M. Waqar Bhatti:
Health Minister, Dr. Azra Pechuho, has acknowledged significant flaws in the province’s Expanded Program on Immunization (EPI), pointing to fake vaccination coverage data as a primary issue in the face of growing outbreaks of vaccine-preventable diseases like diphtheria, measles, and pertussis.
This revelation comes as Sindh struggles with a surge in diphtheria cases, particularly among unvaccinated children. Over a 100 children have reportedly died due to Diphtheria this year while official figures are 34 deaths due to diphtheria so far.
Talking exclusively to The News International, Dr. Azra Pechuho admitted that the vaccination coverage numbers reported by EPI officials are inflated and do not align with actual vaccine utilization. “We are seeing high percentages of coverage reported, but the vaccine utilization numbers and increasing outbreaks tell a different story,” she said, confirming suspicions that have long been held by healthcare professionals.
In response, Dr. Azra Pechuho announced measures aimed at revamping the immunization program, including dismissals for non-performing vaccinators and warnings for those showing leniency in their duties. “Vaccinators who don’t perform will be dismissed, and those showing leniency will receive warnings. We are also increasing the number of vaccinators, providing them with motorbikes and POL cards to facilitate their work,” she added.
The health minister further emphasized the importance of surveillance officers in identifying vaccine-preventable diseases, criticizing their focus on only Acute Flaccid Paralysis (AFP) cases. “Surveillance officers need to focus on more than AFP cases—they are missing other vaccine-preventable cases, and that is unacceptable,” she remarked.
With diphtheria cases on the rise, particularly among unvaccinated children, Dr. Azra Pechuho highlighted ongoing discussions with GAVI to extend the vaccination age up to five years. “Many children are contracting diphtheria because they haven’t been vaccinated. We have requested GAVI to increase the vaccination age to five years so children who missed their doses can still be vaccinated,” she explained. This request comes in light of diphtheria and measles cases being reported among older children as well.
One of the primary challenges in ensuring vaccination coverage is the absence of a comprehensive birth registry, according to the health minister. “We don’t have accurate data on the number of children in the province due to the lack of a birth registry. We’ve decided to waive off the birth registration fee and have asked NADRA to waive it as well, with the Sindh government bearing the cost,” Dr. Pechuho said. This initiative is aimed at creating a more accurate target population for vaccination campaigns.
She also announced the launch of a new vaccination campaign dubbed “The Big Catch-Up,” which will begin next month. This four-month-long drive will focus on vaccinating children who missed their vaccines over the past few years, particularly during the COVID-19 pandemic.
The health minister assured the public that those responsible for falsifying data and neglecting their duties would face consequences. “Those found guilty of fake reporting and dereliction of duty will be terminated. This includes District Health Officers (DHOs) who are not performing their roles,” she warned.
Acknowledging a gap in parental awareness regarding vaccinations, Dr. Pechuho admitted, “There has been a shortfall in educating parents about the importance of vaccination, but we are planning awareness drives ahead of ‘The Big Catch-Up’ to address this.”
On the other hand, senior pediatricians and health officials have voiced their concerns over the alarming number of diphtheria cases. Of the 184 suspected cases reported in 2024, 58% involved children who had not been vaccinated at all, according to data from the Pakistan Pediatric Association (PPA). In comparison, 155 cases were reported in the same period in 2023, showing a troubling rise in infections.
According to the PPA, 82 suspected cases of diphtheria were reported in Karachi alone this year, down from 125 cases in 2023. However, the rest of Sindh witnessed a surge, with 102 cases reported in 2024 compared to 30 cases the previous year. Out of the total 184 suspected cases, 34 deaths have been recorded, with many of the children missing their essential vaccinations.
The Pakistan Islamic Medical Association (PIMA) has also expressed grave concern over the resurgence of diphtheria, a disease once thought to be nearly eradicated due to effective vaccination campaigns. “Diphtheria has resurfaced with alarming intensity, raising serious questions about the performance of the EPI and the relevant authorities,” said Prof. Dr. Atif Hafeez Siddiqui, Central President of PIMA.
He emphasized that many children missed their vaccinations during the COVID-19 pandemic, contributing to the current outbreak. “The actual number of fatalities is likely higher than reported, and this outbreak underscores the urgent need for a nationwide vaccination campaign to ensure that every child is protected,” Dr. Siddiqui added.
PIMA has urged the government to guarantee the availability of antitoxins for diphtheria and to ensure the immunization campaign reaches all children, particularly those who missed doses during the pandemic.
As Sindh faces a growing crisis, the overhaul of the EPI and increased awareness among parents are seen as critical steps in curbing the spread of vaccine-preventable diseases and protecting the province’s children.
