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System in freefall: Flawed EPI programme

May 23, 2013

IF there were any doubt left about the shambles the country’s Expanded Programme for Immunisation is in, a recent indictment delivered by a string of national and international health agencies will have put paid to them. Spurred into action by the deaths of over 400 children due to measles between January 2012 and 2013, several organisations including Unicef, USAID, the Aga Khan University and the Pakistan Medical Research Council as well as the Ministry of Inter-Provincial Coordination undertook a comprehensive analysis on the countrywide failure of the immunisation programme. USAID said our EPI system was in a “freefall of disrepair”; WHO pointed out the low rates of routine vaccinations; the National Institute of Health noted that measles deaths occurred in all the provinces though Sindh was worst affected, and criticised the inabili-ty to identify and vac-cinate vulnerable populations. Most worryingly, it seems that the districts are reporting a once vaccinated child as fully covered when several vaccines, including measles and polio, require follow-up doses.

The situation cannot be remedied without the political and technical leadership at both the federal and provincial levels demonstrating far more commitment than they have in the past. For years, health — particularly child health — has been relegated to the background with the focus settling instead on more high-visibility killers such as extremism and militancy. While these are of course life-threatening issues, so are the illnesses that kill a shockingly high number — 435,000 — of children under five each year. Some 20pc die of illnesses that could have been prevented if vaccinations under the EPI had been administered. While this generation of leaders needs to leave behind a country worth inheriting, it also needs to ensure that those that inherit it have a fair shot at reaching adulthood.