AFTER three decades of virtual eradication, diphtheria has made a devastating comeback in Pakistan, particularly in Karachi. Cases of the highly contagious throat infection began to resurface in 2015 and were exacerbated by the 2022 floods. It claimed the lives of 55 children in Sindh last year and this year, so far, has led to 40 child mortalities. The WHO emphasises that diphtheria can lead to serious complications, including respiratory distress and heart damage. Symptoms typically appear within a few days of exposure and include sore throat, fever, and swollen neck glands. Without proper treatment, the disease can be fatal in up to 40pc of cases, particularly among unvaccinated children.

The efficacy of the diphtheria vaccine is now under scrutiny as experts raise concerns over its potential failure to protect fully inoculated children. While this investigation is crucial, it should not detract from the immediate need for widespread immunisation. In some areas of Pakistan, routine vaccination rates have plummeted to alarming lows — Balochistan reports coverage as low as 37pc. Moreover, the fact that a significant portion of diphtheria cases involves children over the age of five — outside the Expanded Programme for Immunisation coverage — points to the urgent need for extending the age limit to ensure better protection. Beyond vaccine coverage, the shortage of diphtheria antitoxin has left hospitals struggling to treat patients, forcing many to refer cases elsewhere. This, coupled with the insufficient number of vaccinators in Sindh (3,500 against a requirement of 12,000), reflects a system stretched to its limits. Ultimately, the fight against diphtheria boils down to a concerted effort by all stakeholders. While vaccination drives are always of the essence, public awareness and parental cooperation are paramount. Vaccine hesitancy is a major obstacle, with 250,000 reported cases of refusal in Sindh alone. Without changing this mindset, any progress made by the government will be undermined, leaving children vulnerable to preventable, life-threatening diseases.

Published in Dawn, October 22th, 2024