THE ALARMING RESURGENCE OF DIPHTHERIA IN PAKISTAN: A WAKE-UP CALL

Abstract

Post COVID era, Pakistan has witnessed a concerning resurgence of diphtheria¹, a potentially deadly but vaccine preventable disease.² Global public health efforts has once succeeded in nearly eliminating this disease, however this re-emergence emphasizes upon the importance of continuous commitment to vaccination efforts and stringent public health policies. The resurgence of diphtheria in Pakistan demands urgent attention from policymakers, healthcare professionals, and the public at large.

Recent data indicates a distressing increase in diphtheria cases across the country.^1,2 Factors contributing to this resurgence may include lapses in vaccination coverage specially during the COVID pandemic, weakened healthcare infrastructure, and challenges in reaching remote or underserved populations. Additionally unvaccinated immigrant influx has contributed to sporadic outbreaks in the country.

As per unofficial reports, more than hundred clinical cases of diphtheria have been treated at hospitals during the last year.³ There may be multiple contributing factors to this rise of diphtheria cases. As seen in other vaccine preventable disease resurgences, one of the primary factors attributed to the resurgence of diphtheria may be a decline in vaccination coverage. In the population currently affected, this decline may be due to a combination of factors, including vaccine hesitancy, limited access to healthcare facilities, misinformation and difficulty in vaccine availability during COVID-19 era. A very active awareness campaign to educate communities about the importance of vaccination and improve accessibility to healthcare services must be prioritized. To encourage vaccination, public must be made cognizant of the grave consequences associated with diphtheria complications.⁴

A persistent factor for all communicable diseases in resources limited countries such as Pakistan is weakened healthcare infrastructure, particularly in rural and underserved areas. Due to an inadequate health budget, the country faces challenges like insufficient resources, shortage of healthcare workers, and inadequate facilities hinder the delivery of essential health services, including immunization. Strengthening healthcare infrastructure, particularly in remote regions, is critical to effectively combat diphtheria.⁵

A significant barrier to effective vaccination efforts is the hindrance in reaching remote areas either due to transportation or due to aggressive resistance from locals.⁶ Secure mobile clinics, use of innovative approaches like telemarketing and social media can play a vital role in achieving our goal.⁷

Encouragement can be provided to the general public with a concerted effort to combat misinformation and build their trust in vaccination. Using religious and other famous public figures to aid our cause by educating communities about the safety and efficacy of vaccines is essential in dispelling myths and misconceptions. Public awareness campaigns, led by healthcare professionals and supported by community leaders, can serve as powerful tools in this endeavor.⁸

The resurgence of diphtheria in Pakistan is an alarming situation and needs to be addressed actively. This requires a committed multi-faceted approach, including improving vaccination coverage, strengthening healthcare infrastructure, and enhancing public awareness. Swift and sustained action from policymakers, healthcare professionals, and communities is essential to combat this concerning trend and protect the health and well-being of the nation.

This resurgence is a reminder that constant vigilance even after elimination of outbreaks is the key to keep vaccine preventable diseases at bay.