LAHORE: As if numerous health issues in the country are not enough, a potential risk of contracting tuberculosis (TB) for a large number of children looms large due to the last two-month interruption in the supply of BCG vaccine and syringes to the provinces.

The Federal Expanded Programme on Immunization (EPI) failed to procure this life-saving vaccine last year to meet the demands of all the provinces which has now emerged as a “serious crisis”.

According to the official figures provided by the Federal EPI Cell, 0.977 million doses of the BCG vaccine are required to meet the countrywide need every month. It said 580,000 children are born in Pakistan every month including 270,000 in Punjab, 125,000 in Sindh and 70,000 in Balochistan.

A single dose of BCG vaccine has been declared mandatory to every baby at birth, making it an integral part of the routine EPI programme since the TB transmission has been alarmingly high in Pakistan.

The World Health Organization (WHO) has recommend Bacille Calmette-Guerin (BCG) vaccine to all children at birth in Pakistan for being in the list of highly endemic countries for this childhood disease.

The provinces said they were not receiving BCG vaccine and syringes from the Federal EPI during the last some months despite many reminders and alerts sent to Islamabad.

Some experts finally conveyed concerns to the federal government. As the impact of the TB disease on children due to missing doses of the vaccine is likely to start within a period of four to six months, a huge population of the toddlers has entered a pool of “missing children for TB vaccine”. Consequently, the chances of epidemic of this childhood disease could not be ruled out in the months to come, warned experts.

Federal EPI Manager Dr Sohail Gilani told Dawn that inordinate delay in the approval of the PC-I for the procurement of the vaccines was one of the major factors due to which the government could not procure the vaccine. He said the PC-I was revised every year but efforts brought no fruit due to certain reasons.

“We have been facing a stock-out like situation for the last two months or so,” Punjab EPI Director Munir Ahmad told Dawn. He said Punjab had written to the Federal EPI about the “potential crisis” surfacing all over the province in the form of acute shortage of the BCG vaccine and syringes but it had not been conveyed any reason for delay of supply by the Centre.

“Though we could not meet the demand required to vaccinate the target population, our health managers are trying to manage the vaccine from other sources,” he said, adding that Punjab required 525,000 doses every month to protect newborns from the childhood TB.

He said according to the latest figures, 550,000 kids are born every month in Pakistan which has some of the highest rates of deaths among children in the world.

Dr Munir said Punjab could hardly manage 80,000 doses of BCG vaccine for April and 100,000 for March. “Now we have not received even a single dose so far for June which means health of a huge population of the kids is at grave risk.”

Balochistan EPI Director Dr Shakir Baloch told this reporter by phone that his province had been facing acute shortage of the BCG vaccine and syringes for the last five months. “Our province had received 50,000 doses of the BCG vaccine from the EPI Islamabad two months ago which were insufficient to meet the requirement due to its highest ratio of wastage, that is, 40pc,” he said.

Dr Shakir said that prior to this last supply, no vaccine was provided to the province for a period of three months. Consequently, a huge population of kids remained unvaccinated for the TB in their early childhood.

He said the Federal EPI informed his cell that it was battling some serious issues in the procurement of the BCG vaccine and syringes from Unicef which has been the prime source of supply. “Balochistan requires BCG vaccine for 340,000 newborns annually,” he added.

Sindh EPI Director Dr Mazhar Khamisani said the issue of acute shortage of the BCG syringes was more disturbing than the vaccine itself. He said the critical shortage of the specially-designed syringes had interrupted the coverage.

Declaring the reservations of the provinces genuine, Dr Sohail Gilani said his cell had been struggling to procure vaccine for the last three years. Originally, the EPI cell had prepared a PC-I in 2012 for the procurement of vaccine and other logistics which was later revised in 2013-14. Later, an amount of Rs1 billion could not be released against the PC-I revised for 2014-15, he said.

“Now we have got the PC-I costing Rs1.9 billion for 2015-16 approved by the Executive Committee of National Economic Council (ECNEC) after tremendous efforts,” Dr Gilani said. He said the process was being accelerated keeping in view the strong reservations of the provinces and in the larger interest of the children at risk of contracting TB.

“Our EPI cell is likely to receive 10 million doses of the BCG vaccine in a couple of weeks,” he said while promising that these would be dispatched to the provinces without delay.

Published in Dawn, June 3rd, 2015

On a mobile phone? Get the Dawn Mobile App: Apple Store | Google Play