IN terms of immunising children against preventable diseases, headlines in Pakistan tend to focus on polio — and for good reason. But beyond the spectre of this dreaded disease, there are a host of other illness that put millions of children at risk in the country. Sadly enough, although the administration of vaccines against a range of diseases, including malaria, tetanus, Hepatitis B and pneumonia, are provided for under the Expanded Programme for Immunisation, the country’s vaccination record after nearly four decades and expenditure in the billions remains dismal. The last seven days of April, World Immunisation Week, has provided ample opportunity to consider the figures regarding routine immunisation. The Islamabad Capital Territory is where the rates of coverage are the highest — though far from robust — at 74pc. Punjab follows at 66pc and Khyber Pakhtunkhwa at 53pc. But as we move down south, the picture becomes more shocking: the rate of routine immunisation under the EPI in Sindh is 29pc, and Balochistan comes in at a mere 16.4pc.

It is not that efforts are not being made to improve the situation. There currently appears to be a push under way to target Balochistan in particular in this regard — the province saw its fiscal allocation under the Public Sector Development Programme raised to Rs772.5m in financial year 2016-2017 from Rs2m in 2012-2013. The EPI centres in the province have procured generators and budgetary allocations to improve vaccine-storage facilities and keep the cold-chain process intact. Other interventions include providing vaccinators with motorcycles to facilitate their penetration into the remote areas that make vaccine coverage in this province a challenge. Yet the fact remains that Balochistan’s 688 union councils (30 districts) currently have just 480 EPI centres and 914 vaccinators — though these ranks are in the process of being beefed up. This is laudable, but perhaps what is really needed to turn the tide is a change of approach: a massive public information campaign across television and radio that makes people aware of not just the risks their infants face but also that vaccination under the EPI is free of cost. Ideally, instead of vaccinators having to go door to door to administer vaccines, which is a cumbersome process that interrupts cold-chain requirements and can compromise the quality of the vaccine, parents themselves should be bringing their children to EPI centres — provided, of course, that they are located at convenient, accessible distances.

Published in Dawn, April 30th, 2017