Aiming to achieve historic success by total eradication of polio from Pakistan, the government is intensifying schedule of supplementary immunisation activities to include four rounds of National Immunisation Days (NIDs) and four sub-national activities in 2008. The next campaign will commence from March 4. This was stated by the Extended Programme of Immunisation (EPI) manager, H.B. Memon, as he briefed the media persons here at an event organised by the United Nations Children Fund (Unicef). The strategy works in Pakistan, still one of the four countries globally that are still polio endemic, Mr Memon said. He said: "Before initiation of the programme the number of cases of polio was estimated to be about 25,000 to 30,000 a year. Some 230,000 children were saved from paralysis after NIDs were introduced in 1994. The number of cases dropped to 1,147 in 1997, 40 cases in 2006, 32 in 2007 and only two in 2008 (Nawabshah and Hyderabad).' Informing about the upcoming sub-national campaign, a total of 16.79 million children under five years of age would be targeted in 54 districts of the country. A total of 43,033 vaccination teams, 7,922 area supervisors and 1,296 zonal supervisors would participate in the campaign. The campaign activities will also be monitored by more than 500 national monitors. Stressing on increasing geographical restriction of wild polio virus, the EPI representative said the majority of districts had been polio free for almost two years. Sixty per cent of the cases in 2006 were from six districts only. There had been no cases from the Federally Administered Northern Areas (Fana) since 1998, Azad Jammu and Kashmir since 2000 or Islamabad since 2003. The vast majority of population, in both Pakistan and Afghanistan, lived in polio free areas, as wild polio virus transmission is currently focal in two main areas

With 1.67 million cases of malaria and around 1,000 deaths last year, the government has changed the drug policy and directed states from January this year to introduce the ACT (artesunate and sulpha pyrimethamine) combination as the first line of anti-malarial drug treatment in chloroquine-resistant areas. Dr G S Sonal, Joint Director, National Vector Borne Disease Control Programme (NVDCP), told The Indian Express that there has been concern over the increasing number of plasmodium falciparum (PF) cases of malaria. India contributes to 77 per cent cases of malaria in South East Asia. PF in the 70s amounted to less than 15 per cent of the malaria cases, but this has now gone up to 50 per cent of the total malaria cases. Moreover the dangerous PF has developed resistance to chloroquine in various parts of the country. Sixty-five per cent of cases of malaria in various pockets of Orissa, Madhya Pradesh, Chhattisgarh, Jharkhand and West Bengal are due to PF and drug resistance to chloroquine is high here. Chloroquine however is useful in states like Haryana, Punjab, Jammu and Kashmir and Himachal Pradesh. At least one million ACT course drugs will be supplied to the high endemic states. So far the government had supplied 20 crore tablets of chloroquine in the country. This quantum of drugs will be slightly reduced, Sonal said. According to Dr A P Dash, Director, National Institute of Malaria Research (NIMR), the PF species of malaria is spreading wider due to migration of population from endemic to non-endemic areas and drug sensitivity studies from various states have observed that there is resistance to the drug chloroquine - which is being used as the first line of treatment for malaria cases. The last time the policy was revised was in 2003. Vaccine for malaria Two sites have been selected for trial of a vaccine against malaria. Epidemiological and immunological data will be collected from the sites selected in Orissa and Madhya Pradesh to test the vaccine. The International Centre for Genetic Engineering and Biotechnology, Delhi, has developed the vaccine and will be tested at these two sites, Director, National Institute of Malaria Research Dr A P Dash said.

Alerted by the detection of two new polio cases in Sindh, the provincial Expanded Programme on Immunisation has decided to intensify its operation and conduct a three-day sub-national immunisation campaign, beginning on March 4, throughout the province. Sindh EPI project director Dr Salma Kauser Ali told Dawn on Tuesday that the federal EPI and the WHO had agreed to bear the additional operational cost and ensure supply of the vaccines needed for the extension of the supplementary immunisation campaign. "Earlier we had planned the administration of anti-poliovirus drops in children up to five in areas including northern Sindh and Karachi, but now the whole of Sindh, except for the desert parts of Umerkot, Tharparkar and Sanghar districts, will be covered under the campaign,' she said. Replying to a question, she said polio workers and officials in Karachi were faced with a serious challenge of being a high-risk area as a couple of its towns, including Korangi, were being considered as exporters of the polio virus. Sindh has made considerable progress in eliminating polio from its limits, but there are 5-10 per cent of the deserving children who have been missed out during the immunisation campaigns. "We plan to reach about 6.5 million children during the planned campaigns, but we also expect supports from the community so that effective vaccines are administered to children on time,' Dr Ali added. WHO polio-eradication team leader in Pakistan Dr Nima Saeed Abid has said that coordination between the health sector and other departments needed to be optimised for an improved surveillance of the polio virus in Sindh. Dr Abid, who heads a group of WHO medical officers engaged in the polio-eradication programme of Pakistan, recently attended a monthly surveillance meeting of Sindh in the city. Various heads of the surveillance system on polio at the district level made presentations and discussed issues such as detection of a case of polio in Hyderabad and another in Nawabshah, capability and sensitivity of the surveillance system to detect all cases, missing cases, reduction or elimination of the gaps in the surveillance system, compatible cases and reasons behind them. Dr Abid told health officials about the observations made at a meeting of the technical advisory group (TAG) on polio- eradication recently held in Egypt, saying that genetic characteristics of some isolated viruses and surveillance field reviews indicated sub-optimal quality in some districts. The TAG meeting also noted that there had been significant progress in social mobilisation, while the quality of management, particularly in planning and supervision in some districts in the high-risk areas and discord between the coverage figures and virus circulation were the two components of the polio-eradication programme which were not reaching acceptable standards. Talking to Dawn after the Karachi review meeting, Dr Abid said there had been lapses in the programme and it was high time that they were rectified on a top priority basis. Maintenance of vaccines quality at the optimum level was also required through proper vaccine management, he said, adding that efforts should also be made to create public demands about both routine and supplementary polio immunisation drops. He stressed the management at district levels to ensure fool-proof surveillance and support for the polio-eradication programme. "Strong political commitment should be translated into action at the delivery level,' he added.

Maverick physician Dr Dhani Ram Baruah today claimed to have invented a vaccine,

Brazil is battling an outbreak of yellow fever. The haemorrhagic illness, which is endemic to the region, has already killed eight people since the beginning of the year, the health ministry

india's National Polio Surveillance Programme reported 471 polio cases until December 14, 2007. Although this is lower than the 676 cases reported in 2006, there is reason for concern. There has

the Union ministry of health and family welfare has given the go-ahead for including an expensive vaccine into the country's immunisation programme despite the absence of scientific data. A meeting