After a heated debate in the Balochistan provincial assembly on Saturday over the cause of death in Quetta of five children from Killa Saifullah, an inquiry committee has been constituted.

It can only be hoped that definitive answers are found — and soon — because they will hold crucial implications for the success (or otherwise) of the province (and country) in vaccinating children against the nine preventable childhood diseases that are covered under the government-run Expanded Programme on Immunisation.

The circumstances surrounding the tragedy that befell these five unfortunate children on Friday are as yet murky.

Read: Anti-measles injections claim lives of five children in Balochistan: parents

The parents of the deceased — all of whom belonged to the same extended family — say that their offspring died as a result of being administered the measles vaccine; the suspicion is that the doses were either of substandard quality or had spoiled as a result of a possible interruption in the cold-chain storage process.

On their part, the health authorities maintain that the children had been weak and dehydrated when they were brought to the Civil Hospital Quetta. They point out that with an anti-measles drive under way in the province, tens of thousands of other youngsters have been administered the same injection (including several at the same time as the ones who lost their lives).

The tragedy raises once again the issue of the many serious problems being faced by Pakistan in its efforts to vaccinate its child population. The challenges faced on the polio front are, as is being widely discussed, formidable.

In fact, the escalating gravity of this one disease jeopardising Pakistani children’s health has tended to overshadow all the other ills that beset the vaccination sector. From mismanagement to problems of outreach to out-and-out negligence, the charge-sheet is one that is long and troubling.

Consider, for example, a survey jointly carried out over 2013 and 2014 by the World Health Organisation and Unicef of 151 vaccination sites across the country, the results of which were widely publicised earlier this year.

It concluded that major improvements are required in most areas of the vaccine and supply management system, and that the country meets the required standards in just one component: the vaccine/commodity arrival procedures.

Yet even this ray of light tends to dim a bit once it is recalled that Pakistan relies heavily on the support of international forums and organisations to obtain the vaccines that are required.

A similar indictment can be read into the discovery last month that a large consignment of the pentavalent vaccine was discovered to have spoiled because the required temperature had not been maintained while it was under storage at the National Health Services Ministry.

That consignment had been worth some $1.3m and could have vaccinated 400,000 infants. When this dismal list is juxtaposed with the slowdown in the rates of routine immunisation at various tiers of society, the picture that emerges is nothing less than forbidding.

It cannot be more obvious that Pakistan needs to urgently reinvent and reorient its child vaccination strategy. But even if the alarm bells have gone off in the relevant administrative quarters, there are few signs that anything other than firefighting is being attempted to combat the challenge.

Published in Dawn, April 22nd, 2015

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