Introduction
Situated in South Asia between Afghanistan and Iran on the west, and India on the east, Pakistan is both a participant and a neighbor in one of the most politically sensitive-and economically underdeveloped-regions of the world. It is home to some 135 million persons residing in an area about twice the size of California. Although it has potential, Pakistan's economy remains impoverished. Only a recent Paris Club rescheduling of Pakistan's national debt has maintained national budgetary solvency. Pakistan's challenges at home, in the region, and in the world have been compounded by its testing of nuclear devices in May 1998 (in response to similar testing by India) and a military coup in October 1999.
For the past few years, the U.S.G. has sought a broader agenda with South Asia, primarily on efforts that enhance stability in a volatile region. Counter-terrorism, counter-narcotics, non-proliferation of weapons of mass destruction, economic reform, and improvement of human rights (especially the rights of women and girls) are central themes in the U.S.G. agenda. U.S. foreign policy objectives in Pakistan encompass these themes, encourage responsible resumption of political and economic dialogue between Pakistan and India, and hold the military's new "National Reconstruction Bureau" to its commitment of returning the country to civilian democratic rule within a scheduled timeframe. Importantly, Pakistan is key to the resolution of these U.S.G. themes and issues with Afghanistan and the Taliban.
USAID does not have a presence in Pakistan, but makes available modest assistance under U.S. legal provisions that allow assistance to, and through, non-governmental organizations (NGOs), for humanitarian purposes. USAID's Pakistan NGO Initiative (PNI) was launched by Vice President Gore (Cairo, September 1994) and then extended by Secretary of State Albright (Pakistan, November 1997); family planning and the rights of women and girls were strong emphases in these USG commitments.
The Development Challenge
Pakistan has some of the lowest social indicators in a region chronically poor by world standards. Women and girls are especially deprived. Cultural restraints severely limit economic opportunities for women, and limit their ability to access social services. Fully 76% of Pakistan's total adult female population is illiterate. The combined school enrollment for both boys and girls at all levels of education is only 41% of the total group, and only half of those are girls. Only 45% of the population has access to health services; malnourished children comprise 38% of the total population; and the under-5 mortality rate is 136 per 1,000 live births. With a population growth rate of 2.6%, a fertility rate of 5.2, and contraceptive prevalence rates at less than 20%, Pakistan will be one of the world's five most-populous countries within the next generation.
Pakistan's average annual per capita income is about $500; though low, even this figure is skewed by higher incomes in urban areas. Per capita income levels in southern and far northern Pakistan are much lower, and about half of the total population is below the poverty line. Accountability and transparency in operations are issues at all levels of government. Although NGOs in Pakistan are often managerially weak, and can suffer from lack of support or outright suspicion, they are generally recognized as a needed, increasingly useful and significant part of Pakistan's development.
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