ISSUES of public health and quality of life are relegated to the margins in Pakistan. This is the primary reason why there have been reports of over 200,000 typhoid cases in Sindh in the first 10 months of the year. These include cases of the dangerous extensively drug resistant, or XDR, strain of the waterborne disease. According to health experts this paper spoke to, while typhoid cases have been reported from across Sindh, 70pc to 80pc of the cases from Karachi are of the XDR strain. Moreover, the situation in the flood-affected areas is believed to be worse, as these regions are in the grip of waterborne diseases, amidst other health and sanitation challenges. The XDR variety is particularly of concern as, true to its name, it tends to resist most antibiotic treatments. The strain was first traced in Pakistan in 2016 when an outbreak began in Hyderabad, and has since become a major challenge for medical professionals.

There are several ways to counter the threat posed by all variants of typhoid that experts, including the WHO, recommend. Many of these are long term, such as improving health and sanitation facilities, as well as providing clean drinking water. But to tackle the disease immediately, it has been proposed that children under 15 be vaccinated against typhoid. Moreover, in order to contain the XDR strain, firm steps must be taken to curb the rampant overuse of antibiotics in the country. Medical professionals need to be made aware of the fact that antibiotics should not be prescribed for minor ailments, while the sale of these drugs, without a doctor’s prescription, must be banned. Awareness campaigns against self-medication are also required. To reduce the burden of typhoid and other waterborne, preventable diseases, the state needs to provide better sanitation facilities and safe drinking water to the public, while initiating extensive vaccine drives. If the XDR strain is not addressed with seriousness, a new public health nightmare awaits Pakistan.

Published in Dawn, December 15th, 2022