Sindh without a disease warning system since past 15 months

WHO had wrapped up its disease warning system in December 2014,

provincial health department had refused to take over the programme

Karachi

Because of “criminal negligence” of the provincial health authorities, Sindh no longer has a disease warning system for the last 15 months as the World Health Organisation wrapped up its Disease Early Warning System (DEWS) programme in December 2014.

The WHO offered to hand over the entire programme to the provincial health department but the latter refused to adopt it, The News has learnt.

The WHO has not only wrapped up its disease warning system but also reduced its presence in the province and many of key positions including the provincial head of office, national professional officers for communicable and non-communicable diseases, and EPI officers are lying vacant for many months.

The DEWS was introduced by the WHO in Pakistan after the devastating earthquake of 2005 in the northern areas of Pakistan to collect reports, investigate and respond to the outbreaks of communicable diseases but later this programme was expanded to the entire country and DEWS coordinators were appointed in each province.

“The DEWS was a successful programme which helped in containing and managing several outbreaks of communicable diseases after natural disasters including the 2005 earthquake and the super floods of 2010 and 2011,” a former WHO official in Sindh told The News.

“Outbreaks of many deadly diseases including diarrhoea, cholera, polio and viral infections were immediately reported to health authorities and with their support, effective measures were taken to control them,” he added.

The ex-official said the WHO decided to wind up the DEWS in the entire country and asked the provincial governments, especially Sindh, to take over the programme but because of the latter’s “criminal negligence”, it was completely wrapped up.

The former WHO official said in 2014, a PC-1 for the programme was prepared twice and sent to the provincial planning and development department but because of the lack of interest shown by the health department, it was not approved.

 “Actually, the then Sindh health minister, Dr Sagheer Ahmed, was not interested in taking over the WHO-run programme and that’s why, the PC-1of the project wasn’t approved.” He said the absence of the DEWS in Sindh was a “great loss” to the people of the province.

“The DEWS had its district coordinators in each and every district of the province, and they collected information about communicable and non-communicable diseases from public and private health facilities and reported it to the WHO country head and the government.”

He said the Punjab and Khyber Pakhtunkhwa governments had set up their own disease warning systems by utilising their Expanded Programme on Immunisation infrastructures but there existed no such system in Sindh at the present.

“Now, at any given time, nobody in the health department is aware of the health situation in the 29 districts of Sindh,” he added. Nobody exactly knows about the actual number of measles cases in Sindh in 2016, the number of deaths in the province, the status of neonatal tetanus cases and many other communicable diseases and because of that, no measures are being adopted to mobilise public and private health resources to contain disease outbreaks and provide healthcare services to the people.

Dr Rana Muhammad Safdar, the national coordinator for the Emergency Operations Centre, Islamabad, also described the closure of the DEWS as an unfortunate event.

“Because of the DEWS, government officials timely responded to disease outbreaks and prevented loss of lives in various parts of the country,” he added.

He said following warnings by DEWS officials, the federal and provincial governments mobilised their health resources in the areas which needed immediate attention while the WHO had also formed clusters of the non-governmental organisations working in the health sector to respond to health emergencies in the affected areas.

WHO officials in Pakistan said the organisation had winded up the disease early warning system by the end of 2014 and decided to train local health authorities in detecting, investigating and responding to outbreaks of lethal communicable diseases.

Maryam Younus, a spokesperson for the WHO in Islamabad, said now the organisation was running a system of “disease surveillance” in Pakistan and training health authorities in performing the role of DEWS as it was the responsibility of the local authorities to take care of the health needs of the public.

She, however, had no answer as to why the WHO had minimised its presence in Sindh where several key position of the organisation were lying vacant. An acting head of the WHO office in Sindh, Dr Sara Salman, dispelled the impression that organisation had limited its presence in the province.

She added that the process to fill the vacant posts was under way.

She said many WHO projects including DEWS had ended in Sindh and people associated with these programmes had left.

It is being perceived that the WHO had abandoned Sindh, which is not true.” Dr Salman said a disease surveillance and response unit was functioning at the office of the provincial health director general since the DEWS was wrapped up.