Our public health crisis

Implementation of Eighteenth Amendment to the Constitution has been little short of a catastrophe for public health.

There is an ongoing and expanding crisis in all aspects of the public health sector that touches every province to a greater or lesser degree. Such is the scale of this complex problem that there is an escalating possibility that Pakistan is going to effectively be quarantined from the rest of the world in an attempt to stop it spreading ill-health globally. Against this background, the government on April 23 launched World Immunisation Week in an effort to reach out to every un-immunised child — which is akin to pelting an advancing pack of hungry wolves with chicken feathers. The usual suspects gathered at the Ministry of National Health Services, Regulation and Coordination (NHSRC), and provincial health ministers and representatives of international partner agencies gloomily perused the national immunisation indicators.



A seminal document in the public health debate is the Pakistan Demographic Health Survey (PDHS) 2012-13 that provides the most accurate picture yet of an ailing nation. The minister of state for NHSRC, Saira Afzal Tarar, said that the federal government lacked data, but the PDHS report is as good a place to start as any. Overall, routine immunisation against childhood diseases stands at 54 per cent, far below the figure that would give herd immunity to any of the diseases being vaccinated against. In Balochistan, the figure was 16 per cent, and falling, according to most recent indicators. Measles and polio are currently resurgent, the national TB programme has been on its knees for the last year despite donor funding sitting in government coffers and the country echoes to the sound of stable doors being slammed after horses have bolted. Implementation of the Eighteenth Amendment to the Constitution has been little short of a catastrophe for public health. Devolved budgets do not come with devolved competencies, nor capacities, and in many ways, the provinces were unprepared to pick up the public health baton and run with it. The federal government is due to launch the ‘Tandrust Pakistan’ campaign in an effort to boost the numbers immunised. Sixty-two million children are to be vaccinated against measles, 3.33 million for polio. We hope the campaign is carried out effectively — our children deserve this.

Published in The Express Tribune, April 25^th, 2014.

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