As many as 15 disease surveillance systems in Pakistan have turned into white elephants of the Ministry of Health and diseases like polio, diarrhea, TB, malaria hepatitis and many others are consistently increasing. Disease surveillance is an epidemiological practice by which the spread of disease is monitored to establish patterns of progression. The main role of disease surveillance is to predict, observe and minimize the harm caused by epidemic and pandemic situations.
Dr Sania Nishtar, president, Heartfile, an NGO working on health sector, told Pakistan Today that currently there were around 15 disease information collection systems in place, inclusive of surveillance systems for acute respiratory infections, polio, bacterial meningitis, diarrhea, hepatitis, HIV/AIDS, malaria, measles and tuberculosis. In addition, there is the Disease Early Warning System (DEWS), the Expanded Program for Immunization System and the Health Management and Information System (HMIS).
She said: “Many of these surveillance systems are fragmented, dependent upon external donor support. Pakistan does not have an integrated disease surveillance system.” She was of the opinion that some surveillance systems were also antiquated and had not benefited adequately from technology. “For example HMIS, a nationwide system of collecting data from public first level facilities, had not been fully automated, so the potential that exists to influence Pakistan’s telecommunication boom and create a central computing facility for the public and private sectors remains untapped,” she said.
She said, “There is no agency clearly mandated for collecting, collating and consolidating and relaying information and data. Now that a new role for the Ministry of Health is being crafted in the post-18th Amendment scenario, due attention should be accorded to health information as one of its mandates. The cost of inattention could be enormous in the event of another outbreak of avian influenza in Asia.” On the other hand, one can easily evaluate the performance of Pakistan’s health sector as according to the Human Rights Commission of Pakistan (HRCP) during the last year 1,047,948 cases of tuberculosis were registered in the country.
There were over 18 million registered hepatitis patients. Over 1.6 million malaria cases, 143 cases of polio, over 7,000 patients were infected with the dengue virus and 31 people died of the disease whereas 114,000 patients of swine flu were reported in 2010. Over 97,400 HIV/AIDS cases had been diagnosed, while 5,000 AIDS patients had been registered.
An official in the Ministry of Health, seeking anonymity, told Pakistan Today that the data of these disease surveillance systems was not reliable as there was no mechanism to monitor, cross check or evaluate this data. He said there should be one unified disease surveillance system in Pakistan, including the representation of public and private health sectors as an infected person visiting a private hospital goes unnoticed by the surveillance system.
When contacted Director General Health Asad Hafiz, he said basically there were 14 surveillance systems functional all over Pakistan, but they were supposed to work as reporting mechanism. “It is true through unified surveillance system we can save our resources and the Ministry of Health is working on a proposal of ‘integrated disease surveillance system,” the DG health said.
