ISLAMABAD: After nearly a decade of vaccine shortages, the government has decided to exempt the procurement of Expanded Programme of Immunisation (EPI) Vaccines from Public Procurement Regulatory Authority (PPRA) rule 21, under which at least three bidders should apply for a contract.

The government has also exempted tuberculosis medication manufactured in India from taxes for a year – from next year, the exemption will be given by the Ministry of Commerce.

A shortage of vaccines is observed nearly every year, which not only causes international embarrassment but can also cause child deaths. In 2012, 5,000 children in Punjab and Sindh contracted measles, and 500 of them died. After the tragedy, the Federal Ombudsman declared, after an inquiry, that the incident occurred because of a shortage of vaccines, and recommended exemption from PPRA rules that require three bidders to be involved in purchases.

Ministry of National Health Services (NHS) Director General Dr Asad Hafeez told Dawn that up until the 1990s Pakistan would receive EPI vaccines from Unicef.

Tuberculosis medication manufactured in India also exempted from taxes

“There was not only smooth supply but the vaccines were much cheaper as Unicef purchases them in bulk. However, in the 1990s some of the local vendors went to court and demanded that the PPRA rules should be implemented on the purchase of vaccines and the court gave directions to ensure the PPRA rules, under which at least three bidders should apply for the contract,” he said.

“However, over the years we were facing problems where sometimes only a single vendor would apply and a number of times bidders failed to supply vaccines after getting the contractor. After the incident in 2012, in which 500 children died, the Federal Ombudsman directed the exemption of PPRA rules and ordered for vaccines to be bought directly from Unicef.”

Dr Hafeez also explained that while the Global Alliance for Vaccines and Immunisation (GAVI) provides vaccines worth over a Rs1 billion for free, its condition is that 92pc of the cost will be paid by the GAVI and the government has to pay the remaining 8pc.

“We get vaccines, such as the pentavalent, pneumococcal and now even the rota virus vaccine, but for the last many years Pakistan was defaulting despite having the funds, because of the rules. We used to run from pillar to post to get exemptions to pay for 8pc of the cost, and the supply of vaccines to the provinces was also being disturbed,” he said.

“On Wednesday, the Cabinet exempted PPRA rule 21, due to which the ministry can now buy vaccines from Unicef at cheaper rates and in time the supply of vaccines will also be ensured,” he said.

EPI National Programme Manager Dr Syed Saglain Ahmed Gilani told Dawn it will now be possible to acquire vaccines at lower rates.

“Last year we awarded contracts to different vendors who defaulted, which delayed supply. Now, everything – including Pakistan’s supply and stocks – are available on the Internet, so it is embarrassing in front of donor and UN agencies.

“The local vendors had become a mafia and they would even go against each other in court. At least now we will be rid of that mafia,” he said.

Dr Gilani added that because there is also a shortage of vaccines in the international market it sometimes takes a year to acquire the supply. “As Unicef will be providing the vaccine, it will ensure that every year we get it according to our requirement.”

Cabinet also decided to exempt tuberculosis medication from taxes, due to a consistent shortage of these medicines.

Dr Hafeez said tuberculosis medicine provided by the Global Fund is free, and is manufactured in India.

“As Indian medicines are on the negative list, every year [the medicines] would get stuck at the port... We used to run from pillar to post for exemptions ever year and had to pay demurrages because the medicines remained at the port for a long time,” he said.

He explained that from next year, the commerce ministry will be authorised to exempt the medicine from taxes every year, allowing for a smooth supply of free tuberculosis medication.

Published in Dawn, November 24th, 2016