“Staggered by the scale of destruction from this summer’s catastrophic floods, Pakistani officials have begun to acknowledge that the country’s security could be gravely affected,” reports the Washington Post. The Pakistani government – already cash-strapped between fighting “the war on terror” and trying to prevent an economic collapse – now faces recovering from the worst flooding in over 80 years.

A new video from the Commission on Smart Global Health Policy, which was established by the Center for Strategic & International Studies, reviews the commission’s progress towards its goal of encouraging the U.S. government to embrace global health as a pillar of U.S. foreign policy.

The video reviews the recommendations from the commission’s March 2010 report, A Healthier, Safer and More Prosperous World: 1) Maintain robust U.S. support for the fight against HIV/AIDS, malaria, and tuberculosis; 2) Prioritize maternal and child health, especially in sub-Saharan Africa and South Asia; 3) Help other nations improve their capacity to prevent and respond to outbreaks of contagious disease; 4) Expand U.S. capacity to fund future global health initiatives by securing long-term investments for such efforts; and 5) Step up U.S. funding for multilaterals engaged in the global health field, including the World Health Organization, Global Fund, UNICEF, the World Bank, and the GAVI Alliance.

In the four years since the end of Nepal’s civil war, political progress in creating a multi-party unity government in Kathmandu has moved in fits and starts. While the effort to bring the Maoists into the fold has made some headway since 2006, continuing environmental and economic troubles in the Nepalese countryside threaten to undermine these tentative steps.

In Islamabad yesterday, Secretary of State Hillary Clinton acknowledged longstanding Pakistani concerns that the U.S.’s ongoing mission in the country is solely military in nature. However, Clinton asserted at the opening of the second U.S.-Pakistan Strategic Dialogue that the “future demands a comprehensive human security, a security based on the day-to-day essentials like jobs, schools, clinics, food, water, fuel, equal access to justice, [and] strong, accountable public institutions.” To that end, she announced a $500 million assistance package earmarked largely for new agricultural and hydroelectric infrastructure development, as well as the construction of new hospitals and other health infrastructure.

The Indian government’s battle with Maoist and tribal rebels – which affects 22 of India’s 35 states and territories, according to Foreign Policy and in 2009 killed more people than any year since 1971 – has been largely ignored in the West. That should change, as South Asia’s “other” insurgency, fomenting in the world’s largest democracy and a key U.S. partner, offers valuable lessons about the role of resource management and stable development in preventing conflict.

Pakistan is at a major demographic crossroads. With a youth-heavy population of some 180 million and an annual population growth rate around 2 percent, the country’s population is projected to swell to roughly 335 million by mid-century. Such explosive growth raises major questions about Pakistan’s future, from looming food and water scarcity, to yawning inequalities in the nation’s educational and economic systems. Some warn that these problems threaten to drive a new generation of disaffected Pakistani youth toward political and religious radicalization.

Recently, I asked a number of leading Pakistani demographers visiting the Wilson Center how their country could best achieve more sustainable population growth rates and effectively harness the economic potential of Pakistani youth.

Educate Girls

Zeba Sathar, Pakistan country director for the Population Council in Islamabad, told me empowering girls through education represents one of the most important means of reducing the total fertility rate, which currently stands at four. “When children are educated—particularly when girls are educated—they take care of their fertility and their family size themselves,” Sathar said.

Yet securing educational opportunity for Pakistani girls has often been an uphill battle, largely due to entrenched social norms. Yasmeen Sabeeh Qazi, Karachi-based senior country adviser for the David and Lucile Packard Foundation’s Population Program in Pakistan, pointed out that a traditional preference for male children in Pakistani society has meant girls do not often receive the same level of family resources as males. This phenomenon has historically fed gender inequality, she said.

“Since boys are preferred, girls are not given the same kind of attention and nutrition, especially in the poorer and less-educated families,” Qazi told me. “But as the education level goes up, you see that this divide starts narrowing.” For Qazi, one of the keys to heightening educational access for girls is to increase both the quantity and quality of schools in rural districts, where two-thirds of Pakistanis live.

Decentralize Family Planning Services

Others I spoke with emphasized improving access to reproductive health and family planning services in rural and urban areas. The federal government’s relatively recent move to delegate operational authority for family planning services to the provincial or district level has encouraged many, such as Dr. Tufail Muhammad with the Pakistan Pediatric Association’s Child Rights & Abuse Committee in Peshawar.

Muhammad said the ongoing decentralization—which he described as “a major paradigm shift”—is meant to increase ownership of population planning policies at the local level, and therefore lead to more effective implementation because “the responsibility will be directly with the provincial government.” Once capacity is established at the local level to design and implement those policies, Muhammad added, “supervisors, administrators, and policymakers will be very close to [family planning] services.”

Manage the “Youth Bulge”

Yet despite the fact that both the public and private sectors are taking steps to address Pakistan’s growth issues, the population crunch will intensify before it potentially eases. Even assuming that greater educational opportunity for girls and increased local control over family planning services help drop Pakistan’s total fertility rate, the sheer size of the current youth bulge—two-thirds of the country’s population is under age 30—means population issues will inform every aspect of Pakistani society for decades to come.

In discussing the current state of Pakistan’s education system, some speakers also asserted that the influence of madrassas, or religious schools, over the student-aged population has often been overstated. Shahid Javed Burki, Pakistan’s former finance member and recent senior scholar at the Wilson Center, said during the panel discussion that inaccurate enrollment estimates created “the impression that the system is now dominated” by those institutions. He noted that more recent figures place madrassa enrollment at just five percent of the total student population.

With a majority of Pakistani students enrolled in regular public schools, he insisted that “public policy in Pakistan has to focus on public education” in order to prevent those students from slipping through the cracks. The problem, he added, was that “the education that they are receiving is pretty bad. It really does not prepare them to be active participants in the workforce and contribute to the economic development of the country.”

Still, most of the experts sounded optimistic about Pakistan’s potential to mitigate some of the adverse effects associated with the near-doubling of the country’s population during the next 40 years. By starting to more openly address an issue that the government and the powerful Pakistani media have long preferred to ignore, they seemed to agree the country is taking a big step in dealing head-on with its looming demographic challenges.

“I don’t look at the Pakistani population as a burden, but rather as an asset,” remarked Burki. “But it has to be managed.”

Photo Credit: “School Girls Talk in Islamabad,” courtesy of flickr user Documentally.

It’s difficult to imagine a scenario for a stable and peaceful world that doesn’t involve a stable and peaceful Pakistan. The country is among the world’s most populous and is also home to the world’s second largest Muslim population, making it the only Muslim majority nuclear state. Its history has been characterized by periods of military rule, political instability, and regional conflicts. This week on dialogue host John Milewski explores the nation’s changing demographics and what they may tell us about near and long term prospects for this vital U.S. ally with guests Michael Kugelman, Zeba Sathar, and Mehtab Karim.

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.