The country is infested with multiple problems. And at the root lies poverty and overpopulation. At the time of independence in 1947, the population of Pakistan was around 30 million, which has increased five folds in the last 5 decades and the demographic forces are dragging the number up to 300 million in 2050. At that time we would perhaps be the 3rd in terms of population, right after India and China. But, with the level of resources we have, at that time, we would most probably be at the bottom of the ladder in economic and social development.
What should be done in this scenario? We cannot curtail the population growth drastically. For that we would have to follow the rights based approach which means that the people should make their own choices about the number of children they want to have, the timing of having children and what methods to use for either spacing or stopping childbearing. And, then there is the question of what programs should take priority-- should we strive for universal education, water and sanitation, primary health, infra structure or population control? This is a billion dollar question.
My answer is that we need everything. But, if we really need to make a hierarchical list, then population planning (the word 'control' is considered politically incorrect these days ) and primary health care should top the list. Then comes economic reforms, universal primary education, governance, environment issues, water management etc.
It seems that most people can take care of themselves if the conditions are right, for example in the absence of government supply of water or natural gas, people pump water from underground and buy gas cylinders. In the absence of (good quality) health and education services, the affluent classes go to the private sector for their needs as they can afford it, and why shouldn't they! But, the real problems are for the chronically poor of this country, those who cannot even have two meals a day, let alone send their kids to schools and buy medicines. They live in one room households, with no water, no access to fuel at home for cooking, no access to schooling (for various reasons), and no access to health care. In a resource poor country like ours, we should take into account the needs of those people.
The programs and policies should have a long term vision and thinking in should take a holistic approach as we are not living in island and in order to survive we need all the basic necessities which are linked with each other anyway. For example, who can deny the links between deforestation and overpopulation, water shortages and poor governance, democracy and freedom of media, media's role in behaviour change etc. In short, Pakistan needs leaders who are good managers, not politicians who are fighting over whether trouser and shirt is Islamic or not.
At present, we all have to be realistic and solve the problems of basic survival needs of the people, and that solution has to be long term, sustainable and acceptable by the people.