MEASLES deaths are being reported from different parts of Sindh on an almost daily basis, with over 200 fatalities reported so far. It has now emerged that around 400 children have also been affected in several districts of Balochistan, where health authorities say they face a shortage of the measles vaccine. While most of the world, including many countries in our neighbourhood, has seen a reduction in measles cases, Pakistan has witnessed several outbreaks in the recent past. And perhaps the core reason for this is mismanagement by the state. Neither the health authorities in Sindh nor the federal government have accepted responsibility for the late purchase of measles vaccines, which has been blamed for this latest outbreak. The federal Ministry of Inter-Provincial Coordination could not purchase the vaccines on time reportedly due to a delay in the release of funds by the Finance Division, while officials in Sindh say they were denied federal funds. The IPC ministry is supposed to run national health programmes until the provinces fully start managing all health matters by June 30.

Then there are the issues other than bureaucratic wrangling that are affecting the routine immunisation campaign. Medical professionals have expressed serious doubts about government claims of satisfactory immunisation coverage. In Sindh, where the measles epidemic is particularly acute, health workers have not been going into the field regularly to carry out immunisations, while political appointments in the health department, from the top down, have also negatively affected the campaign. The unsatisfactory immunisation coverage, shortage of vaccines and their late procurement all indicate that a lack of planning plagues the health authorities. The routine immunisation programme needs to be overhauled and the leaks plugged. Rather than take reactive steps, provincial health authorities need to ensure funds are available to procure vaccines on time and pay staff, field workers are well-trained and doing their jobs, and campaigns are carried out as per plan and with thoroughness to ensure that outbreaks of measles and other vaccine-preventable illnesses do not become regular occurrences. Work must be done in this regard before health matters are totally devolved.