Pakistan is prey to all manner of diseases, most of them curable and in some cases such as polio possible to eradicate completely. The key to control — or mitigation and eradication — is immunisation and therein resides the hurdle. Measles is one of the diseases that have long been controlled and virtually wiped out in large parts of the world. Pakistan is not one of them and according to a report by the WHO, the country can expect an increased number of cases compared to 2016. The report makes a distressing reading. Cases have risen by more than 100 per cent in 2017 compared to 2016, making Pakistan one of the worst-affected countries in the region.
According to the national schedule children aged between nine and 15 months should be vaccinated but the Expanded Programme for Immunisation (EPI) has failed to ensure this. Outbreaks were not detected and if they were then they were not responded to in a timely manner. A measles campaign should have been launched in the first quarter of 2017 — it was not. Punjab and Azad Jammu and Kashmir are the only parts of the country to have herd immunity, all other provinces report a less than 50 per cent immunisation rate and 95 per cent is the WHO benchmark figure.
In the event of a large measles outbreak — and the chances are high of such an eventuality — children are going to die needlessly. Pakistan is not entirely helpless, the victim of unlucky circumstance or some nebulous hidden hand — it has the capacity to rid itself of measles and has failed to do so. The fact that Punjab is largely measles-free now is because decisions were made to resource the EPI programme, recruit and train the vaccinators and get them busy on the ground. Other provinces have that option as well. That they have failed to act in a timely or effective manner is entirely down to provincial governments and local bureaucracies. Measles is not a ‘sensitive’ disease in the same way as polio is. If Punjab can do it so can everywhere else. Or is that too much to expect?
Published in The Express Tribune, February 27th, 2018.
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