Islamabad - Pakistan is making progress in improving its childhood immunisation programme, but sustained commitment at federal and provincial levels is required to increase the coverage of services and reach children who miss out on lifesaving vaccines.

A high-level GAVI Mission concluded this yesterday after its weeklong visit to Pakistan, appreciating the efforts of the government to strengthen routine immunisation.

The mission to Pakistan was led by Anuradha Gupta, Deputy CEO of Global Alliance for Vaccines and Immunization (GAVI), together with the senior officials of Bill & Melinda Gates Foundation, the UK’s Department for International Development, USAID, the Norwegian Agency for Development and Cooperation, UNICEF and WHO. The visit was a follow-up to a similar mission conducted in February 2015. The delegation visited Islamabad, Lahore and Karachi to see the progress made in the last 12 months, understand the challenges that lie ahead, and encourage leaders to reinforce their commitment to end childhood vaccine preventable deaths.

More than 1,000 Pakistani children under the age of five die every day, many of them from diseases that could have been prevented by vaccines. According to WHO and UNICEF estimates, Pakistan’s coverage rate with one of the most basic vaccines (DTP3) stood at 73% in 2014 with large variations between the provinces, districts and communities. The most recent Pakistan Demographic Health Survey, from 2013, showed Punjab had 76% coverage while in Balochistan the figure was just 27%.

GAVI Mission briefed the media at the end of the visit. It highlighted the need of maintaining cold chain and vaccine management system in under privileged areas of the country to ensure optimum utilisation of vaccines and to address equity. It also appreciated the progress made by the provinces in improving routine immunisation coverage but stressed on fulfilling the gap of equity in Balochistan, rationalisation of human resource in Sindh and uniform progress in urban slums and rural areas of Punjab. Mission also stressed on the maximum operationalisation of budget for immunisation on the recurrent side of the health budget.

“I have been deeply encouraged by much of what I have seen during this visit,” said Ms Gupta while speaking to media. “Coordination at federal and provincial level has clearly improved and I have seen for myself some of the innovative work at local level to reach children with vaccines.”

Among the initiatives witnessed by the mission was a recently-expanded approach using mobile phone technology and real-time data to monitor vaccinators, identify children missing out on vaccinations, and strengthen accountability. In Punjab this has significantly increased immunisation coverage. Similar approaches are now being initiated in KP and Sindh.

“All Pakistani children should have access to lifesaving vaccines, no matter where they live, said Angela Kearney, the UNICEF Representative in Pakistan. “We simply must not accept that a child misses out on immunisation because they were born in a remote area or an urban slum. The provision of health services, including immunisation, is a fundamental building block for provinces across Pakistan.”

Gavi has committed US$ 1 billion towards immunisation in Pakistan between 2001 and 2019, making the country the largest recipient of Vaccine Alliance funding. Through this support, Gavi is helping Pakistan to reach its children with the five-in-one pentavalent vaccine – which protects children against diphtheria, tetanus and pertussis as well as haemophilus influenzae type b and Hepatitis B – and pneumococcal vaccine, which protects children against the leading cause of pneumonia, the world’s leading vaccine-preventable cause of death in children.