Motivation as high as mountains in Pakistan to ensure typhoid conjugate vaccine introduction

We are familiar with mountains in Pakistan. Our country’s landscape includes the Karakoram, Himalayan, and Hindu Kush mountain ranges. We are home to the second highest mountain in the world, Dapsang (K-2), as well as Tirich Mir, the world’s highest mountain outside of the Himalayas-Karakoram range. We know that mountains are challenging to climb and often make the road ahead difficult to discern. Yet, the positive side is once that you’ve climbed a mountain, the view from the top is often remarkable.

The work to introduce typhoid conjugate vaccines (TCV) throughout Pakistan feels very much like climbing a mountain. When I think back to our initial footsteps—the first TCV introduction campaign in Sindh Province in November 2019—it feels as though we had just started our uphill journey for TCV introduction. We were energized, hopeful, and focused on the road ahead as Pakistan led the world with the first ever national TCV introduction campaign.

Just months later, by early 2020, our voyage became infinitely more difficult. The world was quickly subsumed by an unclimbed mountain, COVID-19, and our focus shifted to the very basic protections of staying safe as health experts worked tirelessly to better understand the emerging pandemic. Pakistan, like nearly all countries, postponed vaccination campaigns, unsure if and how we could continue to safely reach children during the pandemic.

Unfortunately, typhoid and other infectious diseases did not stop when COVID-19 hit; we quickly saw surges of preventable diseases, including measles and polio, where vaccines lagged. In Pakistan, where drug-resistant typhoid is a growing concern, the potential for increased numbers of resistant cases was worrying, especially as the health system stretched to accommodate those falling ill with COVID-19, leaving little room for those needing care for other illnesses.

As the Government of Pakistan successfully managed the COVID-19 situation and learned how other vaccination campaigns could be carried out safely, the focus of EPI Pakistan remained on being proactive and multitasking; with the proper precautions to ensure healthcare worker, vaccinator, and community safety, we resumed vaccination campaigns. In February 2021, just four months ago, we carried out the second phase of the TCV campaign and successfully reached more than 13 million children in 12 districts of Punjab Province and the capital city, Islamabad. This was the first TCV campaign during COVID-19 and signaled the commitment of the Pakistani government to ensure children are protected against preventable diseases, including typhoid.

Moving ahead with our journey, today represents a remarkable accomplishment for our country as we kick off the third phase of TCV introduction in Pakistan. For the next two weeks, children in the remaining 24 districts of Punjab Province will be reached with TCV, offering protection against this potentially deadly disease. As we work to protect children against typhoid and other infectious diseases, we invest in their futures and the future of our country. We keep children healthy and in school, sparing families the economic toll that often comes with diagnosis and treatment for a disease such as typhoid. And in this time of our health system being stretched to accommodate COVID-19, protecting children against typhoid alleviates this burden on the health system.

During the past year we have faced a massive challenge, and yet during this challenging time, our commitment to the children of Pakistan has been unwavering. Together, we have successfully achieved our objective, working together, making strategic and calculated decisions to ensure that we prioritize urgent health needs even while COVID-19 rages.

There will undoubtedly be more summits to conquer in the future, but today we celebrate this milestone. We celebrate the collaboration and collective effort that brought us to this day, as well as the perseverance and dedication of so many, including health care workers, vaccinators, and community leaders. And we celebrate the children being protected against typhoid, their future bright as they become adults and leaders ready to tackle the new mountains ahead.

Photo courtesy of ©PHC Global.