A dangerous deficit

Disease surveillance mechanisms at district level is insufficient,& sooner the DSRS is up & running again the better

Pakistan is prey to a number of lethal infectious diseases, with Naeglaria, Congo fever, measles and dengue being but four of them. Every year there is a seasonal outbreak of infectious diseases that kill people. It makes eminently good sense to have a central database that tracks infectious disease outbreaks year on year, and until recently Pakistan did indeed have a Disease Surveillance Response System (DSRS) that was run at the national level to monitor disease transmission trends. Such a unit is vital to combating outbreaks of communicable diseases, collect real-time data and devise timely responses at both national and provincial levels. Not for the first time, good sense appears to have deserted those responsible for the development and management of health services in the country.

The system that had worked until recently was established after the earthquake of October 2005, and re-booted after the 2010 floods. It was actually run by the World Health Organisation but has now been discontinued, apparently because of the failure to appoint a single Grade-20 person as the designated chief of the project. The National Institute of Health had, two years ago, approved the establishment of a new Surveillance and Response Division, merging a number of existing units doing related work. This has not happened and the entire project has fallen by the wayside, and threatens Pakistan’s effort to fulfill its obligations under International Health Regulations.

We find this completely inexplicable. This requires little by way of expenditure, is technologically simple and is cheap both to set up and then administer. There is no need for expensive consultants and all the human skills to run this effectively are in-country and until recently were working satisfactorily. Timely reporting of dangerous diseases may help to curtail their spread, and whoever or whichever agency has allowed this to lapse, needs the bureaucratic equivalent of a poke in the eye with a sharp stick. Having disease surveillance mechanisms at district level is simply insufficient, and the sooner the DSRS is up and running again the better. Rocket science it is not — necessary it is.

Published in The Express Tribune, May 29^th,  2015.

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