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[PESHAWAR] Authorities in Pakistan’s Khyber Pakhtunkhwa (KP) province and the adjacent Federally Administered Tribal Areas (FATA) are taking drastic measures to boost vaccination coverage following a steady rise in measles cases in these territories bordering Afghanistan.

"Deaths from measles rose to 44 in the third quarter (July-September) from 23 in the second quarter (April to June) and 18 in first quarter in KP," Muhammad Jamal, a doctor with the WHO’s expanded programme on immunisation, told SciDev.Net.

The total number of measles cases in these territories was 4,122 in the third quarter of 2012 (July-September) against 3,339. in the second (April-June) and 3,131 in the first (January-March), Jamal said. The combined population of the KP and the FATA is estimated to be around 25 million.

In the FATA – where vaccination coverage is a low 43 per cent against the national average of 73 per cent –  a total of 2,345 cases and 23 deaths were registered in the first quarter of the year against 4,298 cases and 28 deaths in the second and 4,921 cases and 42 deaths in the third.

Fawad Khan, director of health in the FATA, told SciDev.Net that the measles outbreak was because  "people didn’t take the idea of vaccination as a basic health requirement seriously and there was an overall lack of awareness of its importance."

Measles, a highly infectious viral disease mostly affecting children, produces cough, high fever and distinctive rashes as symptoms.

Lack of vaccination infrastructure, especially refrigeration for cold chain maintenance, was another issue in the FATA, a rural area with poor access to health services.  

"Frequent power breakdowns turn the vaccines ineffective," Khan said. "We have set aside US$ 4.2 million to purchase solar-powered refrigerators to ensure safe storage of vaccines." 

The problem has been exacerbated by an anti-vaccine campaign mounted by Taliban militants who spread the idea that immunisation programmes were part of a conspiracy hatched by the United States to render the local population infertile.

Secretary for health in the KP, Noorul Iman, said new policies  and strategies are now being adopted to encourage compliance. “Firstly, we have enlisted the support of the clergy in sending across the message through mosques that vaccination was the basic right of children.” 

"Secondly, we are incorporating amendments to the National Immunisation Act of 1958 to make immunisation compulsory for all children," Iman told "Parents will face jail terms if they refuse vaccination against any of ten vaccine-preventable childhood ailments."

Elias Durry, a senior coordinator with the WHO, said his agency was working with the government to scale up vaccination coverage in the KP and FATA.