KARACHI, Aug 30: Health experts have urged the federal health authorities to widen the scope of the Expanded Programme for Immunization (EPI) by including vaccinations for meningitis, pneumonia and diarrhoea, which, according to them, are the major causes of around 35 to 40 per cent of deaths among children under five in the country.

Highlighting the child mortality rate, they said that currently Pakistan had the slowest rate of child mortality change in Asia and the highest child mortality in the world relative to per capita income.

At this pace, the country is likely to miss the millennium development goals set to reduce child mortality by 2015.

The health professionals were of the view that since international help was available in this regard, the government should take advantage of the opportunity to improve its ranking on child health.

These views were expressed during a two-day conference on ‘Equity in Healthcare’ organised by the Pakistan Islamic Medical Association here at a local hotel.

Speaking about vaccinations for the prevention of childhood pneumonia and meningitis, Prof Iqbal Ahmad Memon of the Dow University of Health Sciences (DUHS) said that two organisms, haemophilus influenzae type b (Hib) and pneumonococcus, caused meningitis and pneumonia.

He was of the view that the government should introduce vaccines for these diseases in its EPI programme as the same had been implemented in the developed world and had yielded effective results.

The data pertaining to the developed countries, he said, showed that 19 per cent child deaths occurred due to pneumonia, 15 per cent died of diahorrea while around 54 per cent children in these parts became victims of malnutrition.

Although an exact epidemiological data for Pakistan was not available, according to some estimates of the annual 540,000 deaths of children under five, 160,000 resulted due to pneumonia and 4,000 by meningitis.

Highlighting the correlation between the economy and the health of a nation, Dr Memon said that the burden of diseases, disability and deaths affected a society’s ability to develop.

“Countries that have a higher life expectancy also have a higher level of gross domestic income. Diseases such as meningitis, if not addressed on time and properly, can affect mental health and hearing in the long term. So it is highly important on the part of the government to stress on prevention and take initiatives to make available a comprehensive and effective vaccination programme to the masses.”

Dr Memon said that the government had earlier planned inclusion of Hib vaccine in its EPI programme from August, but now it had been postponed till November for Sindh and September for Punjab.

“In case of pneumonococus, the government should avail itself of the offer made by the Global Alliance for Vaccines and Immunisation (Gavi), which is willing to provide its vaccine at much cheaper rates as compared with the open market prices,” he said.

Pointing out the gaps in the EPI coverage, the health expert said that though the official records put the EPI coverage at 37 per cent to 60 per cent, another nationwide study showed the coverage to be just 35 per cent.

He also stressed the need for creating awareness about breast feeding and the practice of hand-washing that could help check spread of various infections.

Dr Anita Zaidi of the Aga Khan University Hospital (AKUH) talked about the burden of severe rotavirus gastroenteritis in Pakistan and the preventive strategies. Rotavirus, she said, was one of the organisms responsible for causing severe dehydration and even death.

According to an estimate, 400,000 to 600,000 children died of the rotavirus disease every year, mainly in the developing countries.

“The rotavirus burden of Pakistan is high. The vaccine for the virus is available in Pakistan, but is expensive. It can be introduced, possibly in four years, with the help of international donor agencies,” she said.

Dr Naseeruddin Mahmood of the AKUH urged the medical community to make their patients aware of the availability of chickenpox vaccines.

“Chickenpox is not a benign disease, and can cause complications and severly affect the routine family life. So, it is highly recommeded that doctors do not take a decision on behalf of the patients and do tell them that the vaccine, though expensive, is available.”

In his concluding remarks, Dr Ghaffar Billoo stressed the need for a comprehensive EPI and said that child mortality could be effectively reduced if the government included vaccinations for meningitis, pneumonia and diahorrea in the programme.