Tuesday, June 30, 2020

Pakistan: Contraception or Concrete 16 Years On

As I was bumping around looking for something I wrote some years back (2004) about pigs, fish ponds, antibiotics, and influenza in China, I came across a piece I wrote that same year entitled Pakistan: Contraception or Concrete?

The Pakistani press reports that birth rates in that country are falling, but the actual numbers are still grim, with the "good news" being that the population of Pakistan is now "only" doubling every 35 years with a total fertility rate of 4.5.

Noted the UNFPA's Dr Oliver Bracer, "The situation is still very depressing."

Abdul Rasheed Khan, Federal Secretary of Population and Women's Welfare in Pakistan, said a very low literacy rate is the root cause of many health and population-related problems, but that he hopes that the Education Ministry's "Education For All" project, targeting rural populations, will galvanize progress in the family planning arena.

Pakistan's goal is to achieve replacement level fertility by 2020, and the UNFPA has pledged $35 million, over 5 years, to help reduce maternal mortality and improve reproductive health services.


Hmmm.... That's this year.

So what is Pakistan's ACTUAL total fertility rate?

It turns out it's 3.56 (not the goal of 2.1), which is about what the US fertility rate was at the top of the post-WWII Baby Boom.

Back in 2004 I wrote:

The most obvious way that Pakistan's future population growth is likely to manifest itself is in the arena of water and food production.

Over the course of the last 40 years, substantial increases in per capita calorie consumption have taken place in Pakistan, with average consumption rising from 1,753 calories in 1961 to over 2,447 today, according to the FAO. This progress was due, in part, to the creation of the world's largest continuous surface irrigation system; two of the largest dams in the world; nineteen barrages and headworks; forty-three main and twelve link canals; a total of 36,000 miles of canal distribution and 89,000 local watercourses -- over a million miles in all.

Thanks to this massive plumbing system, the Indus River and its canals now irrigate over 35 million acres of land in Pakistan.

The bad news is that Pakistan's population growth keeps racing forward, essentially negating the value of most of these water works. Pakistan's population, which was 60 million in 1970, is 143 million today, and is expected to rise to 242 million by 2025, and to over 332 million by 2050.

Clearly, there is no level of construction that can keep pace with Pakistan's population growth.

Despite these numbing numbers, however, local and international governments and agencies are still far more interested in construction projects than they are in contraception projects.

The World Bank, for example, has spent $3 billion to support reproductive health activities over the course of the last 30 years. While this may sound like a lot of money, this GLOBAL outlay for family planning over the course of the last 30 years pales when seen against the $11 billion estimated cost of the proposed Kalabagh Dam -- a single water project in Pakistan that the World Bank "greenlighted" a few years ago (but has yet to be built due to internal opposition within Pakistan).

Clearly, when governments and international funding agencies get as interested in contraception as they are in concrete, a lot more progress will be made.

In the interim, forests are falling to farms and farms are falling to freeways at a breathtaking rate of speed all over the world, Pakistan included. The thick forests that once covered the Indus plains and which once contained elephants, rhinoceros, wild sheep and leopards are long gone. Today the riverine and mangrove forests of Pakistan are also fast disappearing -- and with them a wide variety of animals like forest hogs, deer, jungle cats, fishing cats, and gray and black partridges (there are over 27 endangered species of birds in Pakistan).

Meanwhile, over 20% of Pakistan's population still does not have enough to eat and in 50 years there will be about twice as many people as there are now -- even with falling fertility rates.

Food for thought ...

So how well has Pakistan done racing the stork (population growth) against the plow (agricultural outputs)?

The good news is that some progress has been made.

The bad news is that in the 2019 Global Hunger Index, Pakistan ranks 94th out of 117 qualifying countries. "With a score of 28.5, Pakistan suffers from a level of hunger that is serious."

The Global Hunger Index has moved Pakistan's score from 36 in 2005 to 28.5 in 2019.

Is that good?

Compared to what?

The bottom line is that for Pakistan and every other developing country, rapid population growth is like running on soft sand when it comes to to economic development.

Yes, with tremendous inputs and work, Pakistan has moved the ball forward a bit.  Things are better now than they were in 2004. But things are far from good.

  • Over a third of all children under age 5 suffer from wasting.
  • One in five children is undernourished.
  • There is still not enough water, much less clean water and sewage treatment.
  • Population growth continues to crowd schools and cripple the delivery of water, sewage and health care systems.

On the environmental front, surface water is horribly polluted, leading to the loss of Siberian Cranes, Indus River Dolphins, and Branded Eagle Rays. The national animal -- the Markhor -- is critically endangered.

Contraception or concrete?  Pakistan did not chose well.

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