Freezing cold in Pakistan, with a heart-warming story to tell

EPI officials, GAVI's Deputy CEO Helen Evans and Mir Hazar Khan Bijaroni, Minister of the Inter-Provincial Committee, talk about Pakistan's rollout of the pneumococcal vaccine.

I never expected to be so cold in Pakistan in October that I wished I’d brought my fleece. But as I stood in the sub-zero temperatures of Islamabad’s vaccine storage room, surrounded by hundreds of thousands, if not millions, of doses of pneumococcal conjugate vaccines (PCV), I wouldn’t have wanted to be anywhere else.

The introduction of pneumococcal vaccines has the potential to save many thousands of lives, drastically reducing Pakistan’s under-five mortality rate. Today I was privileged enough to have an inside view as the process of vaccinating Pakistani children with PCV started in the national capital.

The PCV vaccine is a complex, conjugate vaccine that has, until now, proved prohibitively expensive to the average Pakistani family, many of whom have seen firsthand the terrible effect of pneumonia on babies and small children. Now, with GAVI support, Pakistan aims to introduce pneumococcal vaccine across the country, hopefully vaccinating the country’s entire annual birth cohort of 4.8 million each year from 2015.

As I walked out of the cold room into the stifling heat, I was reminded of the challenges the Government and its partners face in meeting this objective.

Because of its complexity, PCV must be handled with care. It must be stored at a low temperature, between two and eight degrees centigrade, and used within six hours of opening.

These practical issues underline why GAVI has funded an overhaul of Pakistan’s cold chain, to ensure vaccines are stored and transported at the correct temperature, and paid for training for 100,000 female health workers who will vaccinate children in urban and rural communities.

It is hard to comprehend the sense of relief that parents across Pakistan will feel when their children are vaccinated against pneumococcal disease as a result of this work.

Sadly, more than 400,000 children in Pakistan die before their fifth birthday each year. Pneumonia, which is often caused by pneumococcal disease, accounts for one fifth of these deaths. By choosing to work with GAVI through co-financing (paying a proportion of the cost of each dose of PCV) and vaccinate millions of its children against pneumococcal disease, Pakistan is making an investment in its future.

An ambitious target? Yes. One worth pursuing? Absolutely.