When history of Corvid-19 will be written, remotely located Taftan in Balochistan will always be mentioned as the entry point to receive and report cases of Corona virus.However, we are aware that in no time numbers multiplied and every province and areas throughout Pakistan started reporting emergence of the virus that is still very complicated to understand with no preventive or curative vaccine in sight. Critics would say, the situation could have been better handled if the entry point was in any other province of Pakistan.

This is becausethe largest province, Balochistan has the weakest infrastructure, and the highest gender, education and literacy disparities in the country. Provincial adult literacy is 38pc compared to 57pc nationally; female literacy is 18pc compared to 45pc nationally. Its infant mortality rate is 97 (per 1,000 live births) compared to the national average of 74; under-fives mortality rate 111 compared to 89.

While global statistics show that death from the Coronavirus was skewed towards the elderly and the fragile, it is important that we do not get complacent and take every measure to protect our children.

Immunisation is one of the most cost-effective health intervention and way to save lives. “Not only are vaccines safe but also effective, they are a public health”best buy,” an inexpensive way to protect a child for life.”Thabani Maphosa, Managing Director Gavi, the Vaccine Alliance, stated while speaking during his meeting with the Chief Minister, Jam Kamal, November last year.

Gavi, the Vaccine Alliance, has been working closely with Pakistan for the past 20 years to improve routine immunisation in the country. Gavi has committed about US$ 1 billion towards immunisation in Pakistan between 2001 and 2019, making the country the largest recipient of Vaccine Alliance funding. The Alliance members met the highest level of provincial government leadership and officials to discuss the challenges faced by the province related to equitable coverage of immunisation and advocate for prioritization of immunization through adequate and sustained financing.

Balochistan, unfortunately, is the province with the lowest vaccination coverage in the entire country. Although according to Pakistan Demographic Health Survey (PDHS) 2012 and 2017, the percentage of fully immunized children has increased from 16 percent to 29 percent, more than 70 percent children of this province are still vulnerable to diseases.

Balochistan, the largest province in the country is spread over an area of 347,190 sq-km with the lowest population density, nomadic families and difficult mountainous terrain that leads to serious geographical barriers making service delivery costlier and more challenging than in any other province.

According to the Pakistan Polio Eradication Programme, 14 out of 40 super high-risk union councils are located in Balochistan. The polio situation in the province is also of great concern. Launched in 1978, Pakistan’s Expanded Programme on Immunisation (EPI) started as on going Public Sector Development Programme. It aims to save children against ten vaccine preventable diseases which include childhood tuberculosis, Polio, Diphtheria, Pertussis, Tetanus, Diarrhea, Hepatitis B, Haemophilus Influenza Type B, Pneumonia and Measles.

However, as the function of the program was of perpetual nature, continuing it on development project mode resulted in numerous obstacles in overall operation owing to delayed releases and inadequate allocation of funds for timely procurement of life saving vaccines. This led to intermittent interruptions in the immunization deliver system.

As part of the recently developed Universal Immunisation Coverage vision (led by the State Minister of Health) the province has set a target of 80 percent Fully Immunised Children by 2022 and 90 percent by 2023.

Although effectiveness of immunization programmes can be enhanced through human capabilities and commitment, to achieve and maintain province’s immunisation objectives it is critical that not only domestic financing for vaccines increases but the province moves its vaccine budget from development to recurrent budget.

Moreover, heavy dependence on international donors and fluctuation in the donor funding would directly hamper the immunization programme, which would directly trigger the preventable diseases in children with higher child mortality rates.

Immunizationis, not a onetime activity it is a perpetual process. Country wide, every year, the programme immunizes eight million children under one year and the same number of pregnant women to prevent them from Neonatal Tetnus.

It is a perpetual function and therefore it is important that the government understand the serious risk of running this critical programme on project mode through development budget.

In order to ensure continuous and uninterrupted procurement and supply of vaccines including delivery and services, it is important that the Balochistan government formally make child immunization a permanent part of regular health system.

In a country where safe drinking water, hygiene and sanitation are not available to very large population, preventing illness through vaccination is crucial. However, without sustainable and uninterrupted financing for immunization programme, we put our children at great risk. Vaccines need to get to all children, wherever they are, any interruption or break in the immunization and supply of vaccine may lead to re-emergence of these diseases resulting in increased morbidity and mortality. Permanent health services should be regularized to assure their inclusion in all upcoming and future health sector budgeting.