PM’s assistant launches drive against XDR typhoid in Sindh

Special Assistant to Prime Minister for Health Dr Zafar Mirza on Friday inaugurated a Typhoid Conjugated Vaccine (TCV) campaign against the extensively drug-resistant (XDR) bug in Sindh, claiming that Pakistan would be the first country to vaccinate such a large number of children against the waterborne disease after it was exported to seven countries of the world.

“Cases of XDR typhoid were detected in seven countries of the world and case investigations tracked them back to Sindh and Punjab, where this strain of extensively drug resistant typhoid is present.

Under international obligations, we have to take measures to contain this outbreak,” he said while speaking at the inaugural ceremony of the TCV vaccination at a hotel in Karachi. On the occasion, three children under the age of 15 were given TCV shots at a ceremony, which was also attended by provincial health minister Dr Azra Pechuho, National Coordinator EOC Islamabad Dr Rana Muhammad Safdar, National EPI official Dr Arshad Chandio, Rehan Baloch, and a large number of paediatricians and health officials.

The prime minister’s special assistant praised the Sindh health minister for planning to vaccinate over 10.1 million children against XDR typhoid in the province and called for adopting a broader health approach to contain the outbreaks of blood-borne and waterborne diseases in the country.

“Vaccination can only help us to contain the outbreak, but we need to improve the water and sanitation conditions to prevent waterborne diseases, including typhoid, as well as polio in the country,” he observed.

AKU symposium

Later, speaking at the 22nd annual National Health Sciences Research Symposium of the Aga Khan University in Karachi, Dr Zafar Mirza expressed his government’s commitment to work with the provinces and public and private key stakeholders on the implementation of the National Action Plan for Anti Microbial Resistance (AMR).

The theme of the three-day symposium is ‘Antimicrobial resistance: an opportunity to transform global health’. He maintained that in order to prevent any further outbreak of HIV like in Ratodero, they had decided to introduce auto-lock syringes in the country after international experts blamed unsafe injection practices and poor infection control for the spread of HIV among children there.

National and international experts attending the symposium said that up to 95 per cent of the population of Pakistan could be carrying bacteria that makes them resistant to life-saving antibiotics, adding that antimicrobial resistance happens when microorganisms, such as bacteria, fungi, viruses and parasites change when they are exposed to antimicrobial drugs.

Microorganisms that develop AMR are sometimes referred to as ‘superbugs’. As a result, the medicines become ineffective and infections persist in the body, increasing the risk of spread to others.

A recent UN report warned that the threat of AMR can be a global health crisis that could lead to 10 million deaths every year by 2050. Pakistan is the sixth most populous country in the world, and it is expected to rise to fourth place by 2050.

If not managed timely, AMR may lead to a “health emergency-like situation” that might have implications for the country’s health system as well as economy, they said. Antibiotics have been a founding stone of modern medicine. Use of antimicrobials has enabled the implementation of novel treatment modalities such as cardiac bypass surgeries, joint replacements and bone marrow transplants. Management of infectious complications would not have been possible without antibiotics.

The spread of resistant bugs is now taking us back in the pre-antibiotic era where advance medical interventions may become compromised, said Rumina Hasan, a professor of microbiology at the AKU and chair of the 22nd NHSRS organising committee.

“Antimicrobials have also been instrumental in the control of infections in farm animals and in crops, allowing an increase in agricultural output and providing food security. Emergence of antimicrobial resistance threatens this progress,” she added.

Realising that AMR puts the gains of the Millennium Development Goals at risk and jeopardises achieving the Sustainable Development Goals, WHO-instituted a global action plan to tackle AMR in the 68th World Health Assembly in 2015, which was endorsed by all countries, including Pakistan.

“The misuse and overuse of antimicrobial medicines is fueling resistance worldwide and the Eastern Mediterranean Region is no exception. Drug-resistant infections are estimated to cause at least 700,000 deaths globally each year,” said Maha Talaat, WHO EMRO regional coordinator for infection prevention and control, and the keynote speaker. “Implementation of AMR surveillance, hospital infection prevention and control, and antimicrobial stewardship are extremely important measures to curtail the spread of resistant bugs.”

“Although AMR is a global problem, estimates suggest that 89 per cent of deaths related to AMR in 2050 will occur in Africa and Asia. The UK government has set up the Fleming Fund to provide the much needed resources to better understand and address AMR. Such Coordinated global actions are required to minimise the emergence and spread of AMR,” said Anthony Huszar, South East Asia Regional Coordinator, Fleming Fund, and the keynote speaker.

AKU President Firoz Rasul, deans Adil Haider and David Arthur, and interim CEO of the Aga Khan University Hospital Shagufta Hassan also addressed the symposium and applauded the organisers and participants for highlighting the issue of AMR.

The NHSRS is the AKU’s annual flagship event that focuses on a health sciences topic relevant to Pakistan and the region. The second and third days of the symposium will cover discussions on animal AMR, antimicrobial use surveillance, food safety, control of antibiotics quality in Pakistan, ‘Ignite’ and several other sessions.