Pakistan, with a population of over 235 million as of September 2022, is the fifth most populous country in the world [5]. Between 1998 and 2017, the country experienced an average annual population growth rate of 2.4% [6], the highest in South Asia [7]. Pakistan’s high population growth rate could be attributed to several factors, including Pakistan’s low contraceptive prevalence. Pakistan has the lowest contraceptive prevalence rate in South Asia, which over the last few years, has stagnated at 35%. One in five married women in Pakistan are unable to access effective methods of family planning if they want to avoid pregnancy or plan the number and spacing of their children. Low contraceptive prevalence may be attributed to weak service delivery systems and markets, and cultural norms [7]. According to the United Nations Population Fund (UNFPA), if contraceptive use rises from the current 35% to 55% in Pakistan, 4,200 mothers and 140,000 infants could be saved from maternal death and infant mortality each year [6].

Pakistan is one of the most urbanized nations in South Asia. According to the country’s 2017 Population Census, 36.4% of the population live in urban areas. By 2025, the UN Population Division estimates that nearly 50% of the country’s population will be living in cities [8]. Currently, more than half of Pakistan’s urban population live in ten major cities, having populations exceeding one million [9]. However, there are only 2 cities in the country with a population exceeding 10 million (Karachi and Lahore) [2]. Pakistan is confronted with a host of urban challenges. For instance, urban population growth in the country has not been matched by growth in housing units or equitable access to land, resulting in housing shortages and the growth of slums [8]. In Karachi, there are more than 600 slums. Further, Karachi is home to the largest slum in Asia, Orangi Town, with an estimated population of 2.4 million [10]. The country’s rapidly growing urban population is also putting intense pressure on the environment, through increased demands for fresh water, energy, land, and other resources and through the generation of more waste and pollution [2].

Over the past two decades, Pakistan has achieved significant poverty reduction and has reached middle-income status [11], [12], but the country continues to face considerable macro-fiscal fragility that could place significant constraints on its ability to sustain growth and further enhance equity [12]. From 2007 onwards, the country's economic performance has been affected by devastating floods, internal security hazards, and the energy crisis [2]. Over the period 2000 to 2018, growth of per capita gross domestic product (GDP) averaged only around 2.1% [11] – less than half of the regional average [12]. Further, Pakistan’s economic growth was seriously impacted by the COVID-19 pandemic [11].

Supported by accommodative macroeconomic policies, Pakistan’s economy expanded by 6% in Fiscal Year (FY) 2022, as it recovered from the impacts of COVID-19 [11]. But amid the devastating floods that hit the country in 2022, the country’s GDP growth is forecast to slow to between 2- 3.5% in fiscal year (FY) 2023 (ending 30 June 2023) due to the floods, policy tightening, and critical efforts to tackle sizeable fiscal and external imbalances [13], [14]. According to the Post-Disaster Needs Assessment (PDNA) of the 2022 floods, the loss in GDP as a direct impact of the floods is projected to be around 2.2% of FY22 GDP [15], [16].  

Pakistan's economy is driven by three main sectors - agriculture, manufacturing, and services. The sectoral shares of GDP production in 2018-19 were: Agriculture (18.5%), Manufacturing (13.5% - 13.8%); Other Industries (5.8%); and Services (53.86%) [2]. As a result of the direct impacts of the 2022 floods, the agriculture sector is projected to contract the most, at 0.9% of GDP, with floods causing the most losses to cotton, dates, sugarcane, and rice crops. The damage and losses in agriculture will have spillover effects on the industry, external trade, and services sectors. For instance, flood-related cotton losses are expected to weigh on the domestic textile industry, as local cotton constitutes about half of the industry’s required cotton input. Textiles account for around one-quarter of total industry output and more than half of goods exports. Similarly, the local food processing and slaughtering industries will be negatively impacted by the expected reduction in food harvests and reduced supply of livestock. As a result, industry sector value added is consequently expected to shrink by 0.7% of FY22 GDP, while services sector value added is projected to decline by 0.6% of FY22 GDP [15], [16].

The devastating floods will also have adverse effects on poverty reduction [14]. Prior to the floods, in 2018-2019, 21.9% of the population (around 50 million people) lived below the national poverty line. Rural poverty was more than twice as high as urban poverty (28.2% compared to 10.9%), and four out of five poor households lived in rural areas. As a direct consequence of the floods, the national poverty rate is projected to increase by 3.7 to 4.0 percentage points, pushing between 8.4 and 9.1 million more people into poverty, according the Post-Disaster Needs Assessment (PDNA) of the 2022 floods [16].

In order to achieve sustainable development, Pakistan recognizes that there is a need to improve its Science, Technology and Innovation (STI) base [17]. To move in this direction, the Government of Pakistan formed in 2018-19, several Task Forces to strengthen science and technology in the country. As a result of these efforts, the development budget of the Ministry of Science and Technology (MoST) has been enhanced, allowing for the implementation of several new important STI initiatives, for instance, on alternative energy and artificial intelligence. The 2020-21 budget for the Science and Technology Division of the Government of Pakistan was estimated at 311 Rs millions [18].

Further, since its independence, Pakistan has formulated 3 STI policies – (1) the National Science and Technology (S&T) Policy 1984; (2) National Science, Technology, and Innovation (STI) Policy 2012; and (3) the National Science, Technology and Innovation Policy - 2022, which was approved on 11th January 2022 by MoST. This new policy recognizes the pivotal role of technology and innovation in addressing Pakistan’s development challenges and stresses the need for capacity building in technology development. It also calls for the transformation of the country’s cities into ‘’smart cities’’, that will employ emerging technologies aiming to give the citizens the opportunity to lead healthy lifestyles, through the provision of modern facilities like e-governance, modern security systems, efficient transport systems, green energy, and sustainable infrastructure. The policy also recognizes the importance of ICT based services, such as internet, for social development [17].

Pakistan faces some of the highest disaster risk levels in the world [19], ranked 24 out of 191 countries by the 2023 Inform Risk Index [20]. This risk ranking is driven particularly by the nation’s exposure to earthquakes and the risk of internal conflict [19], [20]. However, Pakistan also has high exposure to flooding, including, riverine, flash, and coastal, as well as some exposure to tropical cyclones and their associated hazards, and drought [19]. In response, the Government of Pakistan has built a strong foundation for disaster management, around the National Disaster Management Authority (NDMA), the Provincial Disaster Management Authorities (PDMA), and national legislation from 2010. In addition, the Government has well-established national development and disaster risk reduction frameworks, including the Pakistan Vision 2025, the National Disaster Management Plan (NDMP) 2012-2022, and the National Flood Protection Plan (IV) (NFPPIV) 2015-2025 [21].

Internal conflict and disasters are driving migration and displacement in Pakistan. In 2020, according to the Internal Displacement Monitoring Centre (IDMC), 104,000 displacements due to conflict and 829,000 displacements occurred due to disasters in different areas. Approximately 910,000 persons were Internally displaced people (IDPs) in 2021. Many of these people remain displaced across the country, as conflict and poverty prevent them from returning to their areas of origin. This movement puts pressure on the already weak health care systems of hosting districts and contributes to a worsening food security situation in the country [22].

Food insecurity persists in some areas of Pakistan, in particular in Balochistan and Sindh, the provinces with the highest prevalence of food insecurity, malnutrition and poverty. Between March and June 2021, over 3.8 million people (26% of the population analysed) in Pakistan’s Balochistan and Sindh provinces were facing high levels of acute food insecurity, according to the Integrated Food Security Phase Classification [23]. Further, lost food stocks, poor harvests, and rising food prices due to the 2022 floods are expected exacerbate food insecurity and nutrition outcomes in the country. According to the Post-Disaster Needs Assessment (PDNA) of the 2022 floods, an additional 7.6 million people face food insecurity at the national level in Pakistan, increasing from 7 million to 14.6 million people, as a result of loss of production and price increases. The highest number of food insecure people are in Sindh (8.2 million), followed by Balochistan (2.4 million), KP (2.3 million), and Punjab (1.7 million) [16].

Gender inequality is of significant concern in Pakistan [24]. In the 2022 Global Gender Gap Index Report, Pakistan ranked 145 out of 146 countries on the Global Gender Gap Index, placing only above Afghanistan. This index measures the current state and evolution of gender parity across four key dimensions (Economic Participation and Opportunity, Educational Attainment, Health and Survival, and Political Empowerment). However, Pakistan did register significant improvement across three subindexes, with the highest positive variation on Economic Participation and Opportunity [25]. The Government of Pakistan remains committed to the cause of women empowerment. This is reflected in medium- and long-term strategic vision documents, pro-women laws enacted, and the policies of various institutions and ministries to mainstream gender into their planning and service delivery [24]. There is also an increasingly visible women’s movement in the country, as recently seen during the 4th Aurat (Women’s) March on 8 March 2021 for International Women’s Day [26].