserved rural areas, is one of the most effective ways to slow population growth. But access without empowerment is insufficient. Keeping girls in school, delaying early marriages, and increasing women’s participation in the workforce are all proven pathways to lower fertility rates and stronger human capital.

Equally important is governance reform. Pakistan’s fragmented institutional approach, with health, education and population departments operating in silos, undermines efficiency and impact. A coordinated national strategy, backed by sustained financing and clear accountability mechanisms, is essential. Fiscal incentives must also be reconsidered. A system that rewards provinces primarily on the basis of population size may deepen the very problem the state seeks to fix. There is, however, a narrow window of opportunity. With a large proportion of its population under 30, Pakistan stands at the cusp of a potential demographic dividend. However, without investment in health, education and job creation, this dividend could just as easily become a demographic burden. Managing population growth is not about limiting people, it is about expanding opportunity. Pakistan must move beyond counting its citizens to investing in their futures. And it better move fast, before the numbers overwhelm the state’s capacity to respond.

Published in Dawn, April 6th, 2026