The federal government, Sindh health department and international donor agencies inaugurated the world’s first immunisation campaign to protect children against extremely drug-resistant typhoid in Sindh.
The campaign was initiated after more than 10,000 people in the province contracted the disease, with the majority being children under the age of 15. The drug-resistant typhoid strain had also spread to other parts of the world because of Pakistan.
“When the history of those who got XDR typhoid around the world was tracked, it revealed that they travelled to Pakistan,” said Dr Zafar Mirza, special assistant to the prime minister on health, at the launching ceremony on Friday.
“We had exported the strain to seven other countries. Since we are a signatory to the International Health Regulations, it is compulsory for us to fulfill our global health responsibilities.”
Dr Mirza said the need for the typhoid conjugate vaccine was the most urgent in Sindh following which the vaccine will be rolled out in Punjab and other provinces.
“It will become the 11th vaccine in EPI’s routine immunisations in Sindh from January 1, 2020,” said Dr Arshad Chandio, national programme manager of the Expanded Programme on Immunisation. “In routine immunisation it will be given to children with the measles vaccine at the age of nine months.”
The ambitious campaign
More than 8,000 vaccination teams will be working on ground, Dr Akram Sultan, the programme director for EPI Sindh, told the audience.
The teams will include 15,120 social mobilisers, 1,428 first level supervisors, 425 second level supervisors, 462 AEFI (adverse event following immunisation) doctors, vaccinators, nurses, medical officers, paramedical staff, private doctors, lady health workers and NGO workers. They will cover 937 fixed sites and 6,992 outreach sites.
“We’re ready to go on with the campaign,” said Dr Azra Pechuho, Sindh’s minister for health and population welfare. “We’ve interacted with schools and madrassas to reach school-going children. We’re also targeting out-of-school children.”
The need for a special typhoid vaccine
Back in 2017, there were 515,914 typhoid cases reported in Pakistan. Sixty-three per cent of the cases and 70% of typhoid deaths were among children under 15 years of age.
The need for a preventive vaccine that targeted typhoid and its dangerous extremely drug-resistant strain was urgently felt, Dr Mirza said, adding that Dr Pechuho had been instrumental in introducing the new vaccine in Sindh.
“Typhoid is a highly contagious disease that spreads more quickly and easily when people live in crowded neighbourhoods with weak water and sanitation infrastructure. Beginning the vaccination in urban areas is critical in preventing the disease among the communities most at risk,” Dr Pechuho said.
Dr Mirza also conceded that the country’s public health infrastructure was weak and with no work done on prevention, extremely drug-resistant diseases were beginning to spread.
The typhoid conjugate vaccine (TCV) is a safe, one-dose vaccine, injected usually in the arm and expected to provide long-lasting immunity in adults, children, and infants older than nine months of age.
This campaign, however, is only targeting children between the ages of nine months and 15 years.
The World Health Organization has recommended the use of the vaccine along with focusing on integrated preventive measures such as improvements in safe water, sanitation and hygiene.