Robin Iqbal

In April 2019 a scaremongering video of children becoming unconscious after being administered polio vaccine in Badaber, Peshawer, appeared on social media nearly bringing the entire national immunization program to a grinding halt. Even more unnerving is to note that the perpetrator was a local school teacher. The video is a clear manifestation of the prevailing mindset of masses that greatly swaddles the success of such campaigns in our country.

The last mile for the vaccine i.e. from centralized distribution centres to sub district-level clinics, and finally to the patients, will certainly be strewn with myriad of challenges. Before the vaccine fights the deadly virus in Pakistan, it will have to face the people first.

Conspiracy theories against the existence of the coronavirus are still morbidly rampant in the country including the educated class. One doesn’t have to look far to hear notions like it being a manmade virus, designed to keep a check on global population –the government is killing its own people in the name of coronavirus as it brings foreign aid, they are denying the very existence of the virus altogether, etc. – the list goes on. Our public is by and large equally skeptic about the vaccine.

The likely impediments to the deployment are going to be, as is in the case of polio vaccine, firstly the general distrust against the vaccine. Many a time such programs have been labeled as being un-Islamic (haram) and designed to make the population sterile. Secondly, since the deployment of vaccine will inevitably require government partnering up with World Health Organization (WHO) and other such agencies, it is quite likely to be viewed as a foreign program, which implies an unsettling undercurrent of mistrust.

Thirdly, the inter-district or inter-city movement of people, for various reasons, might leave a certain number of people remaining unimmunized, willfully or otherwise. Additionally, the marginalized population in the country like the transgender and slum dwellers are likely to evade the authorities’ radar thus continuing the overhang of virus’ spread. Fourthly, the risk of substandard or altogether fake vaccine appearing in the market, a phenomenon not so novel in our part of the world, could potentially jeopardize the whole program. Circulation of any such vaccine could further fuel the underlying distrust and ultimately cost lives. The requisite technical wherewithal for deployment to the far-flung areas of the country like cold chain storages, etc., will prove to be a significant challenge in itself.

Equitable distribution of vaccine between provinces by federal authorities, or lack thereof, has a potential to give the situation a political angle. Furthermore, managerial and coordination issues at the level of city or district governments like shortage of staff, lack of inter-departmental liaison, etc., could also pose a serious impediment to the coronavirus vaccine deployment.

Lastly, post-immunization program, if not managed properly, could lead to a host of problems. Unsafe disposal of used syringes may lead to spread of other degenerative diseases like HIV, Hepatitis, etc. Environmental pollution may rise as a result of used pharmaceutical waste; an area in which our country is lagging behind at global level.

Therefore, sensitization of public will be a keystone of the entire immunization program; without public getting onboard, the policy is not likely to yield great dividends. Rigorous campaigning for education of masses at grass root level, in both print and electronic media, will be required in this regard. Awareness on programs like Covax and initiatives on similar lines as ‘Team Halo’ could prove to be highly beneficial.

Additionally, local clergy and tribal chieftains hold the power of swaying public opinion particularly in the rural areas. Making them an instrument of government’s policy, expounding the benefits of vaccination will play a key role. Equitable distribution of drugs between provinces based on headcount and priority of immunization will preclude any chances of political turmoil.

It will also be incredibly important to conduct the immunization program across the length and breadth of the country simultaneously. A robust week-long project, on the lines of general elections, will have to be conducted. A government directive, ensuring that both public and private sectors make their employs available for the vaccination must be issued. The government ought to update its database on the transgender and other marginalized members of the society lest they slip through the cracks.

Also, mass transit between districts and provinces will have to be halted for this period, in order to ensure that the entire population undergoes the program. The Drug Regulatory Authority of Pakistan (DRAP) will have to proactively work in order to keep a check on counterfeit vaccine. A helpline for easy reporting of such infractions should be established by DRAP. In order to avoid friction between managerial echelons, district level teams comprising representatives of public health experts, district health organizations, district management group, partnering agencies like WHO, etc., working under the auspices of Army will have to be formulated for a wholesome response. The inclusion of Army will not only help to overcome the shortfall in manpower faced by the district administration but will also lend credence to the efficacy of the vaccine itself.

Facilities for safe disposal of a monumentally large number of used syringes and associated paraphernalia will also have to be looked into. All in all, the light at the end of the tunnel has started to become visible. With so much already invested in procurement of the vaccine, both the society and government will have to play their part of role to make the campaign a success. The government would be well counseled to anticipate the challenges likely to be encountered beforehand, and start the remedial measures now.

(The writer is a freelance columnist)

Attiya Munawer

The political climate in the country continues to heat up and the intensity of political confrontation is gradually increasing. Then, the question arises as to what will be the outcome of the countryseemingly reachinga dead end due to the escalating confrontation between the government and the opposition, and how much irreparable damage will be done to national interests in this turmoil? This question has rightly worried every sensible and conscious Pakistani, with smoky rhetoric from both sides, in which every effort is being made to declare the opposing party hostile to the country and clearly incompetent and dishonest, is fueling the fire. In this war of words, the fact that the other side also represents millions of Pakistanis but it is not taken into account, while power is something to come or gone.

It is clear that the government is trying to stay in power and oust the opposition, while Prime Minister Imran Khan is proving lucky in that the opposition parties that wanted to oust the government through the movement have their own differences and contradictions. MaulanaFazal-ur-Rehman, head of the JamiatUlema-e-Islam, who is credited with uniting the opposition under the banner of the PDM, is facing a major uprising within his own party. MaulanaFazal-ur-Rehman says that all this is the result of government fabrications and conspiracies. He is right, but this is what happens in such cases. If the opposition wants to oust the government, then the government will use all sorts of tactics to thwart them. Maulana should have already dangled his sage as a precaution.

However, Maulana’s grip on his own party is strong and raising the banner of rebellion of these four gentlemen alone will not harm the party. The real problem is the differences within the opposition on various issues and not being on the same page. There is an ambiguity about the goals of the opposition that the desire to overthrow the present government is in place. Earlier, it was claimed that this government would step down in a month, but now there is a clear disagreement over the resignations, the Senate and the by-elections, and the timing of the resignations is also a matter of controversy. Most PML-N leaders say a decision on resignation or sit-in should be taken after the long march, while some opposition parties want to run in the by-elections and Senate elections, while expecting the PPP to resign and will come out of the Sindh government seems illusory, although Bilawal Bhutto has said that we are ready to make this sacrifice, but in the current situation it does not seem possible to do so in practice.

In the face of this situation, the government seems happy that the opposition movement is disintegrating with its own contradictions and that the PDM has broken the deadlock. In fact, the leaders of the opposition did not even consider the far-reaching motives of their strategy in the words of MaulanaFazal-ur-Rehman because Maulana is trying to run the PDM as a political party, even though it is an alliance of opposition parties in which each political party has its own point of view. Maulana himself, even thoughis not a Member of Parliament, is still holding on to their resignations and for other political parties, resigning is fine as far as claims are concerned, but in practice it is unworkable at a time when the government is stable. Although Maryam Nawaz has become quite an eagle and has gone too far on the instructions of her father based in London, it would be good for the anti-establishment figures to be relieved, but the Muslim League (N) concerns are being raised within, As far as Bilawal Bhutto Zardari is concerned, his zeal and enthusiasm are valuable, but the final decision will be made by his father Asif Ali Zardari and he will never throw his party into the fire of resignations.

At present, the country is in the throes of political chaos and speculation, the government and the opposition is taking over each other or politics is turning into animosity and confrontation. Getting out of this situation is the most important need of the hour for the betterment of the country. Both the government and the opposition should realize the deteriorating situation and come up with an appropriate and acceptable mechanism for their own interests, because the politics of siege and annihilation and walling off each other is not in the interest of the country and the nation. Leadership of political parties should prioritize democratic principles and public aspirations, not criticize each other for their own party, factional and personal interests. The people are watching the ongoing confrontation between their elected representatives in a world of frustration and surprise. The leadership of political parties should put democracy before individuals, because their mistakes have been the main reason for the bedrock of democracy, so learning from the past and choosing the right path for the present and the future is the primary responsibility of the political forces.

Twitter: @AttiyaMunawer