A PROJECTION that Pakistan’s population could reach 400m by 2040 should not be treated as another dramatic number to be quoted at ceremonies and forgotten by the next budget. It is a warning about the size of the state’s future obligations. Every additional child will need vaccination, nutrition, schooling, safe water, transport and, eventually, work. Yet the present system already fails millions on each count. The issue, therefore, is not that families are having children irresponsibly while the government looks on helplessly. It is that the state has never made voluntary family planning a dependable part of primary healthcare. Advice is sporadic, contraceptive supplies run out, trained staff are unevenly distributed, and women often cannot seek reproductive care without cost, distance, stigma or male permission obstructing them. Speeches about ‘individual responsibility’ ring hollow when the practical means of exercising that responsibility is unreliable.

The government’s new national council can matter only if it converts alarm into measurable provincial action. Family planning must be available through every Basic Health Unit, maternity service and postnatal visit, with a range of safe methods, proper counselling and follow-up care. It must reach young couples and remote communities. Men must be addressed directly rather than leaving contraception to women who often have the least authority in the family. Lady Health Workers need supplies, training and protection from political neglect; districts lacking contraceptive access should receive priority resources; and contraceptive shortages, maternal deaths and unintended pregnancies should become performance indicators. The $2m in reproductive-health assistance from China and UNFPA is welcome, but donations cannot substitute for a permanent domestic budget and functioning procurement system. Above all, population policy must remain rooted in consent and dignity. Coercive targets will punish the poor, deepen mistrust and drive women away from healthcare. The convincing case for smaller, well-spaced families is not bureaucratic control but better survival, health and opportunity for mothers and children. Pakistan does not lack councils or policy documents. It lacks continuity between announcement and delivery. A population of 400m is not inevitable; it is the possible outcome of another 14 years in which contraception remains harder to find than government warnings. Our future population will be shaped less by speeches and more by whether family planning is available at the nearest clinic.

Published in Dawn, August 3rd, 2026