On a wing and a prayer: No decision yet on extending the Federal EPI

Planning Commission reluctant to approve programme after 18th amendment.

ISLAMABAD:

The federal Expanded Programme on Immunisation (EPI), which requires a clear road map to save children from dying from vaccine-preventable diseases, is bumbling along without a national manager, while its staff awaits a decision on its extension.

For the past four years, EPI has also had to contend with a staff shortage. An official at the Ministry of National Health Services, Regulations and Coordination (NHSRC), requesting anonymity, said out of 95 vacancies, 27 are for public health specialists. “The government is unable to find a qualified health expert for the top slot.”

“Scarcity of human resource has resulted in poor management of vaccines, monitoring and coordination with the provinces,” said the official. “The federal EPI is being run by 30 to 40 staff members, out of whom the majority are junior administration officials.”

He claimed that most federal EPI officials did not know how provinces carry out routine immunisation programmes or how funds and vaccines released by the federal government are utilised.



A major portion of the EPI building, constructed in Chak Shahzad for Rs300 million, was handed over to the federal EPI in 2012. It was subsequently given to the TB Control Programme and Polio eradication staff. A proposal for the extension of the EPI programme was pending with the Planning Commission, but they were not willing to approve it. They say the programme was devolved to the provinces under the 18th Amendment, the official said.

The annual Public Sector Development Programme (PSDP) allocation for EPI is Rs2,792.693 million with a foreign exchange component of Rs477 million contributed by international donor, Global Alliance for Vaccines and Immunisation (GAVI).

GAVI also provides substantial in-kind assistance, which came to $107.9 million, whereas the government was required to finance only seven per cent in 2013.

The government cannot fund an aggressive awareness campaign on the media during World Immunisation Week, said the official. “The only option left is to hold press conferences, though some TV anchors will voluntarily host shows during the week to disseminate the message.” There is minimal involvement of the private sector in immunisation service delivery, resulting in missed opportunities, added the official.

“There are allegations that a major chunk of EPI funds for Sindh are being channelled into a private account of an official, but no one has investigated the matter.”

EPI National Manager Dr Ejaz Khan said most vacancies could not be filled because of the ban imposed by the government on recruitment.

Published in The Express Tribune, April 26^th, 2014.