According to the UN’s latest mid-range demographic projections for Pakistan, the country’s population–currently about 185 million–will rise to 335 million by 2050. This explosive increase, however, represents the best-case scenario: Should fertility rates remain constant, the UN estimates this figure could approach 460 million. Such soaring population growth, coupled with youthful demographics, a dismal education system, high unemployment, and a troubled economy, pose great risks for Pakistan. Predictably, many observers depict Pakistan’s population situation as a ticking time bomb.

At the same time, some demographers contend that the country’s population profile can potentially bring great benefits to the country. If young Pakistanis can be properly educated and successfully absorbed into the labor force, such experts explain, then the country could experience a “demographic dividend” that boosts social well-being and sparks economic growth. On June 9, the Wilson Center’s Asia Program, Environmental Change and Security Program, and Comparative Urban Studies Project, along with the Karachi-based Fellowship Fund for Pakistan, hosted a day-long conference to examine both the challenges and opportunities of Pakistan’s demographics, and to discuss how best to tackle the former and maximize the latter.

Pakistan at a Crossroads

In her opening address, Zeba A. Sathar of the Population Council declared that Pakistan is “at a crossroads.” Demography will play a key role in determining the country’s future trajectory, she said, yet there is presently little discussion about demographics in Pakistan. Sathar’s presentation traced Pakistan’s recent demographic trends. Despite its high population growth, Pakistan’s fertility rates have actually been in decline since the early 1990s–a fact that Sathar attributed to progressively higher ages at marriage (for both men and women), but also to the “reality” of abortion. However, Pakistan’s pace of fertility decline has slowed in the last few years–a consequence, Sathar argued, of Islamabad’s failure to promote social development (particularly education) and of the international donor community’s prioritizing of HIV/AIDS funding over that of family planning since 2000. Sathar concluded that achieving Pakistan’s “demographic dreams” will require more educational and employment opportunities (particularly for women) and better access to family planning in rural areas.

In the following panel, Wilson Center Senior Scholar Shahid Javed Burki noted the long-standing failure of demographers and economists in Pakistan to work together on the country’s population issues. This failure, Burki asserted, has resulted in poor choices and bad policy. He also criticized officials and scholars for being reactive in their population proposals, rather than proactive. Burki emphasized that good policy choices can produce favorable results. If, for instance, the population policies launched in Pakistan’s early decades had been sustained to the present, the country today would have 30 million fewer people. Similarly, had Pakistan followed the Bangladeshi approach and concentrated on the economic empowerment of women, today there would be more than 40 million fewer Pakistanis. Good policies matter, Burki repeatedly asserted, and Pakistan’s large and growing population, if dealt with wisely, can be an asset rather than a burden.

Development Through the Bangladeshi Model and Education

Like Burki, Yasmeen Sabeeh Qazi of the Packard Foundation pointed to Bangladesh as a relative success story. She highlighted Bangladesh’s reproductive health services system, which has served to increase the health of Bangladeshis and reduce their poverty. Indonesia and Iran, whose fertility rates are one-half Pakistan’s, provide other examples in the Muslim world where official policy has made a significant difference. Qazi’s presentation emphasized the linkages between family planning, reproductive health, and development. Noting that one-third of pregnancies in Pakistan are unplanned, she underscored the correlation between smaller family size and higher gross national income. She urged the government to fashion a population policy that expands access to reproductive health services, strengthens the health system generally, promotes education (especially for girls), and creates more jobs.

Moeed Yusuf of the U.S. Institute of Peace examined the prospects for radicalization of Pakistan’s youth. Pakistan’s stratified education system, Yusuf cautioned, is not training productive, employable members of society. Only graduates of elite private schools or of foreign schools are prepared for the economy of the 21st century. Meanwhile, the economy is not producing the quality jobs the young expect, leading to an “expectation-reality disconnect” that fosters not only un- or underemployment, but also anger and alienation. Moreover, the state, by deliberately cultivating the ultra-right elements in Pakistani society who most want to radicalize the country’s youth, is part of the problem. Still, Yusuf added, echoing the hopefulness of other speakers, it is not too late. These disturbing trends can be reversed, with help from outside friends like the United States, which, Yusuf counseled, should focus on assisting Pakistan’s education system, support rural private schools, and allow more Pakistani students to study in the United States.

Plugging Public Sector Holes with Private Initiatives

Saba Gul Khattak focused her luncheon address on the work of the Pakistan government’s Planning Commission, of which she is a member. In recent years, Pakistan’s population programs have been devolved from the federal to the provincial and sub-provincial levels. This decentralization, she averred, has opened the way for a genuine reform agenda. But it has also contributed to a situation where no one at the federal level feels any “ownership” over the country’s population programs. Implementation has always been the most vulnerable point in the policy process–and the lack of “ownership” only accentuates this problem today. Khattak emphasized the linkages between population, health, education, and development. Today, she asserted, children are seen by their parents as a source of old age security. Only when the government fills this void through the establishment of an effective social security structure will Pakistan be able to reduce its fertility rates. Development must accompany a truly effective population program.

In the afternoon panel, Sohail Agha of Population Services International discussed the role of the private sector in family planning in Pakistan. He argued that this sector has made a “substantial contribution” to Pakistan’s increased use of condoms: In 2006-07, a period when condom use spiked by nearly 8 percent, about 80 percent of this increase was covered by contraceptives provided by the private sector. Additionally, he noted that a 2009 survey found that urban Pakistanis exposed to social marketing campaigns about condom utilization increased their use of the contraceptive by 10 percent. Furthermore, he described private-sector-led health financing plans for women’s fertilization–a method of contraception that, like condoms, has increased over the last 30 years in Pakistan.

Engaging Youth and Political and Religious Leaders

Shazia Khawar of the British Council discussed the “Next Generation” report, a 2009 Council study about Pakistan’s youth. The report, based on a survey of 1,500 young people across both rural and urban Pakistan, concludes that young Pakistanis are deeply disillusioned about their country and its institutions, with three-quarters of those surveyed saying they regard themselves as “primarily” Muslims, not Pakistanis. The report’s “critical point,” said Khawar, is that Pakistani youth participation in policy development is nonexistent. To this end, the British Council has spearheaded several initiatives to engage the country’s youth in Pakistani politics and to spark dialogue between young Pakistanis and policymakers. Khawar concluded, however, that success is possible only if Pakistan’s top political leaders “pledge themselves to this agenda.”

Mehtab S. Karim of the Pew Research Center offered a comparative perspective, discussing demographics in the broader Muslim world, with particular emphasis on Bangladesh and Iran. Why, he asked, has Pakistan experienced less fertility decline than most of its fellow Muslim-majority nations? He suggested that the answer lies in the failure of Pakistan’s political and religious leaders to make early and sustained commitments to family planning. In Bangladesh, he explained, the country’s very first government made lower population growth rates a “prime goal.” And in Iran, spiritual leader Ayatollah Khomeini issued a fatwa in support of contraceptive use soon after the Islamic Revolution. Yet in Pakistan, according to Karim, religious figures have consistently opposed Islamabad’s family planning efforts, and the government has proven unwilling or unable to combat this resistance.

Scott Radloff of USAID discussed his agency’s family planning and reproductive health (FP/RH) projects in Pakistan. FP/RH aid to Pakistan was largely cut off during much of the 1990s due to the Pressler Amendment–a 1985 modification to the U.S. Foreign Assistance Act that banned most U.S. military and economic assistance to Pakistan unless the U.S. president certified that Pakistan had no nuclear weapons. President George W. Bush waived this prohibition in 2001, and since then USAID FP/RH assistance has risen to nearly $45 million. Current interventions focus on strengthening services within Pakistan’s Ministry of Health and Ministry of Population Welfare; improving contraceptive supplies and logistics; expanding community-based services; and increasing awareness and commitment, including among religious leaders.

Participants concurred that Pakistan’s demographic situation is fraught with risk. Yet they also highlighted a series of hopeful signs. Yusuf noted the absence of an “imminent” danger of youth radicalization; Khawar pointed to the testimonies of “many young leaders determined to do their part” that flow from the “Next Generation” report; and both Karim and Qazi cited Bangladesh and Iran as proof that successful family planning programs are possible even in countries marked by deep poverty or conservative Islam. The presenters were also in accord about the necessary policies moving forward: more extensive family planning and reproductive health services, better education, and more job opportunities (particularly for women). At the same time, speakers repeatedly underscored the profound challenges facing the implementation of such policies. Still, for all the talk about major obstacles and challenges, there was recognition that more modest and simple steps can be taken as well–such as promoting more discussion about demographics within Pakistan, and especially among experts from different disciplines.

Michael Kugelman is program associate and Robert M. Hathaway is director of the Wilson Center’s Asia Program.

Photo credit: Traffic in downtown Karachi, courtesy Flickr user Ali Adnan Qazalbash.

The landmark Women Deliver conference, which concluded last week, reinvigorated the global health community’s commitment to improve reproductive health at both the grassroots and global levels. Providing a major boost was the Gates Foundation’s announcement that it will commit an additional $1.5 billion over the next five years to support maternal and child health, family planning, and nutrition programs in developing countries.

“We haven’t tried hard enough,” said Gates Foundation co-founder Melinda Gates. “Most maternal and newborn deaths can be prevented with existing, low-cost solutions.” Examples of these efficient and effective solutions were presented at the three-day conference’s dozens of panels on a wide range of issues, including climate change, contraceptive commodities, fistula, gender inequities, adolescent family planning, communications and technology, and much more.

President Obama’s National Security Strategy (NSS), released last week, reinforces a commitment to the whole of government approach to defense, and highlights the diffuse challenges facing the United States, including international terrorism, globalization, and economic upheaval.

Following the lead of the Quadrennial Defense Review released earlier this year, the NSS for the first time since the Clinton years prominently features non-traditional security concerns such as climate change, population growth, food security, and resource management:

USAID’s “Feed the Future” initiative is being touted for its potential to help stabilize failing states and dampen simmering civil conflicts. Speaking at a packed symposium on food security hosted by the Chicago Council last week, USAID Administrator Rajiv Shah called food security “the foundation for peace and opportunity – and therefore a foundation for our own national security.”

After years of largely being ignored in Washington policy debates, Pakistan’s “other” threats – energy and water shortages, dismal education and healthcare systems, and rampant food insecurity – have finally moved to the front burner.

For several years, the Woodrow Wilson Center’s Asia Program has sought to bring these problems to the attention of the international donor community. Washington’s new determination to engage with Pakistan on its development challenges – as evidenced by President Obama’s signing of the Kerry-Lugar bill and USAID administrator Raj Shah’s comments on aid to Pakistan – are welcome, but long overdue.

The crux of the current debate on aid to Pakistan is how to maximize its effectiveness – that is, how to ensure that the aid gets to its intended recipients and is used for its intended purposes. Washington will not soon forget former Pakistani president Pervez Musharraf’s admission last year that $10 billion in American aid provided to fight the Taliban and al-Qaeda was instead diverted to strengthen Pakistani defenses against archrival India.

What Pakistani institutions will Washington use to channel its aid monies? In recent months, the U.S. government has considered both Pakistani NGOs and government agencies. It is now clear that Washington prefers to work with the latter, concluding that public institutions in Pakistan are better equipped to manage large infusions of capital and are more sustainable than those in civil society.

This conclusion is flawed. Simply putting all its aid eggs in the Pakistani government basket will not improve U.S. aid delivery to Pakistan, as Islamabad is seriously governance-challenged.

Granted, Islamabad is not hopelessly corrupt. It was not in the bottom 20 percent of Transparency International’s 2009 Corruption Perceptions Index (Pakistan ranked 139 out of 180), and enjoyed the highest ranking of any South Asian country in the World Bank’s 2010 Doing Business report.

At the same time, the Pakistani state repeatedly fails to provide basic services to its population – not just in the tribal areas, but also in cities like Karachi, where 30,000 people die each year from consuming unsafe water.

Where basic services are provided, Islamabad favors wealthy, landed, and politically connected interests over those of the most needy – the very people with the most desperate need for international aid. Last year, government authorities established a computerized lottery that was supposed to award thousands of free tractors to randomly selected small farmers across Pakistan. However, among the “winners” were large landowners – including family members of a Pakistani parliamentarian.

Working through Islamabad on aid provision is essential. However, the United States also needs to diversify its aid partners in Pakistan.

For starters, Washington should look within civil society. This rich and vibrant sector is greatly underappreciated in Washington. The Hisaar Foundation, for example, is one of the only organizations in Pakistan focusing on water, food, and livelihood security.

The country’s Islamic charities also play a crucial role. Much of the aid rendered to health facilities and schools in Pakistan comes from Muslim welfare associations. Perhaps the most well-known such charity in Pakistan – the Edhi Foundation – receives tens of millions of dollars each year in unsolicited funds.

Washington should also be targeting venture capital groups. The Acumen Fund is a nonprofit venture fund that seeks to create markets for essential goods and services where they do not exist. The fund has launched an initiative with a Pakistani nonprofit organization to bring water-conserving drip irrigation to 20,000-30,000 Pakistani small farmers in the parched province of Sindh.

Such collaborative investment is a far cry from the opaque, exploitative foreign private investment cropping up in Pakistan these days – particularly in the context of agricultural financing – and deserves a closer look.

With all the talk in Washington about developing a strategic dialogue with Islamabad and ensuring the latter plays a central part in U.S. aid provision to Pakistan, it is easy to forget that Pakistan’s 175 million people have much to offer as well. These ample human resources – and their institutions in civil society – should be embraced and be better integrated into international aid programs.

While Pakistan’s rapidly growing population may be impoverished, it is also tremendously youthful. If the masses can be properly educated and successfully integrated into the labor force, Pakistan could experience a “demographic dividend,” allowing it to defuse what many describe as the country’s population time bomb.

A demographic dividend in Pakistan, the subject of an upcoming Wilson Center conference, has the potential to reduce all of Pakistan’s threats – and to enable the country to move away from its deep, but very necessary, dependence on international aid.

Michael Kugelman is program associate with the Asia Program at the Woodrow Wilson International Center for Scholars.

Photo Credit: Water pipes feeding into trash infected waterway in Karachi, courtesy Flickr user NB77.

“Conflict-affected countries have some of the worst reproductive health indicators,” said Saundra Krause of the Women’s Refugee Commission at a recent Wilson Center event. “Pregnant women may deliver on the roadside or in makeshift shelters, no longer able to access whatever delivery plans they had. People fleeing their homes may have forgotten or left behind condoms and birth control methods.”