ISLAMABAD: Even after about two years, a PC-I to obtain loans from the Islamic Development Bank (IDB) and Japan to purchase polio vaccine and bear the administrative cost of the anti-polio campaigns could not be approved.

As a result, with each passing day it is becoming difficult to hold the anti-polio campaigns, an official of the Ministry of National Health Services (NHS) told Dawn on condition of anonymity.

Minister NHS Saira Afzal Tarar confirmed that there was an issue of operation cost of the campaigns, adding that she had been trying to approve the PC-I that has been pending due to various reasons since November 2012.

The ministry official said the international community had expressed concerns that Pakistan was not spending even a single rupee on the eradication of the crippling disease so it should be forced to reserve fund for the campaigns to bring a sense of responsibility to the government.

In November 2012, the Central Development Working Party (CDWP) approved a plan to obtain a $326 million loan from the IDB, Japan and other organisations. The Bill and Melinda Gates Foundation announced that it will pay the interest on the loan, he said.

PC-I to obtain loan from international agencies not approved even after two years

The IDB initially released some funds but after that it has been waiting for the approval of the PC-I. In June 2013, the PC-I was revised but it is yet to be approved.

“The amount of the loan has to be transferred to the World Heath Organisation (WHO) and Unicef for utilisation on the eradication of the disease due to which no one is interested in getting the loan,” the official said.

On the other hand, in the near future availability of polio vaccine can become an issue due to lack of funds. Even if the vaccine is made available, there would be the issue of operational cost of the polio campaigns, the official said.

It may be noted that the demand for the polio vaccine is increasing all over the country. On July 15, the first polio case of the year was reported from the rural area of Sindh. On July 26, the first case from Balochistan in the last two years was reported from Qilla Abdullah. On August 7, the first case of Punjab was reported from the tehsil of Kallar Kahar in the district of Chakwal.

The health ministry official said whenever a polio case was reported a case response emergency campaign (CRC) has to be conducted in the nearby area.

“The CRCs have been announced in Sanghar and Qilla Abdullah and the local management is waiting for the vaccine. Moreover, vaccine is being given to the internally displaced persons of North Waziristan,” he said.

District Health Officer (DHO) Qilla Abdullah Dr Abdul Ghaffar Baloch told Dawn: “It has been decided to hold a campaign in 27 union councils where 130,000 children will be covered.”

DHO Sanghar Dr Shagufta Nasreen said a vaccination drive was carried out in the five kilometre radius of the area from where the polio case was reported.

“I have announced the CRC on August 18 and hope we will get the vaccine on time,” she said.

When contacted, Minister Saira Tarar said though the demand for vaccine had increased all over the country, at the moment there was no issue of vaccine shortage. However, she added, there was an issue of the operational cost.

“Saudi Arabia has provided us 10 million doses of vaccine to give to the persons who intend to travel abroad,” she said.

“Sindh has demanded the vaccine to hold campaigns in Karachi, Hyderabad and Sanghar, which will be sent to them soon,” she said, adding that provinces had reserves of vaccine and can use it for the CRS.

In reply to a question, she said Balochistan missed the Lot Quality Assurance Sampling (LQAS) and should ensure the usage of the vaccine. However, the case from Kallar Kahar was different as the affected child had received seven doses but might have complaint of low immunity.

Ms Tarar said in 2012 the PC-I was submitted to the planning division without taking an input from the ministry of health. As a result, the planning division raised an objection. So a revised PC-I with the input of the ministry was submitted.

“The planning division objected again and said it should be approved by the Council of Common Interest (CCI). But the ministry informed the commission that polio was a federal subject so there was no need to get approval from the CCI,” she said.

“I have personally talked to Federal Minister for Planning Ahsan Iqbal and Finance Minister Ishaq Dar to resolve the issue and I am sure that the PC-I will be approved in the current month,” she said.

Published in Dawn, Aug 11th, 2014