Among Pakistan’s many high-voltage problems, runaway population growth remains at the top of the list, yet it continues to be the most neglected. A recent media seminar in Karachi underscored this issue in stark detail. With a population exceeding 241.5 million today, Pakistan is now the fifth most populous country in the world and is projected to reach 300 million by 2030 and 400 million by 2050.
Unchecked population growth has significantly undermined the quality of life. The latest Human Development Index ranks Pakistan at 168th out of 193 countries, marking a 35-year low and painting a bleak picture unless immediate corrective measures are pursued. The effects of rapid population expansion are felt across every sector—rising food insecurity, limited employment opportunities, crumbling infrastructure, and overstretched healthcare systems.
A persistently high fertility rate is the main driver behind this rapid growth. Pakistan’s fertility rate, defined as the average number of children a woman bears during her reproductive years, currently stands at 3.6—the highest in South Asia. This uncontrolled increase has resulted in widespread malnutrition: 40 percent of children under five are stunted, 18 percent wasted, and 29 percent underweight. The infant mortality rate is alarmingly high as well, with 62 infants dying per 1,000 live births, amounting to nearly 140,000 deaths annually.
The burden of rapid population growth is evident in labour markets and in the deteriorating conditions of schools, hospitals, roads, and the already strained energy sector plagued by corruption and inefficiency. Per capita public spending on health and education remains significantly lower than in comparable countries. Pakistan also has one of the world’s highest numbers of out-of-school children—24 million, according to a recent survey.
Low per capita investment in education, health, and skills training inevitably produces a population that is poorly educated, nutritionally deficient, and inadequately prepared for the demands of a modern economy. An estimated 37 percent of young Pakistanis between 15 and 24 years of age are neither employed nor engaged in education or training (NEET). Job creation continues to lag far behind the requirements of a youth bulge in which 64 percent of the population is under 30. Pakistan’s expenditure on education is a mere 0.8 percent of GDP, far below UNESCO’s recommended four to six percent. Consequently, the workforce is less productive, earns lower incomes, and contributes less to the national economy through taxes.
Such a labour force is ill-equipped to navigate the complexities of a modern economy and largely remains confined to low-productivity work, which undermines economic performance overall. The result is a dependency ratio of 68 percent, far higher than Bangladesh’s 52.2 percent and India’s 46.1 percent. This essentially means that nearly 70 percent of Pakistan’s working-age population is not contributing productively.
Population pressure also weighs heavily on the health sector, where basic hospital facilities are lacking, immunisation coverage is inadequate, and maternal health indicators remain troubling. Pakistan records approximately 4.5 million births each year, placing enormous strain on hospitals that are chronically short of beds, medicines, and trained staff.
The country is also among the ten most climate-vulnerable nations. Rapid population growth is compounding the crisis by intensifying demand for water, food, and land. Climate change has pushed water scarcity to existential levels. Per capita water availability has declined by nearly 80 percent over the past seven decades. Agricultural land continues to shrink as unchecked urbanisation encroaches on fertile areas.
Simultaneously, Pakistan faces a housing deficit of nearly 10 million units. Rising population levels have led to crowded cities where unauthorised settlements have mushroomed, resulting in sprawling slums and severe environmental degradation. Urban services such as water, sanitation, transport, and energy are becoming increasingly scarce with each passing year.
It is imperative that Pakistan confront the population challenge with urgency and embed it within the broader development framework of the country. Population policy must be integrated with economic planning. Family planning programmes and awareness campaigns need to be pursued far more aggressively. Simultaneously, innovative strategies must be developed to boost female labour force participation. Expanding economic opportunities for women will reinforce the importance of girls’ education, ultimately contributing to lower fertility rates.
Policies that expand employment opportunities for women through vocational training, enhanced childcare support, and incentives for firms to hire and retain female workers must be prioritised. In addition, easier and wider access to family planning services should be ensured, with an emphasis on strengthening primary healthcare. Global experience shows that effective population planning is one of the most powerful levers for building an economy capable of supporting both current citizens and future generations.