KARACHI: Sindh seeks WHO help to curb skin ailment
KARACHI, March 18: Sindh health secretary Noshad Shaikh has requested the WHO to include Pakistan in the list of countries being provided extensive support in view of high incidence of cutaneous leishmaniasis in Sindh and the country as a whole. In his keynote address at a workshop on cutaneous leishmaniasis, he said he was personally monitoring the situation and since December 15 last more than 13,000 cases had been reported.
He described cutaneous leishmaniasis as a relatively new public health problem in the provincial as well as country context and expressed his gratitude to WHO Consultant Dr Jorge Alvar for having come all the way from Geneva to facilitate the activity.
Noshad Shaikh stressed that in view of the rapidly growing incidence of the disease, it was imperative for all stakeholders to speedily draw up a multi-pronged inter-sectoral response to this public health problem to prevent further spread of the disease.
The health secretary assured the participants that the department of health would assign a very high priority to this health problem. The policy move will be backed with the requisite financing. However, it was necessary to be clear on the correct strategies to be employed, he said.
The provincial department of health and the WHO that jointly organized the programme were moderated by WHO Operations Officer for Sindh, Dr Ghulam Nabi Kazi.
Earlier, Additional Secretary, (Planning and Development) of the health department Dr Manzoor Ahmed Memon, in his presentation pointed out that the disease which was unknown until the year 2000 in Sindh is now spreading in several districts of the province, as well as in Balochsitan, NWFP and FATA.
He stressed that the problem required concerted efforts and expressed his confidence that the workshop would provide the correct direction for embarking towards an effective control of the disease.
Director, National Malaria Control Programme Dr Mohammad Aslam Khan, gave a brief overview of the disease in Pakistan and highlighted the objectives of the workshop that included sharing the WHO HQ regarding leishmaniasis control in other parts of the world, sharing and updating information from district managers in the endemic areas of Pakistan, sensitising the national and provincial disease control programmes on the need for country specific long-term control strategies, understanding the factors increasing the prevalence, highlighting the need for a country specific plan of action or sort out strategies most appropriate in the context of the disease epidemiology.
WHO National Technical Officer on Emergency Preparedness Jamshaid A R H Qureishi apprised the participants about the history and prevalence of leishmaniasis in Pakistan, WHO’s interventions and the expected outcome of the workshop.
He stressed that the endemic of the disease was progressively growing in Pakistan since the first documented outbreak of the disease in Dir during 1995, while the second known outbreak was in Kurram Agency in the last quarters of 2001 in the fallout of Afghan crisis.
It was, however, pointed out that since 2001 the disease has increased in all parts of Pakistan although the province of Punjab had been largely spared with only one outbreak in 2003 in Chakwal district.
He listed the WHO interventions that included rapid assessments, acquiring services of experts from WHO HQ and the regional office for visiting NWFP and Sindh, procurement of more than 24,000 vials of Glucantime and Sodium Stibogluconmate for distribution to the affected areas, advising the ministry of health for registering the drug in Pakistan, conducting workshops in all the affected provinces, preparation of guidelines on the treatment and prevention of the disease.
This was said to be besides provision of technical advice to the Ministry of Health and provincial governments on technical issues pertinent to leishmaniasis and establishment of a surveillance system for leishmaniasis in the Kurram Agency.
WHO Technical Officer for Roll Back Malaria, Dr Qutubuddin Kakar, gave a brief overview of the situation prevailing in Pakistan. He pointed out that there were three types of leishmaniasis - zoonotic cutaneous leishmaniasis (ZCL), anthroponic cutaneous leishmaniasis (ACL) and visceral leishmaniasis (VL).
He reminded that both ACL and VCL were endemic in Pakistan. He discussed the biology, causative organisms and vectors of the disease in different parts of the country. As regards the control of the disease, he pointed out that it is most successful where the vectors live, rest and feed indoors.
According to him, the principal methods of the control include application of insecticides, environmental manipulation, personal protection methods, including use of repellents and insecticide treated nets, besides biological control using pathogens still in infancy.
Dr Jorge Alvar of WHO-HQ gave a global scenario and recounted his experience in Afghanistan, Nepal and India with regard to cutaneous and visceral leishmaniasis. He stressed the need for carrying out advocacy for the patients suffering from this disease, enhancing control efforts and simultaneously carrying out research to devise the exact magnitude of the problem and strategies of the control.
He stressed that ultimately disease control was the responsibility of the government in the long run. However, it was supporting Afghanistan and India in countering this disease. He highlighted the need for proper disease surveillance, paying attention to various aspects of case management, reinforcing the public health system, monitoring drug resistance and limitations of spraying.
He thanked the Sindh government for holding the workshop and providing experts from all over the country an appropriate forum to deliberate the problem.
WHO Operations Officer for Sindh, Dr G N Kazi in his vote of thanks expressed his gratitude for Sindh health secretary Dr Noshad, Dr Jorge Alvar, provincial programme managers and all the participants for attending the workshop at short notice and providing their inputs and hoped that the workshop would pave the way for future interventions. He stressed the need for developing a proper programme for the control of Leishmaniasis at the federal and provincial levels.—APP
