Electing leaders on a sinking ship

There is an invisible elephant in the room and no one wants to talk about it. With elections only 16 days away, everything under the sun is becoming a campaign issue in Pakistan today. And yet, there is one very pressing problem in the country that no one wants to talk about, not even in an election year. Five Pakistani children will die by the time you finish reading this article (one child per minute) and no one wants to talk about what’s killing them (helpful hint: it’s not terrorism).

The invisible elephant in this year’s election is that one in 10 Pakistani children won’t make it to their fifth birthday, with the majority dying due to vaccine-preventable diseases. This jarring statistic stands in sharp contrast to the prevalent attitude of Pakistanis when it comes to raising the profile of health or vaccine-preventable diseases as an election issue. Most Pakistanis will roll their eyes when they hear about health as an election priority, preferring to focus on ‘hard’ issues like skyrocketing inflation, violent extremism and crippling electricity shortages. But the hard truth is that there is no issue more important in these elections than the precious lives of the most vulnerable segment of society — our children.

Pakistan’s infant and child mortality rates are some of the highest in the world, according to Dr Saadia Farrukh, a health specialist associated with Unicef. Dr Farrukh shares that “out of every 1,000 children born in Pakistan, 78 will die in the first year of their life and 30 will lose their lives within the first week of coming into this world. The major causes of these deaths are malnutrition, pneumonia, diarrhoea, and other communicable and vaccine-preventable diseases.” Surprisingly, funding isn’t the key bottleneck that is holding back immunisation programmes, which could prevent these deaths. It’s the lack of public awareness and misconceptions about vaccinations that result in these easily preventable deaths.

Vaccines save millions of lives around the world and are among the most cost-effective health interventions ever developed. This is exactly why institutions like the World Health Organisation (WHO) and Unicef are making public awareness programmes a strategic priority in Pakistan. For example, WHO is commemorating World Immunisation Week from April 24 to April 30. Similarly, Unicef is “undertaking a number of activities aimed at raising awareness of the importance of vaccinations, including social mobilisation activities, which range from reaching out to community elders, religious leaders, political leaders, as well as awareness sessions with mothers and schoolchildren,” according to Azmat Abbas, a media spokesperson for Unicef.

Elections are a great time to raise awareness about vaccine-preventable diseases as the issue can be thrust into the national spotlight by political parties. “Strong political will is the key to defeating vaccine-preventable deaths,” says Dr Nima Saeed Abid, Acting Representative for WHO in Pakistan, who argues that “selling the case for immunisation” shouldn’t be difficult for politicians. However, the most worrying part of Pakistan’s immunisation story is that political parties don’t want to spend their political capital discussing this issue on the campaign trail because the people aren’t demanding a solution to this problem with enough urgency. This is exactly why civil society must lobby political parties to formulate an across the board consensus on the issue and secure pledges of support for immunisation and public awareness programmes. This will also enable civil society to forcefully counter the narrative of extremists, who claim that vaccinations are part of a western conspiracy to cause harm to Pakistani children, especially by impacting their reproductive health.

With elections only days away, the state of Pakistan’s most vulnerable children is somewhat analogous to the state of passengers aboard the Titanic. Imagine yourself onboard the Titanic after her fateful collision with the iceberg that would eventually sink the ship. Imagine the captain and crew of the ship having heated discussions on the direction that the Titanic should continue to sail in, even as the passengers begin to jump ship. Now imagine yourself in Pakistan, having heated pre-election discussions on the direction of the country, even as children fall prey to diseases that are easily preventable with vaccinations. As a nation, the time has come to stop brushing deaths from vaccine-preventable diseases under the proverbial carpet. Pakistan’s children are running out of time. The clock is ticking.

Published in The Express Tribune, April 25^th, 2013.