The Health Ministry’s warning that Pakistan’s population could reach 400 million by 2040  is concerning for the future of this country. The warning should trigger a serious debate at the national level about how the government intends to provide jobs, food, water, education, healthcare and housing to millions of additional citizens when the existing system is already under severe strain.

Pakistan is already one of the world’s most populous countries. Rapid population growth places additional pressure on overcrowded schools, underfunded hospitals, housing, sanitation, transport and labour markets. The problem is no longer about what might happen tomorrow. It is about pressures already confronting Pakistani society.

Perhaps the most disturbing dimension is the condition in which many Pakistani children enter the world. The attached assessment rightly highlights the extraordinarily high prevalence of childhood stunting and malnutrition. More than 60 per cent of children being affected by stunting or related forms of malnutrition would constitute a national emergency in any serious policy framework. Malnutrition damages physical development, cognitive capacity, educational performance and eventually earning potential. This is why population policy cannot be separated from human development. Having more children is not necessarily an economic asset if the state and families cannot provide them with adequate nutrition, healthcare and education. A large population becomes an economic dividend only when people are healthy, educated, skilled and productively employed.

The country’s population challenge is also closely connected with women’s education, early marriage, maternal health and access to reproductive healthcare. Family planning remains underutilised, while millions of women do not have convenient access to reliable reproductive-health services. The solution, however, cannot simply be another advertising campaign telling families to have fewer children. Information must be accompanied by accessible services, trained health workers, contraceptive choices and genuine reproductive autonomy.

There are countries that have demonstrated that demographic change is possible. Bangladesh provides perhaps the most relevant example for Pakistan. The two countries share many cultural and social characteristics, yet Bangladesh succeeded in reducing fertility dramatically. According to UNFPA, Bangladesh’s total fertility rate fell from 6.3 births per woman in 1975 to 2.3 in 2011.

How did it happen? Not through slogans alone. Bangladesh developed a national family-planning programme in the 1980s that deployed large numbers of female health workers who went door-to-door providing information and contraceptives. The World Bank has described this as a major factor behind Bangladesh’s fertility decline and demographic transition. The country subsequently combined family planning with investments in female education, including a major secondary-school stipend programme.

Thailand offers another striking example. Its fertility rate fell from about 6.1 children per woman in 1965 to 1.5 in 2015, with the World Bank attributing much of the transformation to rising education and incomes and the successful National Family Planning Programme launched in 1970. The programme benefited from a strong network of government health services, trained personnel, administrative coordination and sustained political commitment. The World Bank once described Thailand’s programme as among the most successful national family-planning programmes in the world.

These examples also contain an important lesson. Population planning must not be reduced to fertility reduction alone. Thailand’s success eventually created a new challenge: rapid population ageing and a shrinking working-age population. The objective for Pakistan, therefore, should not be coercive population control but planned demographic transition accompanied by human development.

Pakistan must also recognise the economic dimension of the problem. Every year, millions of young people enter the labour market. If the economy does not create sufficient productive employment, the much-discussed “youth bulge” can become a source of unemployment, frustration, poverty and social instability rather than a demographic dividend.

This is where population policy intersects directly with economic reform. A smaller or slower-growing population without jobs and skills will not automatically produce prosperity. Conversely, a large population can become a tremendous economic asset if the country invests in education, healthcare, vocational training and employment-generating industries.

If population growth is genuinely considered a national emergency, Islamabad and the provinces should establish measurable targets for contraceptive availability, maternal healthcare, female literacy, child nutrition and fertility reduction. Progress should be reported publicly every year. Population planning should be incorporated into education, health, poverty reduction, urban planning and economic policy rather than treated as the responsibility of one ministry.

Pakistan also needs a massive expansion of primary healthcare and community-based reproductive services. Lady health workers and other frontline personnel should be properly trained, supported and equipped. Couples should receive accurate information and access to a range of safe family-planning methods without unnecessary administrative barriers.

Female education is equally critical. International experience shows that women’s education, delayed marriage, better employment opportunities and access to healthcare are closely associated with smaller family sizes. Pakistan cannot seriously address population growth while millions of girls remain outside school.

Above all, population planning requires continuity. The country cannot afford another cycle of announcing a policy, establishing a committee and then abandoning implementation. The choice is not between population and development. It is between planned human development and unmanaged demographic pressure.