New finance bill and population planning

The news that the supplementary finance bill proposes removal of tax exemption/subsidy on contraceptives is very concerning. Considering that there is now a broad consensus in the country regarding the urgent need to lower our population growth rate to improve the wellbeing of our people and enhancing our development prospects, this decision seems ill-timed and counterproductive.

As the fifth most populous country in the world, with the fastest growing population growth rate in the region, Pakistan is lagging behind almost all countries in the neighborhood, except Afghanistan, in terms of improving its health and socio-economic indicators. A large proportion of our mothers are anemic and dying because of closely spaced and repeated pregnancies. We are importing food to feed our people while the per-capita water availability is also diminishing. A high proportion of our children are malnourished. We do not have the resources to provide the infrastructure to educate the increasing number of children being added to our population.

Nearly 17 per cent of married women of reproductive age in Pakistan want to adopt family planning but are unable to do so. Consequently, out of 9 million pregnancies annually, 4 million are unintended. This unmet need is higher among poor rural families who experience a higher proportion of unwanted pregnancies and have larger households. Among the many reasons contributing to the high unmet need; affordability of and accessibility to family planning services are identified as major barriers. Currently 53 per cent of couples who are practising family planning, obtain contraceptives from pharmacies, shops and the private medical sector. They will be the ones most directly affected by this new tax. Public sector procurement will also become dearer.

Compared to men, lack of family planning services disproportionately affects women. By undergoing repeated pregnancies and by the burden of nurturing their families, their health and wellbeing is more adversely affected. Denying family planning services by making contraceptives less affordable has serious gender and human rights implications.

Globally, food and medical supplies are tax exempt. Contraceptives are included as public health goods and considered a social utility. The US Food and Drug administration recognises them as medical devices and in Pakistan too, they have been included in the essential drugs list. Many countries including developed nations, realising the importance of contraception in promoting health, offer tax relief on contraceptive products with the aim of improving the well-being of their people. Tax exemptions are offered to make contraceptives affordable and enlarge the supply chain. In some country’s taxes levied on luxury items are specifically diverted for subsidising family planning products.

Taking notice of the alarming population growth rate, borne out by the results of the 2017 census, the honourable Chief Justice of Pakistan took suo motu notice and constituted a group of experts to develop a plan of action to bring down our population growth rate to sustainable levels by 2030. The plan was endorsed by the Council of Common Interests in 2018. Contraceptive security is included among the eight strategies for achieving the planned goals. Taxing contraceptives will undoubtedly jeopardise the implementation of the CCI plan of action.

Since contraceptives are an essential medical commodity, they should not be equated and taxed with items that are not considered necessities of life or luxury goods. The wellbeing, safety and security of our people depend upon lowering our population growth rate. Let us make the lives of our people easier and healthier by helping them to balance their household size with the resources available to them. Family planning services must remain affordable and accessible — it is a human rights imperative.

Published in The Express Tribune, January 8^th, 2022.

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