Call for complete overhaul of EPI after Diphtheria kills hundreds across Sindh
M. Waqar Bhattiؔ
Islamabad: Senior healthcare professionals, including pediatricians and infectious disease experts, have demanded a complete overhaul of the Expanded Program on Immunization (EPI) in Sindh following EPI’s consistent failure to vaccinate children against vaccine-preventable diseases, such as diphtheria, measles, and pertussis, despite vast resources allocated to the program.
According to experts, the spike in preventable disease outbreaks, particularly diphtheria, underscores the inefficiency of the EPI.Why Karachi’s SIDH only facility treating Diphtheria in Sindh?
Around 100 children have reportedly died of diphtheria in Karachi alone this year, although the Sindh health department and EPI officials claim “only 28 deaths province-wide, with 10 in Karachi”.
These figures, however, are strongly disputed by senior pediatricians, who are alarmed at the surge in cases.
Healthcare professionals attribute the current crisis to years of mismanagement, complacency, and widespread corruption within the immunization program.
“EPI Sindh officials are doing everything except vaccinating children,” said one senior healthcare professional, who spoke anonymously. “Even after outbreaks, they fail to conduct case responses or visit affected areas. Instead, they focus on hiding facts from health department officials and the media.”
Experts have long criticized the falsified vaccination data provided by EPI officials, which obscures the real number of unvaccinated children. This lack of transparency has created an environment where outbreaks of vaccine-preventable diseases have become a recurring issue across Sindh.
According to the Ministry of National Health Services, Regulations, and Coordination, Pakistan has seen sporadic transmission of diphtheria since 2000, with notable outbreaks documented since 2013.
The situation, however, has worsened post-COVID-19. From January 1 to December 27, 2023, a total of 996 diphtheria cases were reported across Pakistan, leading to 124 deaths. Sindh accounted for 24.4% of the total cases. Only 36% of reported diphtheria cases had been vaccinated.
A key issue highlighted by experts is the rise in vaccine refusals. “Parents are becoming increasingly reluctant to vaccinate their children, and funds meant for public awareness campaigns are being misappropriated,” said the anonymous pediatrician.
The situation has been further compounded by corruption within the EPI Sindh program. Officials nearing retirement are often placed in critical roles with little regard for their competence or dedication. “These officials are only interested in personal gain, with no real concern for the health and safety of our children,” the pediatrician added.
Experts are now calling for a complete restructuring of the immunization program, with a focus on accountability and transparency. They argue that without a fundamental shift in how the EPI operates, outbreaks of preventable diseases will continue to threaten the lives of children in Sindh.
The recent diphtheria outbreak is just one example of a broader pattern of preventable diseases re-emerging across Pakistan. In 2023, 53% of diphtheria cases occurred in males, and 47% in females. While 25% of cases affected children under the age of five, 75% involved individuals over five, highlighting gaps in routine immunization beyond early childhood.
The current crisis extends beyond diphtheria, with outbreaks of measles, pertussis, tetanus, and tuberculosis also being reported across Sindh. Experts warn that without immediate and drastic reforms, these diseases will continue to spread.
Pediatricians are urging the Sindh government to overhaul the EPI system, prioritizing robust monitoring, transparent reporting, and targeted efforts to vaccinate zero-dose children. They also emphasize the nee…
