LAHORE - Speakers at an advocacy workshop for policy makers and healthcare providers have stressed the need for making zinc and ORS integral part to cope with diarrhea.

Punjab Health Department and Pakistan Medical Association arranged the workshop on ‘Management of Diarrhea with Zinc and Low Osmolarity ORS’ in collaboration with the Micronutrient Initiative (MI) here at a local hotel on Monday. More than 60 participants including senior health staff, university academia, UN agencies, INGOs representatives working in health and micronutrient sectors along with renowned medical practitioners and pediatricians participated in the workshop.

Dr Zulfiqar Bhutta, a renowned researcher and scholar from Agha Khan University Karachi, said that globally more than 2.5 billion diarrhea episodes occur annually. Due to this more than 0.7 million children die before reaching their 5th birthday. He informed that not a single child dies of diarrhea in any developed country. He said that half of diarrhea related deaths happen in 5 major countries and Pakistan is amongst these. He said that during many years the diarrhea related deaths rate has stayed stagnant (125,000/year) in Pakistan as it has not put concrete and tangible effort in management through sanitation, pure water, health and hygiene improvement. He mentioned that ORS and Zinc are the main pillars of global action plan for pneumonia and diarrhea management. He said that Pakistan has only 30-40% ORS usage rate in diarrhea. He informed that more than 40 studies across the globe indicate that Zinc administration of 10 mg/day along with ORS reduces the severity and duration of diarrhea to more than 40%. Pakistan has the policy of using the combination of Zinc and LO ORS as diarrheal management, and it is in the curriculum of LHW program, but its implementation is only at 4-5%. He mentioned that though Zinc is in essential drug list, districts need to include it in procurement list.

Medical practitioners and pharmacists need to include it in curriculum. Scaling up of it is also needed through GPs and pharmacies and community awareness sessions. He asked policy makers to make this session the part of their implementation and monitoring strategy.

Dr. Khalid Nawaz, NPM Micronutrient Initiative informed the participants about the role which MI is contributing for the reduction of micronutrient deficiencies in the country. These programs include Universal Salt Iodization Program, Vitamin A supplementation, Multi-micronutrient Powder and Wheat flour fortification with iron and folic acid. He shared that by looking at status of zinc deficiency in the country and its implications on child health, The Micronutrient Initiative will support Government of Pakistan in addressing the issue for improved child survival rates. The use of zinc and low osmolarity ORS will be promoted for management of diarrhea in coordination with medical associations and Government of Pakistan.  

Munawar Hussain, Program Manager Punjab and AJK of Micronutrient Initiative described meeting’s objectives. The main objectives were; an overview of diarrhea treatment protocols and the evidence on use of Zinc with LO-ORS in effective management of childhood diarrhea, evidence on its implementation in Pakistan & its impact, implications for policy: barriers and what needs to be done, especially by government departments, drug regulatory authorities, pharmaceutical industries and medical practitioners.