The US Department of Public Health and Human Services has recently issued a voluminous report titled Healthy People 2000, a guideline and recommendations for health promotion and disease prevention. Thousands of physicians, scientists and agencies collaborated in the compilation of this report which took several years in making. Somehow year 2000, marking the turn of the century, holds great expectations and as a result committments of many communities to improve the quality of life. Though the nature of problems vary among communities because of differences in the age distribution of population, the basic recommendations remain same. Quality of life of a nation is measured by the quality of health of its poeple.

Pakistan with its population of 120 million people inhabiting an area of 310 thousand square miles giving us a density of 360 people living per square mile with gross national per capita income of Rs. 12,000. The population growth rate is 2.9% which is probablyt the highest in the world causing us to double our population every 25 years. The most interesting aspect of the Pakistani population is its age distribution. Only 7% of population is above age 50. About 16% of the population is less than 10 years old. In this group of population the death rate is 12% whereas the overall death rate is 1.5%. The birth rate is 4.5%, one of the highest in the world. High infant mortality rate also suggests that the risk to mothers during pregnancy are high. Even though 88 infants out of 100 survive, some of them may be malformed or retarded. This risk is serious because it seriously skews the statististics of people labeled as healthy. Enhanced maternal care should receive very high priority; about equal to efforts to reduce birth rate.

There are about 900 hospitals, about 60,000 physicians, 2,500 dentists, 5,000 pharmacists and 18,000 nurses; all, except physicians, are well below the world average in number.

To cope with challenges of the population growth, limited per capita income and increasing cost of healthcare, concrete and elaborate plans must be in place. The planning begins by creating targets for the year 2000. Based on Healthy People 2000 recommendations and transforming the figures to the Pakistani population, the crude death rate should decline by 20-25% except for infants where a 50% decrease in death rate should be our target. This would, of couse, had to be coupled to reduced crude birth rate.