PESHAWAR: The Khyber Pakhtunkhwa government has integrated the Expanded Programme on Immunisation (EPI) with the UN-run Polio Eradication Initiative (PEI) to ensure eradication of polio and strengthen general immunisation, especially in merged tribal districts where vaccination stood at 40 per cent only against the national target of 80 per cent.

The Emergency Operations Centre (EOC) for polio eradication will spearhead the vaccination programme and report to the health secretariat.

“We are focusing on the merged districts where vaccination is extremely weak. KP will take over the EPI programme there to remove administrative bottlenecks,” KP EOC’s coordinator Kamran Khan Afridi told Dawn.

He said that the exiting mechanism required a change for better utilisation of resources to eradicate polio and put in place a mechanism to contain its transmission in future.

Mr Afridi, who made a presentation to the chief secretary in a meeting of health task force in March, pointed out faulty chain of command in tribal districts and proposed that they be given in control of KP EPI. The concept paper was accepted.

He said that the EOC, established specifically for polio eradication in the province in 2015, would also supervise the EPI, which came under the DG health before. “We have started preparation to make accountable the staff and deliver for the safety of our children,” he said.

The decision, taken on the recommendations of National Emergency Action Plan 2018-19 for Polio Eradication, calls for enhancing essential immunisation coverage of injectable polio vaccine (IPV) and Penta III. It will safeguard children against polio and five other diseases by raining vaccination to 80 per cent at the district level.

A senior official said that the move had removed main hindrances to polio eradication after rational deployment of staff and better coordination among all partners under the government. He said that it would reinforce the government’s writ on polio programme which was seemingly in the hands of UN presently.

The PEI, comprising workers of the WHO, Unicef and other bodies, operated under their respective managements, which would come under the EOC, the official said. There was a disconnection between the health secretariat and EPI as the latter worked with the EOC which had given birth to a communication gap. Now, EOC will keep in touch with the health department on vaccination, he added.

He said that there was evidence of virus emerging from areas from where it was eradicated before and therefore trained staff was needed to immunise children to prevent polio re-infection.

“This will ensure smooth sailing of the vaccination programme, including poliomyelitis in KP and merged districts, because they would be operating under one umbrella,” Dr Akram Shah, director EPI, told Dawn.

He said that there were separate heads of EPI in merged tribal districts and KP till now, which often led to complications with regard to the immunisation initiatives. There is a shortage of vaccination staff in tribal areas, but EOC is well-equipped to provide human resources for controlling diseases among children.

Officials said that strengthening of EPI was critical to polio eradication as recent cases also showed that children protected with essential immunisation escaped residual paralysis.

Published in Dawn, June 23rd, 2019

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