Public ill-health

Diphtheria is a condition primarily of childhood and an effective vaccine has been available since early 20th century

The population of Pakistan is prey to a range of preventable diseases, and despite mechanisms being in place to mitigate or even eradicate some of these, they not infrequently fail. Diphtheria is a condition primarily of childhood and an effective vaccine has been available since the early 20^th century. Worldwide deaths from diphtheria have declined sharply since the end of the Second World War as vaccination became generalised. The majority of deaths today are in sub-Saharan Africa, but there can be outbreaks in unvaccinated populations and Pakistan is experiencing one such. Twenty children have died in Punjab from the disease and inquiry has revealed a trail of error, negligence and incompetence.

The Punjab Expanded Programme on Immunisation (EPI) was said to have “woken up” and written to the federal EPI asking for two additional doses of vaccine within the routine immunisation. Inquiry reveals that the Punjab EPI had failed in its preventative duty by not giving two additional doses to children as per international guidelines. Furthermore, the EPI steering committee, which was supposed to meet every three months to review patterns of immunisation, had not done so, and in fact had not met for a year. At the very least, this is a gross dereliction and beyond inexcusable. Children have died needlessly and the reason they have died is a breakdown in the public health chain. In one area — Attock — vaccine coverage was as low as 18 per cent in the month of October, considered the peak period for diphtheria infection. This should not have happened and must not be allowed to happen again. The prevention of diphtheria is not rocket science and the mechanisms have long been in place for the administration of the vaccine. There are no ‘cultural’ issues surrounding vaccination as there supposedly are with polio. There have been no claims that there is a shortage of funds to purchase the vaccine or that the vaccine itself was in some way faulty. This is an entirely human failure. Those whose job it was to ensure the continuity of the chain of child health failed to do so — and the outbreak is not yet over. Heads should roll, though we doubt they will.

Published in The Express Tribune, December 16^th,  2015.

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