By: A. Sami Malik
Karachi/Quetta, Sindh/Balochistan - November 2015: “If there is a doubt about the efficacy of the vaccine, there is no point vaccinating a child.” says Mohammad Qadir, vaccinator at the National Institute of Child Health, Karachi. “These are life-saving vaccines and the importance of maintaining their efficacy cannot be overemphasized.”
“On the average I vaccinate around 60 children every day. Parents bring their children here because this is a big hospital and we always have the required vaccines available. BCG, polio, pentavalent, pneumonia, measles, we have them all but more importantly the cold chain management system is much more reliable now than it was before. When I vaccinate a child, I am certain that the vaccine will work. The new UNICEF warehouse from where we get our vaccines is a blessing.”
UNICEF has been supporting the Government of Pakistan for Health Systems Strengthening (HSS), a fundamental requirement for ensuring effectiveness and sustainability of immunization programmes to achieve better results.
UNICEF is one of the key technical partners in HSS – supported by Gavi – the vaccine alliance. It is an international organisation which brings together public and private sectors with the shared goal of creating equal access to new and underused vaccines for children living in the world’s poorest countries.
In 2013, Gavi provided a generous contribution of USD 3.1 million to UNICEF for supporting the implementation of HSS activities in Pakistan. One of the three strategic objectives of this grant was to contribute in resolving the major constraints in delivering immunization and set in place a state of the art Cold Chain Management (CCM) system which is meant to ensure the efficacy of vaccines used to protect children and mothers against vaccine preventable diseases. CCM includes elements such as cold chain inventory; supply chain; stock management; transportation and distribution of vaccines - all integral to the overall process of immunization.
Funds provided by Gavi are being used by UNICEF for constructing 16 new and renovating 3 existing warehouses for better storage and distribution of vaccines in addition to the construction of dry stores for the logistics. These warehouses are being constructed in Sindh, Punjab, Khyber Pakhtunkhwa, Balochistan and Gilgit Baltistan. Till date, four warehouses have been completed and are fully functional whereas another seven will be ready by the end of the year.
A large warehouse has been constructed by UNICEF in Karachi, the most populous city of Pakistan. This warehouse has six cold rooms to store the vaccines and enough space to keep related material such as vaccine boxes etc. It is fully operational and the management staff is full of praises for this new facility which is a leap forward in strengthening the CCM system in Pakistan.
“The old warehouse where we stored vaccines worth millions of dollars, was an old army barrack in a run-down condition,” says Fahad Fehmi, Vaccine Management and Cold Chain Logistics Officer who is in charge of the newly constructed warehouse in Karachi. “The new UNICEF warehouse is the best in the province. Vaccines for polio, measles, tetanus, Hepatitis B and the pentavalent vaccine are stored and supplied from here to all 23 districts of Sindh as well as the 18 towns of Karachi city.”
As per the guidelines on the storage of vaccines and maintaining their efficacy, the temperature in the cold rooms is controlled between 2 to 8 degrees Centigrade at all times. To further improve the temperature management, UNICEF has recently acquired Temperature Monitoring Device Mapping Censors (TMDMC) system which will be soon installed in the colds rooms. This will further improve the temperature management.
“UNICEF has scheduled a training session for the CCM staff from across the country to provide hands on training on the temperature mapping of the cold chain,” says Fahad Fehmi. “I am excited to learn about the new system as it would certainly enhance our capacity to maintain the cold chain. With the construction of this new warehouse, putting in place the latest vaccine management technology and training the relevant staff how to use the latest system for Effective Vaccine Management is a major milestone in the arena of vaccine management thereby contributing to Health Systems Strengthening.
During a recent visit to Pakistan, UNICEF Regional Director for South Asia, Ms. Karin Hulshof inaugurated one of the warehouses constructed with Gavi funds in Quetta, capital of the Balochistan province. Highlighting the significance of strengthening the health systems in the country, she said, “Partnership between Gavi and UNICEF is enhancing the Expanded Programme on Immunization (EPI) for reduction in preventable diseases and paving the way for improved health services for children in Pakistan.”
Gavi’s collaboration with UNICEF for strengthening the HSS in Pakistan is bearing fruit. This is evident from the fact that as opposed to 306 cases of polio in 2014, only 38 cases have been reported in the current year so far. It has also helped getting improved results for routine immunization.
“Improved access to quality immunization services requires strengthening and up gradation of infrastructure and vaccines storage facilities,” says Dr. Saadia Farrukh, Health Specialist UNICEF. The construction of 19 warehouses as per WHO standards with Gavi HSS support is a sustainable intervention which will not merely reduce vaccine wastage but would also ensure that high quality potent vaccine reaches to every child of the country.”