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A ‘default state’ in combating measles

April 15, 2013

LAHORE, April 14: The Global Alliance for Vaccines and Immunisation (GAVI) has declared Pakistan a ‘default state’ in the backdrop of its inability to fulfil its co-financing obligation for Pentavalent vaccine for 2012 and because of Islamabad’s deficit that has shot up to $24 million to launch an effective campaign against measles.

The decision has come at a time when the country is confronted with the measles epidemic, which has claimed the lives of 500 children since January 2012 and affected another 15,000, a senior official in the federal ministry told Dawn.

The GAVI is a public-private global health partnership committed to saving children’s lives and protecting people’s health in poor countries by increasing access to immunisation.

“Pakistan’s inability to fulfil co-financing obligation for Pentavalent vaccine for 2012 has resulted in denial of support by the international body to combat the deadly disease,” the official said, quoting a document.

He said the default had taken the measles outbreak to an alarming level in the country and the situation might turn ugly in case an effective vaccination campaign was not launched before the forthcoming monsoon.

The total cost of the measles campaign in the country for children up to 10 years of age was estimated at $65.6 million, he said.

Ironically, the official said, only the Sindh government had allocated $4 million for vaccine procurement while the federal and other provincial governments had yet to make a firm commitment to cover the remaining deficit. He said the Inter-Provincial Coordination (IPC) had not even called a meeting with the Finance Ministry and other relevant ministries regarding internal fund mobilisation.

Citing lack of proper accountability, monitoring and oversight mechanism, three leading donors – USAID, World Bank and DFID – have expressed reservations to invest in the proposed measles supplementary immunisation activities (SIAs).

The official said it was the federal government’s responsibility to cover the $30.6 million funds deficit and there were chances of getting support from the GAVI. The federal government has already applied for $35 million support from the GAVI, which has yet to take a decision. It has also approached other partners and Measles Rubella Initiative (MRI) has approved $2.64 million for the proposed SIAs.

“According to policy, if any country remains at ‘default’ status, it will not be eligible to get any other GAVI support,” the official said.

He said the government could avert this situation by speeding up its process of Pentavalent vaccine and communicate the procurement order to GAVI. He said in February a joint WHO-UNICEF-GAVI mission visited the country and after reviewing available surveillance data they formulated findings according to which incidence of measles was very high across all provinces.

The official said the commission suggested the federal government conduct a nationwide vaccination campaign in two phases targeting all children below 10 years. In the first phase the campaign should be launched by June in all districts of Sindh, Balochistan, KP, FATA, eight southern districts of Punjab besides Lahore, Faisalabad and Islamabad.

In the second phase, it should begin by the end of this year in the remaining districts of Punjab, all districts of AJK and Gilgit-Baltistan.

The recommendations were endorsed by the National Immunisation Technical Advisory Group (NITAG).