Immunise or die

There is a very real possibility that Pakistan will, in the next year, be effectively placed ‘in quarantine’ by the World Health Organisation (WHO) as a result of the failure of the polio immunisation programme. Peshawar has recently been identified as the world’s largest pool of the polio virus and those associated with the programme have been targeted on several occasions. In the measles outbreak of 2012-13, over 300 people died. Measles is 100 per cent preventable if children are vaccinated. In national terms, the Expanded Programme on Immunisation (EPI) is facing a range of challenges that stretch from underfunding to undermanning, coupled in both cases with the devolution of health budgets to the provinces as a result of the Eighteenth Amendment.

The government has now decided to have a comprehensive overhaul of the EPI in order to strengthen coverage, with the goal of presenting an action plan drawn up with national, international and provincial stakeholders by the middle of February 2014. The National Institute for Population Studies has reported that in aggregated terms, immunisation ratios have actually dropped in Sindh and Balochistan, with coverage in the latter now down to a borderline catastrophe at 16.4 per cent. Elsewhere, the percentage of children completely immunised has gone upwards at a crawl, with the national figure growing from 47.3 per cent in 2006-07 to 53.8 per cent in 2012-13. In part, the reason for this has been the focus on the polio campaign, which has led to neglect of other areas of need, as well as a lack of capacity in the system. Our population is suffering from chronic ill health while health services are underfunded and under-resourced. A key factor in the problem is poor immunisation coverage, which creates widening pools of ill health and disease among children that stretches thin resources even thinner. Childhood immunisation to produce herd immunity is essential; failure to achieve that may render Pakistan a global pariah.

Published in The Express Tribune, January 31^st,  2014.

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