Placing childhood immunisation on the political agenda

Islamabad - The death of a family member is always devastating for the kith and kin attached to the individual   but what transforms the pain to an irreparable guilt, is the fact that it could have been prevented. As a Muslim, it is indeed our belief that life and death lies in the hands of God but we also consider doctors as messiahs, therefore apart from praying to God we also look up to the doctors to save lives through science.

 A developing country like Pakistan faces umpteen challenges when it comes to the pace of growth.  Be it technology, agriculture, education or health, the problems are massive and remedies far too less.  With a population of over 193.2 million, 393,959 children in Pakistan under the age of five die before reaching their fifth birthday. So it will not be unwise to hold ourselves, our government and our society responsible for the deaths of 393,959 innocent lives every year.

In Pakistan, the Expanded Program on Immunization (EPI) was launched in the late 70’s.  Today, 40 years later, the program covers ten childhood diseases namely, TB, Polio, Diphtheria, Pertussis, Tetanus, Hep-B, Haemophilus influenza-b (Hib), diarrhoea, Pneumonia and Measles. However, the challenge is to ensure that no child is deprived and left unimmunized from these ten lifesaving vaccines that can prevent the above mentioned ten childhood diseases.  The aim of the program is to protect around six million children between 0 and 23 months against the ten diseases and also to protect 6.81 million pregnant women and their neonates against tetanus.

EPI’s objective is to increase the immunization coverage area both in urban as well as in rural areas despite the obvious obstacles such as accessibility in form of roads and transport, provision of cold chain supply to ensure proper vaccine transportation, storage and handling.  In order to generate specific data on diseases, the team at EPI surveillance systems has been trying to make Heraclius efforts to achieve their objectives for which  the Federal EPI cell and the four provincial programs Sindh, Punjab, Khyber Pakhtunkhwa and Baluchistan are working in close coordination.

It is an undisputed fact that if the literacy rate was high and the religious knowledge of people in our country was sufficient to understand the severity of the menace, the number of children dying in the country would have been far lower than what we have today.

Despite the arduous efforts on part of the public and private sector, the national immunization coverage according to the last PDHS was only 54%. There is a big difference between urban and rural coverage for various reasons, poverty, illiteracy and lack of resources to name a few.

To strengthen and improve immunization coverage, it is imperative to involve existing institutional structures of the legislature including National and provincial chapters of SDG’s Task Forces and Parliamentary Committees comprising those Parliamentarians who are working directly or indirectly with healthcare and can take this cause further with a positive approach and raise the issue in the Parliament.

”If you really want to improve infant mortality rate, two things that matter the most are immunization and breast feeding” said Dr Meher Taj Roghani, a paediatrician and an advocate of immunization. 

In order to be able to track the “access to safe, effective quality and affordable vaccines for all” Members of Parliament need to be aware of:

1. Vaccines included in the national immunization schedule

2. Coverage of the target population with these vaccines

3. Financing for these vaccines.

To address the pitfalls in equitable coverage and identify gaps in reaching the target population, monitor the achievement of immunization coverage and influence policy accordingly, immunization scorecards have been developed by International Vaccine Access Centre (IVAC) at the John Hopkins University, US with support from Gavi the Vaccine Alliance to assist parliamentarians to track those statistics and indicators that can help indentify issue that need to be addressed.

On a global level, scorecard in Pakistan can show the international stake holders how close or far the country is from reaching the Global Vaccine Action Plan (GVAP). The tool is intended to be easy to use and straightforward to interpret. It has been made very simple and can be easily replicated.

Appreciating the concept of scorecards, Ms Rominia Khursheed Coordinator, Youth Parliamentarians Forum and member of SDG task Force, believes that public representatives must be encouraged to legislate and make a policy on necessary immunization and increase legislative business to highlight the issues related to routine immunization and polio eradication on the floor of the House.

“We should encourage the members of SDG Task Force to become immunization Advocates through highlighting the importance amongst constituents and through media,” commented the Coordinator.

It is hoped that the role played by Parliamentarians as Advocates for Routine Immunization for children, will build the value of vaccines amongst key political stakeholders and leverage their voice to call for action to strengthen RI programs in Pakistan.

–The writer is a freelance contributor.

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