WHILE Pakistan’s difficult struggle to eradicate polio is well known, with the country termed a ‘key battlefield’ in the fight against the crippling disease, recent reports have emerged that measles, another preventable illness, is also posing a threat to the country’s population. A number of children recently died in Bajaur Agency due to measles while several more are infected. A report in this paper says the immunisation campaign in the agency has been suspended for the past three months. Significant numbers of measles cases have also been reported from Islamabad and Karachi over the last few days. On the polio front, issues have emerged in Khyber Pakhtunkhwa over the vaccination programme, apparently due to a lack of coordination between the provincial government and Unicef which is financing the campaign. There were reportedly over 19,000 cases of families’ refusal to vaccinate children in the province in March.

Clearly then, the common factor in the continuing reports of polio cases and the increased number of measles victims is a poorly managed routine immunisation campaign. Both polio and measles are included on the government’s Expanded Programme on Immunisation. Yet we must ask if the EPI teams are getting to all the targeted children. Access is a genuine concern in conflict zones. However, reports of polio or measles cases in metropolitan areas such as Karachi and Islamabad simply point to bad management. It is essential that government departments — both federal and provincial — as well as donors and multilateral agencies are all on the same page where the vaccination programme is concerned. Experts have said that ‘mop-up’ operations should be conducted in and around the areas where polio or measles cases have been reported while the World Health Organisation has suggested that EPI centres be set up at the local level. To overcome cases of refusing the vaccine, members of the community have to be brought on board to convince parents to immunise their children. The services of lady health workers must be utilised while clerics must be convinced to use the power of the pulpit to inform parents about the benefits of immunisation.