LAHORE, Dec 19: The United Nations secretary-general’s adviser and special envoy for HIV/AIDS in Asia, Dr Nafis Sadik, has said Pakistan must put slower population growth at the head of its list of priorities to achieve sustainable development.

She was speaking at the inaugural session of the third annual population research conference on ‘population and sustainable development in Pakistan’ at the Punjab University on Thursday. The three-day moot has been organized by the Population Association of Pakistan (PAP).

At independence, Dr Sadik said, Pakistan had been adding a million people every year or so while now it was adding a million every three months.

Pakistan’s population could reach 344 million by the year 2050 and this projection assumed an accelerated effort to improve and expand basic social services, to educate women and to strengthen reproductive health and family planning.

She said Pakistan’s development problems had deep roots and needed to be responded in a considered and structural way. It must be admitted that economic development efforts had not succeeded in any terms; not only in comparison with industrial states, but also in comparison with countries in Asia.

It should also be acknowledged that Pakistan had failed to take poverty seriously. “Despite commendable anti-poverty efforts in the last three years like Khushhal Pakistan, Khushhali Bank and the work of the Commission on Human Development, extreme poverty affects about one-third of our people,” she said.

Saying that Pakistan has a very long way to go, Dr Sadik said that Pakistan’s investments in health and education were 1.0 per cent and 1.6 per cent of the government expenditure in 1990, compared with 4.8 per cent and 11.2 per cent in Bangladesh.

She said male literacy in the country was 50 per cent but for women it was 24 per cent. Similar was the situation of masses with regard to access to health facilities.

Infant mortality rate in the country, she said, remained well above the world average at 85 per 1,000 live births and life expectancy is low at 62 years. She said maternal mortality was needlessly high as 340 women die for every 100,000 live births.

She stressed for consistent social investment and long-term commitment by the country’s leaders towards improving education and healthcare, including reproductive health. Dr Sadik said gender inequality had held back Pakistan’s development from the outset. At every economic level in Pakistan, what resources exist were not equitably distributed between men and women, boys and girls.

Many women were still hardly aware that they have rights outside the family. “This not only limits their access to reproductive healthcare, education and participation in the wider world, but also means that oppression and violence within the family goes unpunished or even unnoticed,” she said.

About the looming threat of HIV/AIDS in this region, Dr Sadik said it thrive where there was a pervasive poverty, low emphasis on social investment of all kinds, poor reproductive healthcare and continuing gender discrimination.

Pakistan’s infection levels were comparable to the most seriously affected African countries 10 to 12 years ago. “Botswana now has a 40 per cent infection rate and we could be in the same position a decade from now — unless we act now,” she observed.

Dr Sadik also said that she did not see the necessary understanding of the HIV/AIDS threat or a high level of commitment to confront it, either in Pakistan or anywhere in the sub-region. “In the absence of cure, prevention is the only practical approach.

“It is not true that the Islamic culture will, in some way ,protect people from the infection. Relying on culture will not protect people here from HIV/AIDS.”

She said infection was spreading through intravenous drug use, by commercial sex workers, by men having sex with men and by migrants and refugees, who were around three million in Pakistan alone.

She said contaminated blood products were a major concern and claimed that in Pakistan only less than 10 per cent of blood used for transfusion was properly screened.

PAP president Dr M.S. Jillani said that he had reviewed the entire area of population in the country and calculated nine lapses in the treatment of population matters.

He said the population experts had been concentrating on pure demographic variables in research and studies but no attention was given to the social, economic and cultural aspects of population movements.

The problem of population attracted planners and policy makers’ attention because of rapid growth and resulted in focus on high fertility and the need for family planning. Other aspects of population dynamics were ignored to the extent that even mortality and morbidity were left to the health department.

Since most facilities have been geared to research on fertility-related subjects, basic research had not figured as an area worth serious attention, even historical demography, demography of religion or the demography of tribal societies have not been addressed properly, though they were most relevant to Pakistan.

Dr Jillani said Pakistan encouraged the flow of foreign grants and loans to run population-related programmes which made it addicted to foreign assistance. There should have been efforts to make these programmes self-sufficient and gaining freedom from the donors. This environment subjected population programmes to vacillations in line with the volume of grants from abroad.

He said Pakistan also did not take the initiative to mobilize the private sector and the government to organize independent research-cum-service institutions.

Population Welfare Secretary Abdur Rashid Khan said that despite decline in the population growth rate of 3.6 per cent in 1960s to 2.1 per cent this year, the birth rate continue to be high adding more than three million people annually.

“The population as estimated by NIPS will increase to 195.488 million by the time fertility replacement level is planned to be achieved in 2020,” he said.

UNFPA deputy country representative Karl Kulessa, PAP executive council member Dr Abdul Razzaque Rukunuddin and Punjab University Vice-Chancellor Arshad Mahmood also spoke on the occasion.