ISLAMABAD: Pakistan is set to invest over $186.45 million (approx. PKR 52.2 billion) this year solely for polio eradication, yet former health ministers, advisors, and experts caution that the country’s broader immunisation initiatives, including the Expanded Programme on Immunisation (EPI), are struggling due to an absence of coordination between the two efforts.
With a combined annual investment of approximately $350 million (PKR 98 billion) in polio and routine immunisation, experts argue that failing to merge these programs is leading to resource wastage and hindering progress against vaccine-preventable diseases, including polio, which persists as an endemic issue in Pakistan.
Marking World Polio Day 2024, health leaders such as former special assistant to the Prime Minister on Health, Dr. Faisal Sultan, and former SAPM Dr. Zafar Mirza, alongside caretaker Health Minister Prof. Javed Akram and others, advocated for the integration of the polio initiative with EPI. They argue this would streamline operations, increase efficiency, and ensure that Pakistan’s substantial investment yields tangible health improvements.
Former health minister Dr. Faisal Sultan noted that integration could enhance impact, while Dr. Zafar Mirza highlighted the need to combine polio and routine immunisation efforts to succeed. “Separate programs will not work. We must bridge inequities across provinces, especially in areas like Balochistan and Khyber Pakhtunkhwa, where over 80 percent of children miss routine immunisation, leaving them vulnerable to polio,” Dr. Mirza observed.
The $186.45 million for polio eradication covers vaccine procurement from countries like China, Belgium, and Indonesia, along with operational and communication expenses managed by international partners such as WHO and UNICEF. However, the EPI, which targets 12 other vaccine-preventable diseases, has a lower projected budget of $164 million for 2024, funded by GAVI and the government of Pakistan.
Despite these investments, preventable disease-related deaths and disabilities are rising. Prof. Javed Akram emphasized that duplicating resources in a country like Pakistan is unsustainable. “Combining polio and EPI programs would prevent resource overlap and improve governance. We should bring flu, pneumococcal, and Hepatitis B vaccines under one umbrella. We need to set yearly targets and appoint professionals to lead these programs,” he explained. Akram also noted that polio impacts not only children’s health but also Pakistan’s economy. As of this year, 40 children have been affected by poliovirus, with four deaths from complications.
Ayesha Raza Farooq, Prime Minister’s Focal Person for Polio Eradication, added that the virus now threatens children across 71 districts. She pointed out challenges such as cross-border transmission, unregistered foreigner repatriation, and vaccine hesitancy. “High-risk communities often refuse vaccinations, demanding other government services first, complicating eradication efforts,” she stated.
International health officials supported the call for integration, stating, “Pakistan has the infrastructure, financial support, and workforce to eliminate polio, but needs a holistic strategy to tackle both polio and other vaccine-preventable diseases.”
The roadmap for eradication aims to stop virus transmission by mid-2025. However, experts say success hinges on integrating polio efforts with enhanced routine immunisation and public education. Dr. Nadeem Jan stressed that law enforcement and media support are essential to address vaccine hesitancy and protect polio workers in high-risk areas.
While World Polio Day 2024 serves as a reminder of the global commitment to eradicate polio, Pakistan faces significant obstacles. Nonetheless, experts believe that by integrating polio and immunization efforts into a unified national strategy, the country can overcome these challenges and secure a healthier future for its children.
