It’s easy to get lost in the numbers. Easy to forget that every digit is a life put in danger, or a life lost. Less than four months into this year, there have already been 25,401 reported cases of measles. Thus far, 146 children across the country have lost their lives due to this easily preventable disease, and there are fears that this may only be the beginning.
Documents obtained by The Express Tribune paint a grim picture of what lies ahead: out of 7,000-plus laboratory confirmed measles cases that surfaced in 2012, a staggering 60% of children were not given even a single dose of measles vaccine, while 20% were vaccinated with only one dose. Of those confirmed cases, 68% were below five years of age and 32 per cent were less than 10.
The country’s official estimate of 1st and 2nd dose measles vaccine coverage was 75% and 53% in 2011 and 80% and 53% in 2012, respectively. Not only are the numbers of immunised children declining alarmingly, the actual coverage is considered to be far lower than what the official figures claim. This is evident, the documents say, from the thousands of measles cases that have emerged across the country from 2012 until now.
“These shocking statistics clearly reflect the main reason behind the measles outbreak in the country and the government’s utter failure to ensure optimal coverage of routine immunisation,” said an Expanded Programme on Immunisation (EPI) official who wished not to be named.
“With such poor and embarrassing coverage what message are we giving to the world on the eve of World Immunisation Week, which starts from April 24?” he asks.
It’s not as if there wasn’t ample warning, he says. The recent outbreak in Sindh should have been a wake-up call for the government, but those responsible just kept sleeping with the result that the epidemic travelled to Punjab. Now, Punjab tops the list with 16,608 cases and Sindh leads with 62 deaths.
“The provincial and federal governments’ lethargic and ignorant attitude is clearly reflected by their delay in releasing the amount allocated to launch emergency measles supplemental immunisation activities (SIA) in flood-prone areas by June 2013,” said the official.
The total amount required for SIA is $65 million, out of which $35 million is being paid by the Alliance for Vaccines and Immunisation (GAVI), a global health partnership, while the Pakistani government has to generate the remaining $30 million.
International donors have given a cold shoulder to Pakistan, and thus far Punjab has allocated $14 million and Sindh $4 million. Neither province has actually released the amount yet. Balochistan has not yet shown any interest while the federal government has requested the finance ministry for financial assistance but has not yet received any response.
“If Pakistan fails to raise this amount by the end of May, then it will be impossible to carry out the SIAs in the country and the lives of over 62 million children between the ages of 9 months to 10 years will be at risk,” he warned.
World Health Organisation’s (WHO) focal person on the measles outbreak in Pakistan, Dr Qamarul Hasan, said the reason for the epidemic is because children are either not vaccinated at all or only partially vaccinated.
“Pakistan is one of the top 5 countries in the world having the highest number of unvaccinated children. Of course, no sensible mind can say this is a satisfactory achievement,” he said.
Suggesting steps to control the epidemic, he said the WHO recommends improving both the 1st and 2nd dose coverage to at least 95%, and then sustaining that level. Along with this, he says a nation-wide measles campaign has to be launched targeting all children below 10 years.
And finally, Hasan said the government needs to ensure accountability at all levels for the effective and efficient utilisation of its own and donors’ resources. At this point in time, none of these measures seem to be being carried out, and every passing day only increases the danger to Pakistan’s children.
Published in The Express Tribune, April 24th, 2013.
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