PESHAWAR: Amid downtrend in cases of Covid-19 and Dengue Haemorrhagic Fever, physicians have called upon the government to strengthen the public health department to pave the way for prevention of avoidable ailments in the province.

On Tuesday, 185 new dengue cases were recorded in the province, making total tally 20,420 including 17 mortalities. The mosquito-borne ailment is likely to be vanished by mid-November. So is case with Covid-19, which infected eight persons in the province during the last 24 hours. It has infected a total of 224,845 persons and killed 6,371 so far in the province.

The health department is facing problems in dealing with many epidemics every year mainly owing to an overstretched public health infrastructure as it remains indulged in campaigns against dengue and Covid-19.

Physicians at teaching hospitals say that in developed countries, a separate public health department, headed by director-general, operates with desired infrastructure to deal with epidemics. In Khyber Pakhtunkhwa, public health is a section under director-general health services with no powers over other departments due to which it cannot deal emergencies properly.

Experts say Covid-19 and dengue fever pose challenge every year

However, it has been able to deal with outbreaks of Covid-19 and dengue fever. Dengue fever has been breaking out every year since 2017 and infecting people in few districts of the province.

Despite meagre resources, the public health section of health department has been tackling Covid-19 since its onset in the province but it has not been able to completely focus on all 42 notifiable diseases because of its preoccupation with coronavirus and dengue fever.

In many countries, the public health department controls water and sanitation, livestock, municipalities and power sector besides having vast administrative powers. In Khyber Pakhtunkhwa, it looks towards the district administrations and other line departments for a multi-sectoral approach to tackle epidemics through control and preventive measures.

“A case in point is dengue, which happens every year and vanishes when the temperature falls to a level where survival of mosquitoes, the carrier and transmitter of the dengue virus, become impossible,” said physicians.

Under the Public Health Act, 2017, the department is required to monitor the trend of disease and take appropriate measure to prevent its spread. The public health section with its limited infrastructure is making daily, weekly and monthly reports with the help of its coordinators at the district level but it is unable to take steps against other ailments.

The experts said that public health section remained engaged in massive outbreaks including Covid-19 and dengue because of public repercussion and didn’t give proper attention to typhoid, scabies, Congo and influenza etc.

They said that it diverted all its resources to cope with Covid-19 and tackled the situation to a desired level. It developed PCR laboratories at the divisional level and strengthened surveillance through deployment of health staffers, who performed duty as additional charge. Initially, the staffers were given monetary incentives for field duty including contact tracing and collecting samples in addition to their own duty but that was also withdrawn in January this year.

As there are fewer dedicated staffers with the public health, it enlists support of doctors, paramedics, nurses, vaccinators and lady health workers on temporary basis during every big outbreak.

Physicians said that dedicated staff was desperately needed by public health section to put an eye on all diseases occurring throughout the year. People are dying due to complication of typhoid fever for consumption of contaminated water and food while others fall prey to respiratory ailments due to pollution. Ensuring clean water, sanitation and pollution come under the domains of other departments.

“The public health should be separate entity with control over water, sanitation, police, public health engineering, power, welfare, municipal bodies and other sectors. A strong public health plays significant role in prevention of tuberculosis and immunisation against poliomyelitis, malaria and other vector-borne ailments,” said experts.

As per International Health Regulations of World Health Organisation, every country is required to main robust public health system with permanent and trained staffers at the district level to perform surveillance and prevent common diseases.

“The government has a chance to revitalise public health at a time when cases of Covid-19 and dengue have declined to reduce the burden of diseases,” said physicians.

Published in Dawn, November 9th, 2022