LAHORE, Dec 9: The diphtheria-related deaths of six children and emergence of 19 other cases of the disease in Punjab is a result of ‘terribly low’ routine immunisation coverage (RIC) all over the province.

It transpired after a report titled ‘Rapid Assessment’ revealed extremely low RIC in the population-wise largest province of the country.

Meanwhile, the Word Health Organization (WHO), terming it ‘diphtheria outbreak’ issued a ‘health alert’ for the provincial authorities concerned.

According to the Rapid Assessment carried out by the experts and students of Punjab Institute of Public Health (PIPH), average RIC remained only 57.5 per cent as against 100 per cent target set to save all newborns from the deadly disease.

According to PIPH figures the targeted population (children under one year) in Punjab is around three million that means over 1.3 million of them could not be brought under the RIC in the province.

Several districts of the province reported 40 per cent or below RIC, showing the scale of ‘negligence’ on the part of authorities concerned.

The report has raised serious questions about the authenticity and implementation of the existing immunisation system despite availability of a huge stock of vaccines meant for prevention of various diseases, including diphtheria.

The situation prompted intervention by the WHO Emergency Coordinator in Pakistan, Dr Jorge Martinez and Country Adviser Essential Medicines & Pharmaceutical Policy (NPO) Syed Khalid Saeed Bukhari, who urged the health authorities to take immediate preventive measures in this regard. “I will like to stress out the importance of the government, in this case the health department, (that needs) to increase its resources for the provision of vaccines considering their need and the diphtheria outbreak which is a reflection of insufficient coverage”, Dr Jorge Martinez was quoted as saying by a senior official of Punjab government.

Quoting Mr Martinez, the official said the WHO and EHA (Emergency Health Action) would not always be there to shoulder responsibility of the government and the state towards the citizens with regard to immunisation.

“With regard to disease surveillance, Punjab should have the capacity in terms of human as well as financial resources to fully take over DEWS (disease early warning system) in the coming year”, the official further said, quoting the WHO emergency coordinator.

Mr Bukhari informed his seniors in a message titled ‘Emergency Medical Response (EMR) Diphtheria Outbreak in Punjab’ that so far 100 vials had been delivered to Punjab communicable disease control (CDC) department, while 20 had been given to the Children Hospital Lahore, for the admitted as well as any new patients.

Given the seriousness of the issue, Punjab Chief Secretary Nasir Mahmood Khosa called an emergent meeting of all 36 district coordination officers (DCOs) of the province a few days ago to devise future strategies to counter the diphtheria spread. Punjab health secretary and the director general were also present in the meeting.

After discussing the emergence of diphtheria cases in Punjab, the CS set a target of at least 80 per cent RIC for the children by March 2013 and directed the DCOs and other officials concerned to plug the loopholes and identify and overcome the weaknesses in the system to achieve it.

On the proposal of Unicef, WHO and official representatives, the Punjab government has also notified 2013 as ‘Routine Immunization Coverage Year’.

Punjab EPI Director Dr Tanvir Ahmed, expressing his concern over only 57.5 per cent RIC in the province, told Dawn it was far below the government’s expectations.

Saying 19 children from all over the province were hospitalised with diphtheria, he claimed all were recovering fast due to “prompt response” by the departments concerned.

“The representatives of the WHO, Unicef, EPI, all nine commissioners, health EDOs and DCOs have been assigned the task to take RIC to 80 per cent or above by March 2013,” Dr Tanvir said.

He said a ‘health alert’ had also been conveyed to the authorities concerned in the districts after emergence of diphtheria cases in the province.