ISLAMABAD: In line with the recommendations of the Technical Advisory Group (TAG) on Polio, Pakistani health authorities have finally proposed bringing the Polio Eradication Initiative (PEI) and the Expanded Program on Immunisation (EPI) under one command to enhance immunisation efforts and accelerate polio eradication.
The proposal comes as alarming statistics reveal that over 60 per cent of the 73 children affected by polio last year were zero-dose children, meaning they had not received a single dose of routine immunisation.
Officials in the Ministry of National Health Services, Regulations, and Coordination told The News that the integration of these programs is being proposed to address the persistent gaps in immunisation coverage, particularly in high-risk areas where polio remains endemic. According to the proposal forwarded to Prime Minister Shehbaz Sharif, federal government has been advised to create a new leadership role that would oversee both the polio and routine immunisation programs.
The proposal includes the creation or re-designation of a Joint Secretary for Immunisation Services, who would be responsible for aligning PEI and EPI efforts, ensuring accountability, and improving coordination between different health sectors.
“The proposed joint secretary for immunisation services would report directly to the Secretary of MoNHSRC and oversee the National Coordinator for Polio Eradication Initiative (PEI) and the Director General of the Federal Directorate of Immunisation (EPI),” an official said, adding that this role is expected to enhance strategic planning, stakeholder engagement, and efficient resource mobilisation.
They said local and international health experts believe that combining PEI and EPI under a single command structure could streamline vaccination efforts, improve resource allocation, and ensure that more children receive life-saving vaccines.
TAG, which provides guidance on polio eradication strategies for Pakistan and Afghanistan, has repeatedly stressed the need to improve routine immunisation services alongside polio vaccination efforts.
In its latest meeting, TAG emphasised that a major hurdle in polio eradication is the large number of children who remain unimmunised against all preventable diseases. The group highlighted that strengthening EPI could significantly reduce the number of zero-dose children and, in turn, limit the spread of the poliovirus.
Dr. Jean-Marc Olivé, Chair of the TAG, has warned that while Pakistan has made progress in polio eradication, any delay in strengthening routine immunisation could allow the virus to persist.
He stressed that reaching underserved communities with both routine and polio vaccines is crucial to achieving a polio-free Pakistan. Health experts have long advocated for a holistic approach to immunisation in Pakistan. In a recent article published in The Lancet, Professor Zulfiqar Bhutta, a leading global health specialist, argued that a stronger focus on routine immunisation, alongside maternal and child healthcare services, is essential to eliminating polio.
He emphasised that fragmented vaccination efforts often lead to missed opportunities, especially in vulnerable and conflict-prone regions. Professor Bhutta’s research suggests that integrating PEI with EPI could help Pakistan not only eradicate polio but also improve overall child health by protecting against other vaccine-preventable diseases.
He highlighted that a well-coordinated immunisation strategy could prevent unnecessary deaths and disabilities while reducing the burden on healthcare facilities. Recognising the significance of this initiative, the government has established a high-level committee, led by Dr. Malik Mukhtar Ahmed Bharath, to evaluate the feasibility of merging PEI and EPI.
The committee will assess the potential benefits and challenges of this integration, ensuring that any changes align with Pakistan’s national health goals and global immunisation commitments.
