IN THE SUPREME COURT OF PAKISTAN 
(ORIGINAL JURISDICTION) 
 
PRESENT: MR. JUSTICE MIAN SAQIB NISAR, HCJ 
 
MR. JUSTICE FAISAL ARAB 
 
MR. JUSTICE IJAZ UL AHSAN 
 
HUMAN RIGHTS CASE NO.17599 OF 2018 
(Regarding alarming high population growth rate in 
the country) 
 
In attendance: 
Mr. Anwar Mansoor Khan, Attorney General 
Syed Nayab Hassan Gardezi, DAG 
Mr. Tariq Mehmood Jehangiri, A.G. Islamabad 
Mr. Sibtain Mehmood, AAG, Sindh 
Mr. Zahid Yousaf Qureshi, Addl. A.G. KP 
Mr. Ayaz Swati, Addl.A.G. Balochistan 
Mr. Qasim Ali Chowhan, Addl. A.G. Punjab 
Cap. Retd. Zahid Saeed, Secretary M/o NHS&RC 
Mr. Imran Gichki, Secy. Population Balochistan 
Mr. Abdul Ghaffar, D.G. Population Welfare 
Department, Govt. of Pakistan 
Mr. Asghar Ali, Secy. Population, KP 
Mr. Fazal Nabi Khan, DG, PW, KPK 
Mr. Muhammad Jahangir for PBS, ILD 
Mr. Muhammad Riaz for PBS, ILD 
 
 
Date of hearing: 
03.01.2019 
. . . 
JUDGMENT 
MIAN SAQIB NISAR, CJ.– As of 2017, Pakistan is ranked as 
the fifth most populous nation in the world, with a population of over 200 
million. While all nations and economies rely on population growth and a 
creation of future younger generations, such growth must be sustainable 
and proportionate to the resources available. Approximately 14,000 babies 
are born in Pakistan which is already struggling to feed, educate and 
provide employment for its existing population. Pakistan has experienced 
unchecked population growth since its creation in 1947. From 1998 (the 
previous comprehensive census) to 2017, Pakistan’s population has increased by 
57%, with the addition of approximately 76 million people to the 
population. Projected growth trends from the United Nations suggest that if 
this population growth rate does not slow considerably, Pakistan can 
expect to have its population increase by 50% resulting in an estimated 306 
million people, surpassing the United States, Indonesia, Brazil, and Russia 
H.R.C. No.17599/2018 
 
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to become the world's third largest country in terms of population trailing 
behind India and China. The steadily increasing population rate in Pakistan 
is a ticking bomb which will certainly not wait till it is convenient for us to 
take note of it. What will follow this population explosion is starvation, 
famine and poverty, the likes of which are already visible in areas like Thar. 
Other indicators of overstretched resources and infrastructure are apparent 
in Pakistan’s unemployment rate, maternal and child mortality rate, 
literacy and educational enrolment figures, and access to clean water and 
adequate food. A brief overview of the above figures reveals the extent of the 
resource and infrastructure shortcomings for an already large populace. 
Pakistan currently has a very high mortality rate for children under the 
ages of five years (75 deaths per 1000 live births), an above average maternal 
mortality rate (178 deaths per 10,000 births), and approximately 44% of the 
population lacks access to clean drinking water. Furthermore, Pakistan’s 
literacy rate is 58% while over 22 million children are out-of-school. Future 
projections indicate the number of educational institutions to reduce in 
number. The above figures make it clear that Pakistan is not equipped to 
handle the addition of another 100 million people to its ranks. 
2. 
 
After the Proclamation of Teheran, 19681 (Proclamation) at the 
1968 International Conference on Human Rights, ‘family planning’ was 
recognised by the international community as both a right and a means of 
enabling other human rights. In this regard, paragraphs 16 and 17 of the 
Proclamation are relevant which read as under:- 
 
“16. 
The protection of the family and of the child remains 
the concern of the international community. Parents have a 
basic human right to determine freely and responsibly the 
number and the spacing of their children;  
 
                                                        
1 Pakistan was amongst the 84 members who adopted the Proclamation of Teheran by consensus on 
13.05.1968. The Proclamation affirmed, for the first time in a global agreement, the basic right of parents “to 
determine freely and responsibly the number and the spacing of their children” (paragraph 16). 
H.R.C. No.17599/2018 
 
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17. 
The aspirations of the younger generation for a better 
world, in which human rights and fundamental freedoms are 
fully implemented, must be given the highest encouragement. It 
is imperative that youth participate in shaping the future of 
mankind;” 
 
As obvious from the language of the above reproduced paragraphs, the 
right to freely and responsibly determine the number and spacing of 
children involves imparting sufficient information and means to the parents 
to control reproduction as well as providing them with adequate knowledge 
regarding the advantages and disadvantages of such determination. Also 
apparent from the above language is the interdependence of planned births 
with the right of the younger generation to be afforded all fundamental and 
human rights recognised by the international community. Thus, the right 
to well-informed and controlled pregnancies is a right that paves the path 
for enabling several other rights; for an overburdened economy cannot be 
expected to juggle with a growing population while struggling to provide a 
better facilities and opportunities for its progeny. This right, which forms 
part of the international commitments of Pakistan, originates from the right 
to life under Article 9 of the Constitution of the Islamic Republic of 
Pakistan, 1973 (Constitution), and other fundamental rights such as the right 
to education, equality, speech, information and due process (Articles 4, 25, 25-
A, 19, 19-A and 10-A of the Constitution respectively), which are in turn inevitably 
linked to the economic progress of the State expected to make such rights 
available to its people. Unfortunately, by failing to prioritise the provision of 
information and means of controlling unplanned and unwanted births, the 
country now faces a surplus of unskilled and unemployed manpower for 
whom basic human and fundamental rights are luxuries they can at best 
only hope for, but never attain.  
3. 
 
As the guardians of the fundamental rights of the people of 
Pakistan, this Court has for decades safeguarded the fundamental rights 
H.R.C. No.17599/2018 
 
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guaranteed under the Constitution, and in pursuance of the above 
mentioned international commitment, recognised that such rights cannot 
be severed from principles of socio-economic progress under Articles 37 
and 38 of the Constitution. As aptly observed by this Court in Miss Benazir 
Bhutto Vs. Federation of Pakistan and another (PLD 1988 SC 416):-  
 
“Articles 3, 37 and 38 of the Constitution juxtapose to 
advance the cause of socio-economic principles and should 
be given a place of priority to mark the onward progress of 
democracy. These provisions become in an indirect sense 
enforceable by law and thus, bring about a phenomenal 
change in the idea of co-relation of Fundamental Rights and 
directive principles of State Policy. If an egalitarian society is 
to be formed under the rule of law, then necessarily it has to be 
by legislative action in which case it would be harmonious and 
fruitful to make an effort to implement the socio-economic 
principles enunciated in the Principles of Policy, within the 
framework of the Fundamental Rights, by enlarging the scope 
and meaning of liberties, while judicially defining them and 
testing the law on its anvil and also, if necessary, with the 
co-related provisions of the Objectives Resolution which is 
now a substantive part of the Constitution. 
 
The liberties, in this context, if purposefully defined, will 
serve to guarantee genuine freedom; freedom not only from 
arbitrary restraint of authority, but also freedom from want, 
from poverty and destitution and from ignorance and 
illiteracy. That this was the purport of the role of the rule of 
law which was affirmed at Lagos in 1961 in the World Peace 
Through Law Conference: 
 
“Adequate levels of living are essential for full 
enjoyment of individual's freedom and rights. 
What is the use of freedom of speech to 
under-nourished people or of the Freedom of 
Press to an illiterate population. The rule of 
law must make for the establishing of social, 
economic and cultural conditions 
which 
H.R.C. No.17599/2018 
 
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promote men to live in dignity and to live with 
aspirations”” 
[Emphasis Supplied] 
Fortified with the above cited paragraph, we are inclined to conclude that 
fundamental rights such as the right to free speech or information are of no 
use to those struggling with malnutrition, hunger and starvation. Economic 
prosperity is thus a sine quo non for the implementation of all fundamental 
rights, the paramount right being that of life. A plethora of judgments of 
this Court have sufficiently emphasised that Article 9 of the Constitution 
does not merely protect the right to ‘exist’ or ‘live’ but embodies the right to 
live a meaningful life with a minimum standard of living. In Ms. Shehla Zia 
and others Vs. WAPDA (PLD 1994 SC 693) it was held that:- 
 
“The word ‘life’ has not been defined in the Constitution but it 
does not mean nor can it be restricted only to the vegetative or 
animal life or mere existence from conception to death. Life 
includes all such amenities and facilities which a person born 
in a free country, is entitled to enjoy with dignity, legally and 
constitutionally.” 
 
4. 
 
Similarly in the judgment passed in Suo Motu Case No.19 of 
2016 (2017 SCMR 683) it was held that “[t]he Fundamental Right to life (Article 
9), includes the right to adequate and safe drinking water and basic health care”. In Pir 
Imran Sajid and others Vs. Managing Director/General Manager 
(Manger Finance) Telephone Industries of Pakistan and others (2015 
SCMR 1257) and Abdul Wahab and others Vs. HBL and others (2013 
SCMR 1383) Article 9 of the Constitution was held to include a right to 
livelihood. In the judgments reported as Barrister Zafarullah Khan Vs. 
Federation of Pakistan (2018 SCMR 2001), General Secretary, West 
Pakistan Salt Miners Labour Union (CBA) Khewra, Jhelum Vs. The 
Director, Industries and Mineral Development, Punjab, Lahore (1994 
SCMR 2061), Suo Motu Case No.10 of 2010 (Contamination of Water of 
Mancher Lake due to Disposal Effluent from MNV Drain now converted 
H.R.C. No.17599/2018 
 
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into RBPOD) (2011 SCMR 73), Shahab Utso Vs. Government of Sindh 
through Chief Secretary and other (2017 SCMR 732), Shehla Zia’s case 
(supra) the said Article was held to include the right to safe drinking water 
and a safe and health-friendly environment. In OGRA through Secretary 
Vs. Midway II, CNG Station (2014 SCMR 220) and Iqbal Zafar Jhagra 
and Senator Rukhsana Zuberi Vs. Federation of Pakistan (PTD 2014 SC 
243) the said fundamental right was held to include the right to provision 
of electricity and gas. In Younas Abbas Vs. Additional Sessions Judge, 
Chakwal (PLD 2016 SC 581) and National Engineering Services 
Pakistan [NESPAK] (Pvt.) Limited Vs. Kamil Khan Mumtaz (2018 SCMR 
211) the right to life was interpreted in the following terms:- 
 
 “It is now well established that right to life as envisaged by 
Article 9 of the Constitution includes all those aspects of life 
which go to make a man’s life meaningful, complete and 
worth living. In the case of Employees of Pakistan Law 
Commission v. Ministry of Works (1994 SCMR 1584), it has 
been laid down that Article 9 of the Constitution which 
guarantees life and liberty according to law , is not to be 
construed in a restrictive manner. Life has larger concept 
which include the right of enjoyment of life, maintaining 
adequate level of living for full enjoyment of freedom and 
rights.” 
[Emphasis supplied] 
 
In the recent judgment of this Court passed in Barrister Zafarullah Khan 
Vs. Federation of Pakistan etc. (Constitution Petition No.57/2016 etc.) 
wherein the Federal Government was directed to construct the Diamer-
Bhasha and Mohmand Dams, the right to life and the importance of water 
in this regard was elucidated in the following terms:- 
 
“For the last several decades, there has been reference to the 
right to clean water, as stemming from the right to life 
enshrined in the Constitution as a fundamental right. On a 
national level, various judgments including those reported as 
H.R.C. No.17599/2018 
 
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General Secretary, West Pakistan Salt Miners Labour Union 
(CBA) Khewra, Jhelum Vs. The Director, Industries and 
Mineral Development, Punjab, Lahore (1994 SCMR 2061), 
Suo Motu Case No.10 of 2010 (Contamination of Water of 
Mancher Lake due to Disposal Effluent from MNV Drain 
now converted into RBPOD) (2011 SCMR 73) and Shahab 
Utso Vs. Government of Sindh through Chief Secretary and 
other (2017 SCMR 732) robustly discuss how clean and safe 
drinking water is necessary for the existence of life, and that 
contaminated and polluted water poses a threat to human 
existence. The oft-quoted words of Saleem Akhtar, J. in the 
case of Ms. Shehla Zia and others Vs. WAPDA (PLD 1994 
SC 693), where the immediate context was regarding the 
hazards of electromagnetic fields, are equally germane here:- 
 
“Article 9 of the Constitution provides that no 
person shall be deprived of life or liberty save 
in accordance with law. The word ‘life’ is very 
significant as it covers all facets of human 
existence. The word ‘life’ has not been defined 
in the Constitution but it does not mean nor 
can it be restricted only to the vegetative or 
animal life or mere existence from conception 
to death. Life includes all such amenities and 
facilities which a person born in a free 
country, is entitled to enjoy with dignity, 
legally and constitutionally.” 
 
Therefore water is a resource to which everyone is entitled, is 
indispensable to those who wish to lead a dignified life, and 
forms the basis of many other rights including the right to life, 
health and quality of life. It is a fundamental right that 
emanates from the right to life enshrined in Article 9 of the 
Constitution…” 
[Emphasis supplied] 
 
As evident from the above precedents, it is by now established law that the 
right to life includes a right to basic amenities and living standard, access 
to clean drinking water, electricity, employment etc. and there is no 
denying that the same is heavily dependent on the economic progress of the 
H.R.C. No.17599/2018 
 
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country which suffers a constant handicap on account of the rapidly 
growing population. Poverty is thus deeply intertwined with each 
fundamental right guaranteed in the Constitution, since divorced from an 
economically thriving environment, there remains no meaning of the 
fundamental right to life as explained above, nor can other fundamental 
rights be implemented in their true letter and spirit. The threat of over-
population, or “population explosion” is a doom the country is unknowingly 
moving towards if a national crusade for population control is not launched 
in time. It is an unfortunate reality that the earth is becoming too small to 
accommodate our growing numbers and its resources are rapidly 
decreasing at an alarming rate. This is not only adversely affecting the 
general quality of life but also threatening the mere existence of life on 
earth. Hence in pursuance of its duty to safeguard the fundamental rights 
of the people which is inseparable from socio-economic progress, the 
Supreme Court has suo moto commenced this long and hard but necessary 
journey to control the rate at which our population is multiplying. 
5. 
 
Pakistan’s family planning programme began with private 
sector initiatives in 1953 and expanding to include public sector support 
and involvement in the early 1960s onwards. In 1953 the Family Planning 
Association of Pakistan was established and received a lukewarm response 
from the Government. However, in 1959 General Ayub Khan attended an 
Family Planning Association of Pakistan (FPAP) conference and spoke about 
the need to combat overpopulation. In 1965, with the introduction of the 
third 5-year plan, family planning received renewed funding and support 
from the public sector. In the late 1970s the family planning programme fell 
prey to opposition from General Zia Ul Haq, who opposed publicising or 
expanding the programme due to religious opposition. The next major step 
forward came in 1990 with the introduction of a new National Health Policy 
which required all healthcare outlets to provide family planning services. A 
social action programme was developed which incorporated family planning 
H.R.C. No.17599/2018 
 
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in tandem with rural development, education, and sanitation efforts. An 
ongoing issue with the previous decades of the family planning programme 
was the high degree of centralization which has undoubtedly damaged the 
effectiveness of such programmes. Although Pakistan had success in 
increasing contraceptive use in the 1980s and 1990s, a plateau was 
ultimately reached. The contraceptive prevalence rate (CPR), or the 
percentage of married, non-pregnant women using both modern and 
traditional methods of contraception, rose from 12% in 1990-91 to 28% in 
2000-01, but between 2000 and 2009, there was hardly any change in CPR 
which was 30% in 2000 and remained unchanged in 2006. In 2012, 
Pakistan made a commitment to Family Planning 2020 (a global partnership to 
empower women and girls by investing in rights-based family planning). A number of service 
providers are trained to dispense contraceptives, fit intrauterine devices 
(IUDs), or advise on other birth control measures. Although two other 
Muslim countries, Iran and Bangladesh, had simultaneously launched 
population control campaigns during the 1970s (examined later in this opinion), 
they had remarkable success in such efforts while the campaign in 
Pakistan miserably failed and thereafter for decades the subject of family 
planning remained a taboo for elected governments whose five-year plan 
could never accommodate population planning initiatives.  
6. 
 
Therefore, in the absence of policy initiatives to curb the 
startling population growth and in our capacity as the guardians of the 
fundamental rights guaranteed by the Constitution, this Court was 
constrained to help relaunch this campaign. Initially when this Court took 
cognizance of the instant matter, the Federal and all the Provincial 
Governments (including the respective Chief Secretaries) were required to file their 
concise statements. The learned Attorney General for Pakistan, the learned 
Advocates General of all the Provinces and other stakeholders unanimously 
agreed that a uniform policy for all the Provinces is required to control the 
population of Pakistan. A Task Force was constituted comprising of the 
H.R.C. No.17599/2018 
 
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persons 
mentioned 
below, 
to 
prepare 
a 
policy 
for 
this 
Court’s 
consideration:- 
i. 
Secretary, Inter-Provincial Coordination (Chairman); 
ii. 
Director General Population, Ministry of National Health 
(Member); 
iii. 
Secretaries, Population & Welfare of all Provinces (Members); and 
iv. 
Director General, Population of all Provinces (Members). 
 
The said Task Force submitted its report and after lengthy deliberations, a 
Committee was constituted comprising of the names and having the Terms 
of Reference (TORs) proposed by Capt. (R) Zahid Saeed, Secretary, Ministry 
of National Health Services, Regulations and Coordination who was 
appointed as the convener of the meetings authorized to co-opt any other 
person on account of their expertise in the matter and modify/add the 
TORs 
as 
deemed 
necessary. 
The 
said 
Committee 
submitted 
a 
comprehensive report in which Recommendations (hereinafter referred to as the 
“Recommendations” reproduced later in this opinion) have been made to curb the 
alarming population growth rate in Pakistan. In order to sensitize the 
matter and to increase public awareness on the issue, the print and 
electronic 
media 
was 
also 
directed 
to 
print 
and 
broadcast 
the 
Recommendations continuously for three days free of cost. Thereafter, the 
Council of Common Interests (CCI) held its meeting which ultimately 
approved the Recommendations submitted to this Court. Additionally, a 
symposium was held by the Law & Justice Commission of Pakistan (LJCP) 
and the Ministry of National Health Services, Regulations & Coordination 
(Population Programme Wing) wherein valuable suggestions have been 
made by experts, academics, religious scholars and social activists (which 
shall be examined below). Subsequently, on 29.12.2018, this initiative of 
relaunching a nationwide population planning campaign, alongwith the 
Recommendations, received unanimous endorsement from the elected 
representatives from all Provinces, major political parties and religious 
H.R.C. No.17599/2018 
 
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scholars at a national dialogue organized by the Population Council. Before 
dilating upon these Recommendations, we deem it expedient to provide a 
brief overview of efforts made by other countries including Iran, 
Bangladesh, India and China in this crusade for population control and 
planning and examine the role of the legislature, executive, judiciary, public 
functionaries and other stakeholders in this arduous task. 
7. 
 
The Islamic Republic of Iran:- In Iran, in less than one 
generation the population growth rate of 4.06% in 1984 fell to 1.15% in 
1993 and a total fertility rate of 6.4 births per woman in 1984 declined to 
1.9 in 2010. The reason behind this was a development plan passed by the 
Iranian Parliament in 1989, which included a birth control programme, as 
a part of which, inter alia a huge media campaign was initiated to 
encourage women to space their pregnancies for three to four years, to limit 
the number of children to two, and to avoid pregnancy under the age of 18 
and above 35. Following this the Iranian Parliament removed previous 
incentives for high fertility and clergy bodies and the judicial system issued 
the authorisation for family planning and supported the policy. In 1993, the 
Iranian legislature passed a law regarding family planning which, inter alia, 
provided for incentives for smaller families including for instance some 
social benefits for the first three children in a family. The said law focused 
on 
reducing 
infant 
mortality, 
promoting 
women’s 
education 
and 
employment, and extending social security and retirement benefits to all 
parents so that they no longer consider children as cushions/security for 
their old age. The magnitude of success received by this family planning 
program can be accredited to the government-backed  awareness, 
information and education program in this regard and to a health care 
delivery system that was able to meet reproductive health needs. The 
Ministry of Health of Iran established pre-marital counseling classes 
throughout the country which the government made mandatory for couples 
planning to marry to participate in before they could receive their marriage 
H.R.C. No.17599/2018 
 
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license; population education became part of the curriculum at all 
educational levels; university students were required to take a course on 
population and family planning; and family planning services were provided 
for free by the country’s primary health care system, which is based on 
different levels of care and an established referral system. In rural areas, 
the Ministry of Health and Medical Education is the main provider of health 
care services, and trained health workers proactively provide door-to-door 
family planning related information and services. In urban areas on the 
other hand health services are largely provided by the private sector which 
equally play a significant role in awareness and services for family 
planning. In order to increase and meet the supply of modern 
contraceptives, many are now manufactured in Iran, in fact the only 
condom factory in the entire region is in Iran, which exports its products to 
neighboring and Eastern European countries. As a result of these 
measures, today 74% of married women in Iran between the ages of 15 to 
49 practice family planning; 60% use a modern method; and one-third of 
modern contraceptive users have relied on a permanent method, i.e., female 
or male sterilization.  
8. 
 
The Republic of India:- In India, legislative efforts to curb 
population growth began as early as 1994 when for example, under Section 
175(1)(q) of the Haryana Panchayati Raj Act, 1994, any person having more 
than two children was deemed to be disqualified from being a member of 
the Gram Panchayat, Panchayat Samiti or Zila Parishad. When the 
constitutionality of the said provision was assailed before the Indian 
Supreme Court, it was upheld in the judgment of Javed & Others Vs. 
State of Haryana & Others [2003 (8) SCC 369] recognising that the 
purpose behind such legislation is inter alia to popularize the Family 
Welfare/Family Planning Programme which was in line with the National 
Population Policy holding that “In our view, disqualification on the right to contest an 
election by having more than two living children does not contravene any fundamental right 
H.R.C. No.17599/2018 
 
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nor does it cross the limits of reasonability. Rather it is a disqualification conceptually 
devised in national interest.”. The importance laid by the Indian Supreme Court 
on the implementation of the population control policy to secure the 
fundamental rights of the people of India is evident from the following 
paragraph of the judgment supra:- 
 
“…Reasonableness and rationality, legally as well as 
philosophically, provide colour to the meaning of fundamental 
rights and these principles are deducible from those very 
decisions which have been relied on by the learned counsel for 
the petitioners. It is necessary to have a look at the population 
scenario, of the world and of our own country.  
 
The torrential increase in the population of the country is one of the 
major hindrances in the pace of India's socio- economic progress. 
Everyday, about 50,000 persons are added to the already large 
base of its population…It is a matter of regret that though the 
Constitution of India is committed to social and economic justice 
for all, yet India has entered the new millennium with the largest 
number of illiterates in the world and the largest number of people 
below the poverty line. The laudable goals spelt out in the Directive 
Principles of State Policy in the Constitution of India can best be 
achieved if the population explosion is checked effectively. 
Therefore, the population control assumes a central importance for 
providing social and economic justice to the people of India (Usha 
Tandon, Reader, Faculty of Law, Delhi University, - Research 
Paper on Population Stabilization, Delhi Law Review, Vol. XXIII 
2001, pp.125-131). In the words of Bertand Russell, "Population 
explosion is more dangerous than Hydrogen Bomb." This explosive 
population over-growth is not confined to a particular country but 
it is a global phenomenon. India…has the population problem 
going side by side and directly impacting on its per capita income, 
and resulting in shortfall of food grains in spite of the green 
revolution, and has hampered improvement on the educational front 
and has caused swelling of unemployment numbers, creating a new 
class of pavement and slum-dwellers and leading to congestion in 
urban areas due to the migration of rural poor. (Paper by B.K. 
Raina in Population Policy and the Law, 1992, edited by B.P. Singh 
Sehgal, page 52)… 
H.R.C. No.17599/2018 
 
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…The above facts and excerpts highlight the problem of population 
explosion as a national and global issue and provide justification 
for priority in policy-oriented legislations wherever needed… 
 
…Fundamental rights are not to be read in isolation. They have to 
be read along with the Chapter on Directive Principles of State 
Policy and the Fundamental Duties enshrined in Article 51A. Under 
Article 38 the State shall strive to promote the welfare of the people 
and developing a social order empowered at distributive justice - 
social, economic and political. Under Article 47 the State shall 
promote with special care the educational and economic interests of 
the weaker sections of the people and in particular the 
constitutionally down-trodden. Under Article 47 the State shall 
regard the raising of the level of nutrition and the standard of living 
of its people and the improvement of public health as among its 
primary duties. None of these lofty ideals can be achieved without 
controlling the population inasmuch as our materialistic resources 
are limited and the claimants are many. The concept of sustainable 
development which emerges as a fundamental duty from the several 
clauses of Article 51A too dictates the expansion of population 
being kept within reasonable bounds.” 
 
Another illustration of legislative efforts to combat the menace of growing 
population can be found in the judgment of Air India Vs. Nergesh Meerza 
and Others [(1981) 4 SCC 335] where the rapid multiplication of 
population was judicially noticed and the constitutional validity of 
legislative means to check the population was upheld as the Indian 
Supreme Court found no fault with the rule which would terminate the 
services of air hostesses on the third pregnancy with two existing children, 
holding the rule to be both salutary and reasonable for two reasons:- 
 
"In the first place, the provision preventing a third pregnancy 
with two existing children would be in the larger interest of the 
health of the Air Hostess concerned as also for the good 
upbringing of the children. Secondly…when the entire world 
is faced with the problem of population explosion it will not 
H.R.C. No.17599/2018 
 
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only be desirable but absolutely essential for every country to 
see that the family planning programme is not only whipped 
up but maintained at sufficient levels so as to meet the 
danger of over-population which, if not controlled, may lead 
to serious social and economic problems throughout the 
world.” 
 
The foregoing extracts clearly reflect the conviction and certitude of the 
legislature and the judiciary that the national interest of India lay in 
population control of the severity that disqualifications from elections and 
posts etc., was deemed to be an appropriate and necessary measure to 
enforce India’s two-child policy. For breach of the two-child norm several 
states put together a package of punitive measures including exclusion 
from elections, exclusion from ration cards, kerosene and other BPL 
incentives, denial of education in government schools to the third child and 
withdrawal of welfare programmes. This phased manner of implementing 
the two-child policy, was soon followed by stringent measures in the form of 
Indian Ministry of Health and Welfare’s Guidelines on Standards of Female 
Sterilization, enacted in October 1999. Through a public interest litigation 
decided through the judgment reported as Ramakant Rai Vs. Union of 
India and Others [2009 (16) SCC 565], data from the States of Uttar 
Pradesh, Bihar, and Maharashtra surfaced regarding government practices 
for female sterilization, which largely revealed that the poor, female 
population was targeted which lacked counselling or informed consent, 
lacked pre- and post-operative care, and included unhygienic and un-
anesthetized operating conditions, sterilization of minors, coercion and 
cruelty. In light of evidence of the morbidity suffered by women, along with 
the unreported deaths due to the lack of quality care in sterilisation camps 
the Indian Supreme Court in the noted judgment issued directives 
specifying the quality of care standards along with appropriate protocols 
that were to be stringently followed. While the issue of health concerns and 
human rights violation arising from targeted sterilization of a certain 
H.R.C. No.17599/2018 
 
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deprived class of the population has been addressed by the Indian Supreme 
Court in Devika Biswas Vs Union of India (UOI) and Others [2016 (10) 
SCC 726] as well, the Courts and the legislature and executive in India 
nevertheless remained uncompromising in the object of population 
reduction. As a result of these stringent legislative measures complimented 
by judicial support, in the year 2017 the annual population growth 
percentage in India has decreased to 1.1% while that of Pakistan remains 
at 2.0%.  
9. 
 
The People’s Republic of Bangladesh:- In contrast to India, 
the national family planning program in Bangladesh is considered to be 
“culturally sensitive” because it uses strategies that acknowledge and 
account for gender inequality. A mixed contraceptive method was adopted 
prioritising oral pills over other methods such as sterilization or clinical 
services like IUDs which are met with hesitance, particularly among rural 
populations. The Government of Bangladesh formed a National Committee 
and a National Plan of Action was developed following the International 
Conference 
on 
Population 
and 
Development 
(ICPD) 
in 
1994 
for 
implementation of the goals set in the Plan of Action. Under the integrated 
approach of population and development, national policies were formulated 
on population, maternal health and strategies were developed for 
reproductive health, population, health and nutrition. Taking a community-
based approach, married, literate village-women were recruited and trained 
in basic medicine and family planning to go door-to-door dispensing birth-
control pills and barrier contraceptives, providing outreach services to 
couples, particularly married women with limited mobility outside the home 
or 
compound 
and 
referring 
women 
for 
clinical 
contraception. 
Simultaneously, the government prioritized girls’ education which lead to 
delays in marriage and childbearing as knowledge, status and confidence 
gave them greater control over family-planning decisions. This led to 
remarkable success in population control since prevalence of contraceptive 
H.R.C. No.17599/2018 
 
- 17 -
 
use increased dramatically from 3% to 45% among married women since 
1971 and the fertility rate declined from about seven births per woman in 
the mid-1970s to 3.4 births per woman in 1993. These can largely be 
attributed to its Government’s efforts, particularly over the past 15 years to 
expand access to family planning methods and services and awareness 
campaigns.  
10. 
 
The People’s Republic of China:- China, the most populous 
country in the world which unlike Pakistan can sustain its rapid growth of 
population due to its progressive economy, has been able to control its 
growth rate by adopting the ‘carrot and stick’ rule. Article 25 of the Chinese 
Constitution and Article 12 of the Marriage Law require that family 
planning be promoted by the State. Attractive incentives in the field of 
education and employment were provided to couples following the ‘one-
child norm’. At the same time drastic disincentives were cast on the couples 
breaching such norm which even included penal action. These stringent 
measures have led to a radical decrease in the population growth rate in 
China, therefore, China’s Family Planning Commission, which for nearly 
four decades enforced the country’s notorious one-child policy, will be 
absorbed by a new agency as the government attempts to go back on its 
one-child policy.  
11. 
 
It is pertinent to mention that the elucidation of the population 
control measures of various countries was only for illustration purposes. 
Although Pakistan is at a disadvantage for having launched this population 
control campaign decades after similarly populated countries such as Iran, 
China, India and Bangladesh, we also remain at an advantage to benefit 
from the errors that have surfaced decades after the implementation of the 
respective strategies employed with regard to their population control 
campaigns. Be that as it may, understanding the policy efforts to promote 
birth control and family planning methods only provides half the context 
required to formulate an effective plan. Indeed, a number of the failings of 
H.R.C. No.17599/2018 
 
- 18 -
 
the previous family planning initiatives stem from an ignorance of the 
unique cultural and religious milieu of Pakistani society. A perusal of data 
from the annual Demographic and Health Survey reveals a number of 
preconceived notions, obstacles and misconceptions regarding family 
planning, family size, childbearing and religious instructions regarding 
birth control and spacing pregnancies. Looking to fellow Muslim countries, 
or those nations with similar cultural ideals, it is clear that an effective 
family planning policy is an achievable goal even in spite of cultural, 
societal, or religious hesitance. 
12. 
 
In order to learn from the mistakes of other countries in such 
campaign and to ensure that the efforts made in this relaunched campaign 
do not suffer the same fate as the previous one, a National Population 
Symposium was held by the Ministry of National Health Services, 
Regulations & Coordination (Population Programme Wing) in conjunction 
with the LJCP under the auspices of this Court on 05.12.2018 where 
several experts made valuable contributions to sketching a roadmap for 
this campaign of population control. One of the points raised was that 
family planning campaigns involves a two-fold process of (1) raising the 
demand for contraception use and (2) reducing the unmet need for 
contraception which comprises of a fair percentage of married women. The 
foremost task should be the meeting of demand of contraceptives and 
making them easily assessible to people while increasing the awareness 
with regards to the need of contraceptives. Moreover, the best global 
practices in family planning must be adopted including modern tested and 
effective methods in addition to a contraceptive mix method which has 
proven to be effective in many countries. Global evidence also supports task 
sharing/shifting strategies which should be quickly rolled out in Pakistan 
to enable mid-level and community-based service providers to provide 
services to rural, peri-urban and urban poor communities. We must 
emphasise the need to resort to reproductive health programming which 
H.R.C. No.17599/2018 
 
- 19 -
 
involves the participation of men in contraceptive use and supporting 
women for use of contraception. Subscribing to family planning methods 
will benefit the country in the form of a higher GDP per capita and reduced 
unemployment, increased health benefits including reduced maternal 
mortality, improved infant and child health and fewer abortions; these 
would in turn lead to greater freedom to determine the number and spacing 
of children; environmental benefits include reduced pressure on natural 
resources (water, agriculture, energy, etc.) as well as reduced air water and soil 
pollution; and it will also result in increased resources per capita for 
schooling and healthcare sectors and infrastructure. If resources are not 
increased by rationing the amount of births burdening the economy each 
year, this working population age will either be unemployed or due to lack 
of education and skill training will be working in unskilled and menial jobs. 
In order to ensure that this working age population is productively 
employed, a drastic decline in the population is required which must be 
supplemented with an education ‘emergency’ whereby education and 
technical training for the working age population is provided targeting both 
genders equally. Additionally, strong policy reforms are required centred on 
capturing the demographic dividend, the total fertility rate (TFR) must be 
reduced to a sustainable rate, a national action plan is required to be 
introduced in order to train our human resource and match skills to the 
available work opportunities, and ensure an increase in work opportunities 
for women so as to increase the source of income of each familial house. 
The United Nations Fund for Population Activities2 (UNFPA) is ready to assist 
Pakistan in building consensus on high quality, equitable and voluntary 
family planning as a national priority working with key stakeholders 
including development partners. Under the current Country Programme for 
Pakistan (2018-2022) UNFPA will focus on increasing capacities at all levels to 
accelerate delivery and accessibility of high-quality family planning 
                                                        
2 The principle global inter-governmental organisation in the UN system with a mandate for family planning. 
H.R.C. No.17599/2018 
 
- 20 -
 
information and services; UNFPA stands ready to foster partnerships and 
provide technical support to the implementation of the Recommendations 
approved by CCI and endorsed by the Provincial Legislators. This strategic 
decision will also enable Pakistan to honour the commitments made at 
international and national level particularly those made in the 1994 
International Conference on Population and Development Programme of 
Action and the commitment made to reaching Sustainable Development 
Goals. Finally, coordination must be strengthened at all levels starting from 
the existing fora which include the Country Engagement Working Group 
(CEWG), Provincial FP2020 Working Groups, Family Planning Donor and 
Reproductive Health working groups, civil society organisations and the 
private sector working for the cause of population planning. 
13. 
 
Be that as it may, as mentioned earlier in this opinion, the set 
of eight key Recommendations which have been prepared by the Task Force 
and approved by CCI are reproduced below:- 
 
RECOMMENDATION 
RESPONSIBILITY TIMEFRAME 
 
1. Establish National and Provincial Task Forces for steering, providing 
oversight and taking critical decisions to reduce population growth, lower 
fertility rate and increase contraceptive prevalence rate (CPR): 
 
a. National TF chaired by Prime Minister 
to include Chief Ministers of all the 
Provinces, 
Federal 
and 
Provincial 
Ministers 
of 
Population, 
Health, 
Education, 
Finance, 
Planning 
and 
representatives of civil society. 
 
M/o NHS 
By 31.12.2018 
b. Provincial TFs chaired by respective 
Chief Ministers to include Provincial 
Ministers 
of 
Population, 
Health, 
Education, 
Finance, 
Planning 
and 
representatives of civil society. 
 
PWDs 
By 31.12.2018 
c. Progress towards reducing population 
growth rate, lowering fertility and 
increasing contraceptive prevalence rate 
to be monitored through a robust data 
collection system and assessments of 
results and presented before National 
and Provincial Task Forces. 
 
M/o NHS and PWDs Bi-annually 
(NTF) 
 
Quarterly 
(PTF) 
 
2. Ensure Universal Access to FP/RH Services: 
 
H.R.C. No.17599/2018 
 
- 21 -
 
i. Mandate all public health facilities 
(BHUs, 
RHCs, 
THQHs, 
DHQHs, 
Teaching Hospitals) to deliver family 
planning services as part of the 
essential service package.  
 
Federal/Provincial 
Governments 
By 30.06.2019 
ii. All general registered private sector 
practitioners and hospitals to provide 
FP 
counselling, 
information 
and 
services to male and female clients. 
 
Federal/Provincial 
Governments 
By 30.06.2019 
iii. Lady Health Workers to provide FP, 
ante-natal and post-natal counselling, 
and contraception services on priority 
basis. 
 
Federal/Provincial 
 
Governments 
By 30.06.2019 
iv. 
Current cadre of male mobilizers to be 
made active and accountable for 
counselling men on family planning. 
 
Federal/Provincial 
Governments 
By 30.06.2019 
v. 
NGOs 
and 
Civil 
Society 
Organizations 
to 
work 
in 
close 
coordination with provincial DOHs 
and PWDs to extend FP/RH services 
to underserved and unserved areas. 
 
Federal/Provincial 
Governments 
By 31.03.2019 
vi. Federal and Provincial Governments 
to link population programs with 
Social Safety Net programs like 
Benazir Income Support Program and 
introduce conditional cash transfer 
schemes or incentivized schemes for 
adoption 
of 
FP 
service 
and 
institutionalized birth delivery. 
 
M/o NHS, PWDs 
and BISP 
By 30.06.2019 
 
3. Finances: 
 
i. 
Federal Government to create a five-
year non-lapsable Special Fund for 
reducing Population Growth Rate with 
annual allocation of Rs.10 billion. The 
Fund shall be set up exclusively from 
federal resources without any cut from 
provincial funds. The Fund will: 
 
M/o 
Finance 
and 
M/o NHS 
By 30.06.2019 
a. Meet, for five years, 50% 
amount of additional allocations 
made by the provinces for 
procurement of contraceptive 
commodities over and above the 
budget provision of FY 2018-19 
in the respective head.  
 
M/o 
NHS 
in 
coordination 
with 
PWDs and Finance 
Div. & PD&R Div. 
FY 
2019-20 
through  
FY 2023-24 
b. Meet, for five years, 50% cost of 
increase in LHWs for 100% 
coverage for doorstep services in 
rural and peri-urban areas. 
 
M/o 
NHS 
in 
coordination 
with 
DOH and Finance 
Div. & PD&R Div. 
FY 
2019-20 
through  
FY 2023-24 
c. Support innovative approaches 
of 
Federal 
and 
Provincial 
Governments for reaching poor 
and marginalized population to 
reduce population growth and 
M/o 
NHS 
in 
coordination 
with 
DOH and Finance 
Div. & PD&R Div. 
FY 
2019-20 
through  
FY 2023-24 
H.R.C. No.17599/2018 
 
- 22 -
 
increase 
contraceptive 
prevalence rate (CPR).  
 
ii. 
Federal and Provincial Population and 
Health budgets for FP/RH to be 
doubled over the next two years and 
protected from reallocation to other 
programs 
and 
departments 
while 
ensuring timely releases. 
 
M/o Finance, M/o 
NHS, 
DOH 
and 
PWDs 
FY 
2019-20 
through  
FY 2020-21 
iii. Donor financing to NGOs and private 
sector 
organizations 
involved 
in 
FP/RH to be streamlined through an 
effective coordination mechanism. 
 
EAD and M/o NHS 
 
in coordination with 
PWDs and DOH 
By 31.03.2019 
iv. Corporate Sector to allocate CSR 
funds for FP services and advocacy.  
 
SECP/FBR 
By 31.01.2019 
 
4. Legislation: 
 
i. 
Family Planning and Reproductive 
Health (FP&RH) Rights Bill ensuring 
mandatory FP/RH services by all 
general health care facilities in public 
and private sector. 
 
M/o NHS, M/o Law 
and 
Justice 
and 
Provincial 
Governments/PWDs 
By 31.03.2019 
ii. 
Early Child Marriage Restraint Act be 
introduced by Federal and Provincial 
Governments (Sindh passed this Act 
in 2013). 
 
M/o NHS, M/o Law 
and 
Justice 
and 
Provincial 
Governments/PWDs 
By 31.03.2019 
iii. 
Pre-marital counselling on family 
planning should be mandatory for 
Nikah 
registration; 
LHWs 
or 
appropriate 
service 
providers 
to 
provide the requisite counselling.  
 
M/o NHS, M/o Law 
and 
Justice 
and 
Provincial 
Governments/PWDs 
By 31.03.2019 
iv. 
“Right to promotive and primary 
health care for mother and child be 
made mandatory” as the right to 
education given in Article 25-A of the 
Constitution. 
 
M/o NHS/M/s Law 
and Justice 
By 31.03.2019 
 
5. Advocacy and communication: 
 
i. 
A national narrative to be developed 
in consultation with Provinces and 
other stakeholders to create a sense of 
urgency and necessity of reducing 
population growth rate and achieving 
socio-economic wellbeing for all. 
 
M/or 
NHS, 
M/o 
Information, 
M/o 
Religious 
Affairs 
and PWDs 
By 28.02.2019 
ii. 
Mass movement leading to a call of 
action to be launched involving 
political leaders, corporate sector, 
academia, judiciary, executive, ulema, 
media, intelligentsia, civil society and 
youth.  
 
Federal 
and 
Provincial 
Governments and all 
stakeholders 
Immediate 
iii. 
PEMRA to provide free airtime for FP 
messages on radio and TV channels at 
prime time. 
 
M/o Information and 
PEMRA 
By 15.03.2019 
H.R.C. No.17599/2018 
 
- 23 -
 
iv. 
Behavioural Change Communication 
campaign to highlight the role and 
responsibilities of men in family 
planning.  
 
Federal/Provincial 
Governments/Media 
and Civil Society 
Immediately 
 
6. Curriculum and Training: 
 
i. 
Health and hygiene to be included at 
primary school level. 
 
PWDs and Federal 
and 
Provincial 
Education 
Departments 
 
By 30.06.2019 
ii. 
Life Skills Based Education and 
Population Studies to be included in 
Secondary and Higher Secondary 
schools. 
 
PWDs and Federal 
and 
Provincial 
Education 
Departments 
By 30.06.2019 
iii. 
Population Dynamics in Pakistan to be 
included in College and University 
level education. 
 
HEC, Federal and 
Provincial Education 
Departments 
By 31.03.2019 
iv. 
Population modules to be included in 
training at all Civil Services and 
Judicial Training Institutions. 
 
National School of 
Public Policy 
By 31.03.2019 
v. 
PMDC and PNC to include modules 
on FP/RH in MBBS and Nursing 
Degree Programs, respectively. 
 
M/o NHS, PMDC 
and PNC 
By 31.03.2019 
vi. 
Training to be provided to all public 
and private health care providers on 
all modern contraceptive methods. 
 
M/o NHS, DOH and 
PWDs 
By 31.12.2019 
 
7. Contraceptive Commodity Security: 
 
i. 
Incentivizing Local Production of 
Contraceptives: 
Federal 
and 
Provincial 
Governments 
should 
encourage/incentivize 
the 
pharmaceutical 
companies/investors 
to establish contraceptive production 
units in Pakistan on WHO/FDA 
standards. 
 
M/o 
NHS 
in 
coordination 
with 
relevant Federal and 
Provincial 
authorities 
By 30.06.2019 
ii. 
Pooled Procurement model to be 
adopted by the Federal and Provincial 
Governments 
(subject 
to 
their 
consent) to garner the benefits of 
economy of scale. 
 
M/o NHS, PWDs 
and DOH 
FY 
2019-20 
onwards 
iii. 
Supply Chain Management System to 
be strengthened to ensure availability 
of 
all 
contraceptives 
at 
Service 
Delivery Points. 
 
M/o NHS, PWDs 
and DOH 
By 30.06.2019 
iv. 
FP Commodities should be included 
in the essential drug list of primary, 
secondary and tertiary drug list. 
 
PWDs and DOH 
By 31.03.2019 
 
8. Support of Ulema 
 
i. 
Joint Declaration of Ulema made at 
Population Summit-2015, Islamabad 
M/o 
NHS, 
M/o 
Religious 
Affairs, 
On continuous 
basis 
H.R.C. No.17599/2018 
 
- 24 -
 
to be widely advocated. 
M/o 
Information, 
PWDs and DOH 
 
ii. 
Training courses on family planning 
to be arranged at Provincial Judicial 
Academies 
and 
relevant 
training 
institutes for Ulemas and Khateebs.  
 
DOH/PWDs 
and 
Provincial 
Judicial 
Academies 
By 30.06.2019 
 
Adopting an approach similar to that of Iran, and focusing on the main 
impediment to the cause of population planning, these recommendations 
involve increasing the demand and utilization of contraceptives for which a 
mass movement is suggested taking on board political leaders, Ulema and 
clerics, the corporate sector, academia, executive, judiciary, media, 
intelligential and youth. The Ulema and Islamic scholars must also be 
urged to promote Islamic teachings in the context of controlled birth so that 
each child may be assured an enlightened and prosperous life. For this 
national cause, the Pakistan Electronic Media and Regulatory Authority 
(PEMRA) should allocate free airtime for family planning messages on all 
radio and television channels in prime time. Adopting the community-based 
approach of Bangladesh, these recommendations include the mandatory 
delivery of family planning services by all public health facilities and 
hospitals, as part of the essential service package, as well as the mandatory 
provision of family planning counselling, information and services by all 
registered private sector practitioners and hospitals. After thorough training 
the lady health workers and the current cadre of male mobilizers are 
suggested to be reactivated targeting the women and men of each family 
and ensuring active and accountable counselling for them. More crucially, 
it has been recommended that Federal and Provincial Governments 
introduce conditional cash transfer schemes for adoption of family planning 
services and institutionalised birth delivery and financial support programs 
such as the Benazir Income Support which should be linked with 
population planning initiatives. Moreover, it has been recommended that 
the Pakistan Medical and Dental Council (PMDC) and the Pakistan Nursing 
H.R.C. No.17599/2018 
 
- 25 -
 
Council (PNC) should include mandatory modules on Family Planning and 
Reproductive Health so we may rope in our future doctors and nurses to 
this national crusade. Obviously, the general cooperation of our NGOs and 
civil society is also expected and requested for this national cause. The 
Federal and Provincial Governments should also consider incentivising the 
local production of contraceptives by investors and pharmaceutical 
companies to increase their supply and accessibility and consider pooled 
procurement of contraceptives. The executive must play an active role in 
ensuring effective implementation of such laws. The Federal and Provincial 
Governments have agreed to allocate a sustainable amount of funds for this 
urgent cause, which will be a commitment that they must stick to in order 
to achieve any success in this population control campaign. 
14. 
 
The Recommendations are expected to accelerate government 
efforts to reduce the population growth rate, lower the total fertility rate, 
and increase the contraceptive prevalence rate. These Recommendations 
which are aligned with provincial population policies and recognize the 
Federal Government’s role in fostering, coordinating, and facilitating 
national progress, specify clear priorities, roles and responsibilities, and 
timelines for action. All that remains is for stakeholders at all levels to 
translate these Recommendations into urgent action. Because further 
complacence in controlling population by engaging in futile debates of 
responsibility or blame fixing, will prove to be a sure drift towards disaster. 
Immediate action by all pillars of the State and the public at large is not 
only the need of the hour, it is now a question of survival and thus must 
commence without any delay. As mentioned in the beginning of this 
opinion, it is undeniable that the right to life and several other rights are 
meaningless if owing to overpopulation, people are deprived of basic 
amenities such as food, water etc. Even otherwise, being one of the most 
populated countries in the world, Pakistan needs to realise its responsibility 
and play its role in curbing its uncontrol and unplanned population before 
H.R.C. No.17599/2018 
 
- 26 -
 
starvation, malnutrition, illiteracy, poverty and unemployment become the 
fate of a large segment of its population.  
15. 
 
The population explosion that we so rightly fear can only be 
overcome if we stand against it together as one; if we successfully convince 
the common man that our limited resources cannot feed more than two 
children per house; if we accept that required transformative investments 
in human development can only be made if our hands are not tied by 
severe economic constraints and depleting resources; if we admit that the 
ratio of mouths to feed has long outweighed our resources; if all 
stakeholders, including policymakers, legislators, care providers, civil 
society activists and religious scholars, play their roles in unison to support 
responsible parenthood behaviours in our society; and if we can convince 
ourselves that population planning is not a plan for the future, but a 
remedial step that has already been taken too late: only then can we diffuse 
this ticking bomb. Having equipped the nation with the above 
Recommendations, collaboration of the three pillars of State and all 
stakeholders and the words of wisdom and caution of experts for this 
campaign reduce the population growth rate, this journey we have 
embarked upon will indeed be one that our posterity will thank us for.  
 
 
 
 
CHIEF JUSTICE 
 
 
 
 
 
 
 
 
 
Announced in open Court 
on __________ at __________ 
Approved for Reporting 
Waqas Naseer 
 
 
 
 
 
 
 
JUDGE 
 
 
 
 
JUDGE