NationalVOLUME 19 ISSUE # 47

Challenges in public health: The ongoing battle against polio and hepatitis

Pakistan is at a crucial juncture in its public health landscape, marked by significant achievements and ongoing challenges. While the country recently celebrated the elimination of trachoma, it continues to face serious threats from polio and viral hepatitis. With the recent report of new polio cases and the epidemic proportions of hepatitis A, the need for comprehensive and sustained public health efforts has never been more urgent.

In a significant victory for public health, Pakistan has proudly joined the ranks of the world by becoming the 19th country to eliminate trachoma, a debilitating eye disease caused by bacterial infection. If left untreated, trachoma can lead to severe visual impairment or even irreversible blindness, impacting countless lives and communities. This milestone is not only a testament to the progress made in combating preventable diseases but also a beacon of hope for other nations striving for similar health outcomes.

To commemorate this remarkable achievement, a special event was held in Islamabad, attended by key figures in global health. The Country Representative of the World Health Organization (WHO), Dr. Luo Dapeng, presented the prestigious Trachoma-free Pakistan certificate to Prime Minister Shehbaz Sharif. Dr. Dapeng emphasized the crucial role of WHO’s technical assistance and acknowledged the tireless efforts of civil society organizations and international partners, including Sightsavers, Fred Hollows Foundation, and Christian Blind Mission, in the battle against this preventable affliction.

Among the distinguished guests at the ceremony was Dr. Tedros Ghebreyesus, the Director General of WHO, who hailed this achievement as a “monumental milestone for the country and a significant victory in the global fight against trachoma.” Additionally, Dr. Hanan Balkhy, the Regional Director for the Eastern Mediterranean, congratulated Pakistan not only for eliminating trachoma but also for eradicating guinea-worm disease back in 1997, highlighting the nation’s commitment to tackling neglected tropical diseases.

In his address, Prime Minister Shehbaz Sharif expressed heartfelt gratitude to all partners involved, stating, “Together with our partners, we not only celebrate this achievement but reaffirm our unwavering commitment to effectively control and eliminate diseases that hinder our socio-economic development by ensuring that quality healthcare is within the reach of every citizen in our country.” This statement, while inspiring, raises questions about the actual prioritization of public health in Pakistan’s policy agenda.

Historically, public health has received limited attention from successive governments, including the current administration. In the fiscal year 2022-23, public health expenditure accounted for a mere 1.0 percent of the country’s GDP. In contrast, various studies and a UN communiqué suggest that a minimum of 5 percent of GDP should be allocated to the health sector to ensure adequate service provision and facilitate significant improvements in health outcomes.

For a middle-income country like Pakistan, grappling with economic challenges, achieving such funding levels may seem daunting. However, it is crucial to recognize that even in more prosperous times, public healthcare has not consistently been a top priority for policymakers. During the event, Prime Minister Sharif also pledged to eradicate other contagious diseases, such as polio and hepatitis, demonstrating a commitment to addressing public health challenges that persist.

As Pakistan celebrates this pivotal moment in its public health journey, it must also reflect on the need for sustained investment and prioritization of healthcare infrastructure. Only through a comprehensive and committed approach can the nation hope to safeguard the health of its people and ensure that progress made today translates into a healthier future for all.

Despite Pakistan’s recent success in eliminating trachoma, the country continues to grapple with the challenge of polio eradication. On the same day as the trachoma elimination announcement, Sindh province reported two new cases of polio, bringing the total number of cases across the country this year to 26

The persistence of polio in Pakistan is not due to a lack of effort. The Polio Eradication Programme has been conducting regular vaccination campaigns to immunize children against the disease. However, the program faces resistance from violent extremists who claim that the polio vaccine is a Western plot to sterilize Muslim children. These extremists have targeted and killed several health workers and their police escorts, hampering the vaccination efforts.

Additionally, some misguided parents refuse to have their children vaccinated, further complicating the eradication efforts. The Polio Eradication Programme continues to work tirelessly to overcome these challenges and eliminate the disease.

Alongside the ongoing battle against polio, Pakistan also faces a significant threat from different strains of viral hepatitis. These diseases remain a serious health hazard, primarily due to poor sanitary and hygienic conditions, contaminated water and food, and unsafe medical practices.

Hepatitis A, in particular, has reached epidemic proportions in the country. The risk of morbidity and mortality is further increased by the spread of hepatitis C, which can be transmitted through used syringes, untested blood transfusions, and sexual intimacy.

The persistence of polio and the prevalence of hepatitis in Pakistan highlight the urgent need for comprehensive action to address the underlying causes of these public health challenges. Strengthening the healthcare infrastructure, improving sanitation and hygiene, and ensuring the safety of medical practices are crucial steps in reducing the burden of these life-threatening diseases.

By prioritizing public health and allocating adequate resources, Pakistan can not only eliminate polio but also effectively manage the threat of viral hepatitis, ultimately improving the well-being of its citizens and reducing the strain on the country’s healthcare system.

The persistent challenges posed by polio and hepatitis underscore the urgent need for a multifaceted approach to public health in Pakistan. Despite the dedicated efforts of the Polio Eradication Programme and the acknowledgment of hepatitis as a serious health hazard, the country must confront deeply rooted issues such as misinformation, violence against health workers, and inadequate sanitary conditions. By prioritizing public health initiatives, ensuring safe medical practices, and fostering community trust in vaccination efforts, Pakistan can pave the way for a healthier future, ultimately reducing the burden of these preventable diseases on its healthcare system.

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