• Declares immunisation gap a national public health emergency
• Blames governance failures, corruption, weak immunisation system
• Calls for an immediate audit of provincial health funds

KARACHI: The Pakistan Medical Association has issued an urgent national red alert after clinical and epidemiological data revealed that Pakistan holds a catastrophically high volume of “zero-dose” children in the World Health Organisation’s Eastern Mediterranean Region.

Zero-dose children are those who have not received the first dose of the diphtheria-tetanus-pertussis-containing vaccine (DTP1).

With 651,000 infants completely bypassed by routine immunisation systems, the representative body of the medical fraternity warns that the country is sitting on an epidemiological powder keg, facing an imminent, large-scale resurgence of preventable childhood mortality.

The association formally declared the milestone a National Public Health Emergency, warning that the immunity gap has breached the threshold required to maintain herd immunity, exposing the entire region to uncontrolled outbreaks.

“From a clinical and public health perspective, the presence of over half a million zero-dose children represents a systemic collapse of primary preventive healthcare,” PMA Secretary-General Dr Abdul Ghafoor Shoro said.

“Behind these devastating figures lies a deeper, systemic rot that has hollowed out the nation’s healthcare framework.”

According to the latest WHO regional epidemiological data, 90pc of all zero-dose children in the region are concentrated in five countries: Sudan, Yemen, Afghanistan, Pakistan and Somalia.

While Sudan, Yemen and Somalia are grappling with active wars, extreme violence or total state collapse, Pakistan’s inclusion in this bracket is primarily driven by administrative negligence and governance failure.

“For a non-conflict nation to harbor 14pc of the entire region’s zero-dose children is an unacceptable failure of governance,” Shoro said.

The PMA pointed to critical failures and structural corruption contributing to the crisis.

These include nepotism in administrative appointments, weakened Expanded Programme on Immunisation frameworks, chronic failure to establish secure networks to reach remote territories, and a failure to proactively counter vaccine hesitancy.

“Accumulating 651,000 zero-dose children is a direct consequence of decades of corrupt practices, administrative neglect, and a complete lack of political will from successive governments who do not prioritise the health of this nation,” the PMA stated.

To combat the crisis, the association demanded an audit of all funds allocated to provincial EPI and health departments, ensuring financial transparency, eliminating kickbacks in procurement and holding negligent administrators accountable.

The PMA also demanded that provincial and federal leadership declare routine immunisation a non-negotiable national security priority. It called for utilising localised, GIS-mapped demographic data to track down and inoculate the missing children, prioritising high-risk districts.

Additionally, the association urged modernising vaccine supply chains to prevent thermal degradation, rectifying delayed payments, and providing competitive compensation, rigorous clinical training, and robust security protocols for frontline health workers delivering care.

Published in Dawn, July 16th, 2026