After water and sanitation, childhood immunization is considered to be the greatest public health intervention, saving millions of lives each year. Childhood vaccination is one of the simplest and the most cost-effective objective of an efficient health system. Yet the recent havoc that Measles has played in Pakistan tells a different story. It undermines the performance of the Pakistan health sector in ensuring full immunization coverage of children and in controlling the country-wide epidemic.
Measles is a viral infection of the respiratory tract which causes high grade fever, loss of appetite, redness of the eyes and body rash. It is highly contagious and fatal in children if complications arise. The vaccine is given in a combination MMR (Measles Mumps Rubella) under the umbrella of the Extended Program for Immunization in Pakistan.
The state of vaccine coverage in the country is dismal. With 60% Pakistani children that forego vaccination, Pakistan remains in the top ten countries exhibiting the least vaccination coverage as it struggles to meet the Millennium Development Goals. 210 children in Pakistan died of measles last year alone and an additional 150 children have lost their lives this year. Moreover, an appalling 25000 cases of measles have been reported since January this year; half of these children had already been “vaccinated” against measles. Availability of spurious vaccines in the market is causing inefficacy of treatment, prolonged agony and even has serious repercussions with the death toll rising. It is easy to get lost in numbers, but measles is a preventable disease. The fact that these deaths have arisen is negligence of the highest order.
Proper awareness camps about the seriousness of this disease should be structured. Despite prior notifications in public schools about the vaccination camp, over 25% children were reported absent. On an another occasion, a follow up survey in North Punjab showed that only a mere less than 50% parents in the region were aware of vaccination drive in the area.
There is already palpable donor frustration and fatigue regarding the polio situation in the country and health worker killings. Additional outbreaks such as these are a stark reminder of the lack of healthcare infrastructure which has created doubts in the donors’ minds, the seriousness of which is evident in the recent issue of travel advisory of Pakistani citizens.
The performance of the Punjab Government in controlling Dengue was laudable and lessons from the experience should be incorporated in the disease control plan for measles. Along with the Government, health professionals and the media should help propagate prevention measures that the public can take up in order to end this epidemic.
A child’s health is a sensitive issue. It needs to be dealt with a lot of responsibility and empathy. Officials are entrusted with this responsibility need to be accountable for their actions. There needs to be more political ownership to health and the irregularities that surround it.
Dr. Anis Kazi