Pakistan becomes the First country in South Asia to introduce Pneumococcal vaccine

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HELP advocacy Seminar to strengthen immunization
Pakistan becomes the First country in South Asia
to introduce Pneumococcal vaccine

Efforts should be made to ensure that no child should die
of vaccine preventable diseases

KARACHI: Health, Education and Literacy Programme (HELP) an NGO working for strengthening routine immunization organized an advocacy seminar in collaboration with GAVI on November 2nd 2012 to promote Pneumococcal Vaccine which has been added in the EPI programme. Dr. Suresh Kumar, Special Secretary Public Health Department, Government of Sind was the chief guest on this occasion. It was also addressed by ADO Public Health Dr.Saira Zaidi, Ms.Huma Khawr, Dr.Zahoor Baloch, Dr.Fehmina Arif, Dr. Zahid Laik, Dr. Asif Aslam from UNICEF and Dr. Younis Khan.
Speaking at the occasion Prof.D.S.Akram said that introduction of pneumococcal vaccine was an important milestone in EPI pgoramme in Pakistan. Introducing HELP she said that it was started in 1990 and we work in collaboration with GAVI and EPI Program. Our focus is on reproductive health, preventive medicine and nutrition, pre-primary education in communities. We have been working in Karachi and Sanghar in Khuda Ki Basti, Neelam Colony and Lower Gizri in Karachi where we have started five pre prmary schools. Nutrition resource center and MCH centers are also being established in KKB. She pointed out that TT coverage and routine immunization in these areas where HELP works has improved tremendously over the years. It was because of planning, strict monitoring and accountability which gave us the desired results. The routine immunization in these areas was now about 97-98%. Since we convince them the refusal rate has been negligible.
Dr. Huma Khawar introduced GAVI and said that it provides vaccines for developing countries who cannot afford them. Its main focus is in MCH immunization, safe injection practices, malnourishment, HIV and AIDs prevention. We believe that no child should die of vaccine preventable diseases. Dr.Zahoor Baloch said that in order to reduce morbidity and mortality in children of EPI diseases, we need to increase EPI coverage and introduce new vaccines. At present awareness is lacking in the community. We should promote this vaccine and public should demand vaccination as a right.
Dr. Fehmida Arif said that pneumonia accounts for 98% deaths in developing countires of which 90% are due to pneumonia, 7% due to meningitis and 3% are due to non-pneumonia deaths. Pneumonococcal infection is much more prevalent in Asia and Africa. India, China, Nigeria, Pakistan, Bangladesh has very high incidence of pneumonia infection. India tops the list in this region. Irrational use of antibiotics has resulted in resistance to many conventional antibiotics and it is more common in children. Risk factors include malnutrition, low birth weight babies, non-exclusive breast feeding, and low immunity, lack of measles immunization, indoor air pollution, crowding, smoking, zinc deficiency, asthma and diarrhoea. The possible risk factors include day care centers and Vitamin A deficiency. Lower chest wall in drawings is an important symptom, at times the child is unable to eat and drink. Treatment is with antibiotics but those with danger signs need immediate hospitalization and they will require treatment with injectable antibiotics. Meningitis is a very serious infection which often leads to death. Other infections include otitis media, sepsis etc. About one million children can be saved with preventable measures while six hundred thousand can be saved with appropriate treatment with antibiotics. Hospitalization due to pneumonia has considerably reduced and it can be prevented by immunization, adequate nutrition and control of environmental factors.
Dr. Zahid Laik who had specially come from Islamabad for this meeting said that 95% of the cost of pneumococcal vaccine will be borne by GAVI while Government of Pakistan will contribute only 5%. As compared to other parts of the country, immunization coverage in Sindh province, he said was much less. This new vaccine costs about Rs.4, 600/- per dose and in order to ensure that there is no misuse, the Vaccine for EPI programme is being made available in a vial of two doses. The second dose must be used within six hours. The routine recommended schedule for pneumococcal vaccine is at six, ten and fourteen weeks. In all three injections are needed. Rota virus will be our next target, he added.
Dr. Asif Aslam from UNICEF said that treatment for pneumonia and diarrhoea besides other preventable diseases is available but we have failed to control them. We must improve EPI coverage in Sindh. Many CSOs are active in service delivery and they are improving the EPI coverage. He felt that mothers and children should demand vaccination as a basic right. WHO Representative Dr. Khoso opined that we have not been able to maintain cold chain, children are vaccinated but still they are getting these infections. Mr. Younis Khan from HELP remarked that apart from EPI they were also working to improve water supply, sanitation in these areas. We are seeking help of religious leaders, Church in the area and they have all been very helpful, he added.
Dr. Suresh Kumar in his address said that Pakistan has become the first country in South Asia to include pneumococcal vaccine in its EPI programme. It will bring down morbidity and mortality in the country. Cold chain and vaccine storage facilities have been improved. He thanked GAVI, WHO and UNICEF for their assistance in EPI programme. On our part we have tried our best to improve training of vaccinators to achieve the targets and increase EPI coverage. Responding to a question he said that more NGOs are welcome to participate in EPI programme and they can get vaccines through EDO Health.

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