In order to boost population immunity, EPI has planned measles campaign in October 2018 targeting around 30 million children under 5 years of age, for which application submitted to Gavi in May 2017 has been recommended for approval by Independent Review Committee (IRC)-Gavi. Following decisions of inter-ministerial meeting held on 16th December 2017, EPI would ensure quality of campaign in October 2018 for which the federal Ministry of NHSR&C has initiated the process to make arrangements for such a huge campaign in the country to decrease the burden of measles. However to further reduce disease burden, measles outbreak response is planned by provinces during April, 2018 for which Measles and Rubella Initiative (M&RI) has been notified on 26th February 2018 for mobilizing immediate resources/support to Pakistan in high risk areas of the country. Measles cases in Pakistan have shown a decline since the introduction of EPI programme in Pakistan with two doses of measles containing vaccine being administered at 9 months and 15 months of age. In wake of decreasing burden of measles cases in the country, national follow-up measles campaign was implemented in 2014-2015 to improve population immunity. The reported measles coverage has improved from 86% in 2015 to 90% in 2017. Despite various efforts to strengthen routine immunization and due to immunity gap, measles cases have been reported from the country and as an immediate measure in 2017, on the request of the provinces, WHO conducted measles risk assessment of all districts using the WHO – CDC tool. Based on this assessment mop-up activities were collaborated in the provinces with the support of Federal EPI, Ministry of National Health services Regulations and Coordination, in terms of measles vaccine and logistics to provinces and federating areas for mitigating the measles outbreaks apart from the vaccines issued for Routine Immunization. Following risk assessment approximately 1 million children in Balochistan, around 2 million children in KP, over 1.4 million children in Punjab were vaccinated through outbreak response. Looking into the higher rate of disease burden in Sindh particularly in Karachi, mop-up campaign was conducted during the last quarter of 2017 vaccinating approximately 1.3 million children. The quality of Karachi campaign was appreciated by global partners as well. It is also pertinent to highlight that various reports are highlighting measles case load from Pakistan in comparison to EMRO region counties where reported burden of measles cases is less, it is worth mentioning that certain countries of the EMRO region are in fragile state facing instability and war like situation with negligible or non-reporting of Measles cases. The surveillance systems in these countries are not efficient enough to capture Measles cases. A few countries are not reporting measles cases at all in comparison to Pakistan where there is strong surveillance system. During the recent years various steps have been taken by the Government to strengthen disease surveillance in the country. Government has allocated resources for strengthening VPD surveillance in terms of hiring technical human resource, capacity building of the newly recruited staff along with refresher trainings of existing work force. Development of management information system including VPD surveillance has resulted in enhanced reporting of suspected cases, improved sample collection rate and laboratory confirmation of cases especially in Punjab and KP while Sindh and Balochistan are following the suit to improve VPD surveillance. As the vaccines require certain temperature for which the cold chain has been improved as per international standards and also certified by ISO 9001-2008. In this context the cold chain has been equipped with data loggers and end to end temperature mapping. Additional central temperature monitoring system has been installed across the country. For an accountable vaccine and cold chain management, an electronic system i.e. Vaccine logistics management information system (vLMIS) has been established and rolled out throughout the country. *-*-*-*-*-*-*-*-*-*-*
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