KARACHI, Sept 6: The first inter-provincial coordination meeting for polio eradication and strengthening of routine immunization on Tuesday resolved to interrupt indigenous circulation of polio virus by the end of this year.
The meeting observed that immunization was a proven health intervention and a basic human right. The government should take immunization as one of its prime responsibilities and ensure that it reached every child.
Among the observations and resolutions titled as “Karachi declaration”, the meeting also set a few goals to ensure that at least 80 per cent of the healthcare facilities are fully staffed, equipped and have immunization services available to achieve universal access by the year 2008.
The meeting was arranged by the Expanded Programmed on Immunization, Sindh, and was attended by health ministers of Sindh and Azad Kashmir; health secretaries from the NWFP, Balochistan and Sindh; DCOs and EDOs health.
They called for inter-sectoral approach through the leadership of the provincial governments, district nazims and DCOs for implementation of EPI programmes.
Addressing the technical session during which the Karachi declaration was presented and approved, Sindh Health Director-General Dr Hadi Bukhsh
Jatoi told the gathering to ensure that the Monovallent vaccines, which is being used during national and provincial campaigns, are not used during routine immunization of children.
He said that the special vaccine, which had been selected for oral administration to children in the upcoming two EPI rounds, would not be helpful under the routine immunization. He categorically said that there was no crisis of vaccines used for routine immunization and as such the health practitioners should avoid any such transition.
Earlier, Unicef health and nutrition chief Dr Rafah Aziz informed the participants that monovallent vaccine had been chosen for administration in the remaining two rounds of polio immunization campaign to eliminate Type-1 polio virus.
According to experts, an informal consultation on Pakistan was held in Geneva some three months back and it was concluded that Pakistan could stop wild polio virus transmission in 2005, as the past year had seen marked improvement in the ability of immunization campaigns to reach children.
With all the 16 cases in Pakistan being caused by the persistence of a particular strain of polio virus (P1), a component of the oral polio vaccine drops that targets this type strain, has been singled out for the use in upcoming polio rounds
The Global Director for the Polio Eradicative Initiative, WHO, Dr David said that the strain-1 of the polio virus identified in the Pakistani environs and the use of a monovallnt vaccine, a more targeted vaccine, would be a natural transition. Similar strategy was adopted in India and Egypt, which resulted positively, he added, saying that reaching the last legs makes appropriate to opt for monovallent vaccines.
Health ministers of Sindh and Azad Kashmir, health secretaries from Sindh, Balochistan and NWFP also spoke at the moot. However, representatives of Punjab were largely missed by the participants.
Sindh Health Minister Shabbir Ahmad Qaimkhani said that people from the three provinces made the presentations and apprised people about anti-polio activities in their respective provinces, but it was unfortunate that there was no representation from Punjab.
Underlining the importance of the routine immunization as the core, he said that there was no room for complacency as each time every child would be covered.
He noted that the rate of decline in polio cases during the years in the province suggested that Sindh would attain the zero prevalence rate by the end of 2005. However, he said, unless there were concerted and coordinated efforts by all the concerned officials, the target could not be achieved.
The health minister of Azad Kashmir, Choudhry Masood Khalid, said that zero polio virus prevalence registered in his region was only due to commitment of doctors and members of society as well as the administrators.
Discussing the situation in the NWFP, the provincial health secretary, Abdus Samad Khan, said that there had been tremendous decline in polio cases. Till July this year, only two cases were confirmed while one case had been reported in August which was considered among months of high transmission of diseases.
He said that a huge number of Afghan refugees, inaccessible areas, particularly North and South Waziristan, urban slums, conservative society, restricted participation of females in anti-polio campaigns and ongoing opposition from hardliners were the main challenges in polio eradication initiatives in the NWFP.
Balochistan Health Secretary Shafi Mohammad Zehri said that under the routine immunization, the Unicef-focussed districts had shown improvement in coverage. The up-gradation of vaccinators under Global Alliance for Vaccine and Immunization (GAVI), which was in process, would surely improve the supervision, he added.
Director-General Health, federal government, Dr Abdul Majid Rajput, said that routine immunisation was crucial and important as it fostered defiance against polio and other diseases. He stressed that district governments could move further for capacity building of their health facilities and emergency centres.
Sindh Chief Secretary Fazlur Rehman said that three cases of polio had so far been reported this year, but possibility of more cases could not be ruled out. He said that resources would continue to be made available to eradicate polio.
Sindh Health Secretary Prof Naushad A. Shaikh outlined the challenges and importance of government interaction at all levels for the eradication of polio. He held the coordination among EDOs, DCOs, Nazims and prominent political figures prerequisite to meet the EPI targets fulfilled.
WHO team leader Dr Tony Mounts, Sindh EPI project director Khadim Hussain, Sindh Additional Secretary Health Manzoor Ahmad Memon, DCO Tando Allahyar Mohammad Misbah, Dr Mohammad Azmoudeh of the WHO and Dr Iqbal Memon also spoke at the meeting.
