Pakistan - ReliefWeb News
The information presented in the document is based on the most recent and best available data at the time of publication. The EOC may update and, where necessary, modify the analysis and data in order to ensure the most current and accurate perspective is available to all.
Pakistan and Afghanistan remain the last nations in the world known to have wild poliovirus (WPV). In the past year, Pakistan took giants strides towards closing the immunity gap and interrupting transmission. This can be seen by a number of different indicators.
First, the number of con rmed wild poliovirus (WPV) cases in Pakistan has declined by 82%: from the 306 con rmed cases seen during the outbreak of 2014 to 54 cases in 2015, and it continues to decline in 2016 (Figure 1). With only 13 confirmed cases reported as of June 2016, this year represents a 59% decline in case count compared to a similar period in 2015 (Figure 2).
Second, the country observed a decrease in the proportion of environmental specimens confirmed for WPV: from 35% in 2014 to 20% in 2015, and now that proportion stands at 10% in the first half of 2016.
Third, Pakistan saw a reduction of circulating genetic clusters—from 16 in 2014 to eight in 2015—indicating reduced genetic diversity. Deeper analysis of genetic variations of viruses has shown that, for the first time ever, WPV1 genetic diversity fell during the 2015 high season. In previous years it had risen, sometimes sharply, as the high season progressed. Now, as of June 2016, only three clusters were identified.
Fourth, the proportion of non-polio acute accid paralysis (NPAFP) cases in children between 6 months and ve years of age who reported as ‘zero’-OPV dose has declined from 24% in 2014, to 4% in 2015, and now 2% as of June 2016.
This progress was achieved through dogged pursuit of a one-month, one-bOPV campaign strategy throughout the low season. At the heart of Pakistan’s vaccination efforts was a dedicated and uncompromising focus on improved microplanning and aggressive same-day follow-up of recorded missed children. Improving the performance of frontline workers (FLWs) was a cornerstone of last year’s performance improvement plan, with noticeable impact to morale and motivation. Over the course of the low season, the programme reduced the proportion of “no teams” among recorded missed children in third-party post-campaign monitoring: from a peak of 52% in the November NID, to 18% in the May NID. This can be partly attributed to the diligent effort of many to improve the timeliness of payments to FLWs: over the course of the low season, 81% of districts paid their FLWs within one month of the start of the campaign.
The major paradigm shifts in the 2015 - 2016 NEAP from “coverage” to “no missed children” has driven programme operations with very encouraging results. The proportion of recorded missed children remaining unvaccinated at the end of each campaign was between 3% and 4% throughout 2016, decreasing from approximately 7% over a similar period last year (Figure 3). Except for the October SNID and May NID, the quality of the campaigns at the national level (as measured by third-party independent monitoring) has remained above the NEAP target of >90% (Figure 4). However, performance varied from province to province: Punjab met the NEAP target in all nine campaigns, Khyber Pakhtunkhwa and FATA in eight of nine campaigns, Sindh in seven of nine campaigns, and Balochistan in four of nine campaigns (Figure 4).
Additionally, in the high-risk Union Councils (UCs) of the most important districts, the implementation of a Community-Based Vaccination (CBV) strategy has provided the programme with an edge when it comes to delivering high-quality vaccinations in areas of most concern. As of the end of May 2016, there were 10,995 Community Health Workers vaccinating children in 472 Union Councils. The result has been an increase in the overall quality of campaigns to levels that were unprecedented in these Union Councils. This is evident in the trend of performance improvement observed in lot quality assurance sampling (LQAS) results from high-risk UCs (Figures 5 and 6).
In our efforts to use every tool available to nudge up immunity levels and stop persistent transmission in the core reservoirs, the programme carried out an aggressive combined bOPV/IPV campaign. Over the course of the low season, 1.2 million children between 4 months and 23 months received IPV vaccines, with 1.7 million children under 5 years of age receiving bOPV at the same time. Almost all IPV vaccines delivered to Pakistan for SIAs and routine immunisation have been—and are being—used. As measured by LQAS, the proportion of Union Councils in the core reservoirs obtaining an estimated coverage of 80% or more reached 100% in Khyber agency, 85% in Peshawar, 70% in Quetta Block and 51% in Karachi.
The programme has recognised the importance of reaching and vaccinating children in transit during SIAs, as well as reaching and vaccinating children in highly mobile migratory, nomadic or internally displaced populations. From January to April 2016, a total of 9.4 million children were vaccinated at Permanent Transit Points (PTPs). The proportion of ‘zero’-OPV dose children vaccinated in April and May was 0.8%.
The programme has made tremendous progress in ensuring careful monitoring of performance. Tools used for pre-campaign, intra-campaign, and post-campaign monitoring (PCM) have been standardized. Post campaign LQAS monitoring has expanded with the number of UCs assessed each round, which increased from 265 in January 2015 to 536 in January 2016. Equally important, pre- and intra-campaign monitoring has been expanded with the provision of real-time data to provinces and districts so course correction can be taken even before the completion of the campaign in question.
Underpinning all programmatic activity has been sustained Government commitment and oversight at every level. The Prime Minister’s continued direct oversight and active involvement through the National Task Force (NTF) and the Prime Minister’s Focus Group (PMFG) allowed the programme to heighten oversight and encourage accountability everywhere. Key oversight bodies are functioning well with strong leadership from senior Government Of cials and Ministers. Divisional Task Forces have emerged as crucial for oversight in key areas. Through the implementation of an Accountability and Performance Management Framework, the Government and its partners have ensured that “accountability at all levels” becomes a guiding principle throughout the programme. This has resulted in the rewarding of good performance and, where necessary, the active removal of underperforming senior governmental or partnership staff from positions of authority.
Yet despite these efforts, the virus remains in a few areas—speci cally, the core reservoirs that have sustained the infection for many years and periodically reseed the virus across the country.
In this National Emergency Action Plan (NEAP) for 2016 - 2017, the main objective is to stop transmission in the core reservoirs and maintain or increase population immunity against polio in the rest of the country. To achieve this, the programme has set up a multi-pronged strategy with a well-developed work plan to ensure all children are vaccinated and any circulating virus is detected quickly and responded to immediately.
In the NEAP 2016 - 2017, the programme will:
Conduct 5 NIDs and 4 SNIDs with remaining unvaccinated children <2% of recorded missed children that are not socially and geographically clustered, reaching 95% coverage by third- party post-campaign monitoring (PCM) and achieving a lot quality assurance sampling (LQAS) pass rate of ≥90%
Implement a combined bOPV/IPV campaign in Tier 1 districts and as many Tier 2 districts as possible, depending on IPV vaccine availability
Expand community-based vaccination (CBV) to 100% of Union Councils in Khyber, Peshawar, Quetta, Killa Abdullah, and Pishin, and ≥60% of the target population in Karachi
Focus on improving the quality of campaigns in Union Councils using mobile team strategy in Tier 1, Tier 2, and Tier 3 districts, with the aim of achieving and surpassing all key performance indicators
Improve routine immunisation service delivery in Union Councils bene tting from CBV, as measured by an IPV-1 coverage rate for infants raised to ≥80%. This too will be subject to adequate vaccine availability
Boost surveillance sensitivity by shifting the focus of the surveillance system from measuring “targets achieved” to monitoring, reporting on, and minimizing “AFP cases unreported” and “missed transmission.” Through this recalibrated strategy, the programme will improve the capacity and reach of its surveillance system and effectively transform from a polio programme to a “surveillance system for eradication”
The goal is simple and ambitious: stop polio transmission in Pakistan by the end of 2016.
The next opportunity to make progress on that goal arrives on the 25 July 2016, when the rst campaign of the new NEAP will be held.
International Development Secretary announces new focus on disability on International Day for People with Disabilities
The UK will lead a step-change in the world’s efforts to end extreme poverty by pushing disability up the global development agenda, International Development Secretary Priti Patel has announced.
To mark International Day for People with Disabilities (3 December) Ms Patel is calling on partners to do more to prioritise reaching the poorest and most excluded by ensuring people with disabilities are not being left behind.
The International Development Secretary will give her first keynote speech on disability next week at a Bond event to celebrate the International Day.
In her speech Ms Patel will set out how people with disabilities will be systematically and consistently included in the work the Department for International Development (DFID) is supporting in developing countries.
This builds on the commitment put forward in the Bilateral Development Review 2016, for DFID to become a global leader on disability.
Speaking on International Day for People with Disabilities the International Development Secretary Priti Patel said:
More than one billion people are living with disabilities globally - 80% of whom live in developing countries.
These are some of the most excluded people in the world, often locked out of education, jobs, and overlooked by decision-makers.
I am determined to establish DFID as the global leader in this neglected and under prioritised area – people with disabilities must be at the heart of our work to build a more prosperous and secure future, which is in all of our interests.
I will be working with governments, NGOs, multilaterals, businesses and individuals to ensure that nobody is left behind.
DFID’s focus areas on disability will include:
- upholding our commitment to the United Nations Convention on the Rights of Persons with Disabilities to ensure people with disabilities systematically benefit from international aid and humanitarian assistance;
- ensuring people with disabilities access a quality education and productive employment;
- working with national governments and the private sector to ensure people with disabilities no longer face stigma and discrimination;
- continuing to prevent avoidable disability, for example through our work on health system strengthening and the control of neglected tropical diseases such as lymphatic filariasis and trachoma; and
- pushing partners to collect crucial data to improve our understanding of disability in development, increase their internal expertise on disability; and design programmes that prioritise and deliver results for people with disabilities.
This builds on DFID’s existing work to support people living with disabilities in developing countries access work opportunities and schooling, and access the rehabilitative care they need:
- In Pakistan DFID is helping children with mild to moderate disabilities attend mainstream schools.
- DFID’s investment in Ghana’s mental health system has delivered impressive results – training over 3,867 health care workers and we are helping to erode the deeply-rooted stigmas associated with mental ill health.
- Through work with Leonard Cheshire, DFID is leading African universities and others on research to understand, and find solutions to, the barriers people with disabilities in Kenya, Sierra Leone, Uganda and Zambia face when accessing health services, education, employment and social protection.
The UK is also redoubling efforts to halve the disability employment gap in the UK through the Work and Health Green Paper.
FOOD SECURITY SNAPSHOT
Favourable prospects for 2017 wheat crop production
Above-average production for 2016 summer cereal crops estimated
Rice exports expected to increase in 2016
Prices of wheat and wheat flour strengthened in recent months
Localized food insecurity persists
Favourable prospects for 2017 wheat crop production
Planting of the 2017, mostly irrigated, ‘’rabi’’ (winter) wheat crop is currently underway and will continue until mid-December. Near-average irrigation water supplies in the main wheat-growing areas of Punjab and Sindh provinces are benefitting plantings and early crop development in these areas. However, below-normal rains hindered planting operations in the minor rainfed-producing ‘’barani areas’’, located in the northern parts of Punjab Province.
Current official forecasts put the 2017 wheat output at a record level of 26 million tonnes, 2 percent up from the 2016 bumper output. This forecast rests on expectations that adequate water availability in the main reservoirs will boost plantings, while the good supply of quality seeds, fertilizers and herbicides will increase average yields.
Above-average 2016 summer cereal crops estimated
Harvesting of the 2016 summer (monsoon) season maize and rice crops is almost complete. FAO estimates the 2016 paddy and maize outputs at 10.3 million tonnes and 5.2 million tonnes, respectively, slightly above the previous year’s production. This result follows generally favourable weather conditions during the cropping season, coupled with an adequate water supply for irrigation and good access to fertilizers and other basic inputs.
Rice exports to increase in 2016
FAO forecasts rice exports in 2016 at 4.4 million tonnes, representing a 7 percent increase from the 2015 level, thanks to competitively priced non-basmati supplies.
Wheat exports in the 2016/17 marketing year (May/April) are forecast to increase from the previous year’s low level to 800 000 tonnes, in line with the 2016 overall good output and large carryover stocks.
Prices of wheat and wheat flour strengthened in recent months
Prices of wheat and wheat flour, the country’s main staples, have strengthened in recent months, following seasonal patterns, but remained below their year-earlier levels owing to good availabilities following a bumper 2016 crop.
Food security conditions overall stable but concerns remain in Tharparkar District and northern Pakistan
Overall, the food supply situation is stable following two consecutive years of good harvests and large carryover stocks of the main staples. However, food security concerns remain in some areas, particularly in Tharparkar District and northern Pakistan.
In Tharparkar District (southeastern Sindh Province) and the surrounding areas of Sindh Province, a below-average drought-affected cereal production for the third consecutive year, coupled with losses of small animals, especially sheep and goats, has aggravated food insecurity and caused acute malnutrition.
Food insecurity has been exacerbated by the lingering negative impact of the 2015 floods; the provinces of Sindh, Punjab and Khyber Pakhtunkhwa were most affected. Official assessments reported the loss of lives and severe damage to housing, infrastructure and agriculture. Households in northern parts of the country have also not fully recovered from the impact of the earthquake in October 2015.
The Federally Administered Tribal Areas (FATA) and Khyber Pakhtunkhwa, located in northern Pakistan, are still affected by the return process after the large scale displacement (312 000 families or around 1.9 million people) due to insurgency in FATA. According to OCHA estimates, as of October 2016, over 1.3 million refugees remained displaced in northern Pakistan. These populations rely mainly on humanitarian assistance, including food aid, healthcare and other necessities.
Told rains won't come, some wheat farmers have switched crops - and are on track to avoid losses
By Saleem Shaikh and Sughra Tunio
RAWAT, Pakistan, Dec 2 (Thomson Reuters Foundation) - Like his farming neighbours, Bilal Khan plants wheat in late October or early November each year, and harvests and sells his winter crop a few months later.
But this year, there are no wheat stalks are to be seen on his 3 hectares (5 acres) of land in Rawat, a town some 12 miles (20 km) from Islamabad, Pakistan's capital.
Instead, Khan is growing onions, potatoes, cauliflower, cabbage and carrots.
In late October, the Pakistan Meteorological Department informed Khan and other farmers that no rain was forecast for the crucial wheat-growing months of November and December in parts of northern Pakistan that rely solely on rain-fed agriculture.
The warning was one of the first of its kind from Pakistan's weather service, aimed at helping farmers look ahead months, rather than just days, and plan for crops more likely to survive drought.
"As advised by the weatherman on the radio, I exercised caution and opted for vegetable cultivation, it being less water-intensive," Khan said. He is irrigating his crops with water drawn from a nearby pond.
Winter rains are usually reliable in this region - but already those who did not heed the weather forecast are regretting their decision, as they watch the wheat they planted fail.
Muhammad Khan spent $2,000 on wheat seed which he finished sowing on Nov. 7 on his family's 4-acre farm in Ghool, a village about 90 km southeast of Islamabad.
His nights have been sleepless since he noticed the seeds growing abnormally slowly.
The wheat plants were only 3 inches tall by Nov. 21, rather than the 12 inches he would have expected.
"Even if rains come in January and February, the wheat output would be less than 50 percent" of normal, because the grain heads will be underdeveloped, Khan predicted.
Slow growth makes the crop vulnerable in other ways too. Karaim Nawab, a wheat farmer in Gujar Khan, said if wheat doesn't grow strongly enough to properly grip the soil, the plants are at risk of being flattened if there are heavy winds later in the season.
Wheat is grown on around 9 million hectares (22 million acres) of land in Pakistan, 30 percent of which is rain-fed. Around 25 million tonnes of the crop are produced annually across the country. The Potohar plateau in the northeast, where Islamabad and its surrounding area are located, produces 3 million tonnes.
EL NINO INFLUENCE
Farmers usually finish sowing wheat by mid-November and, under normal circumstances, two rainy spells in November and December drench the fields, allowing the seeds to germinate. The harvest begins in April.
This year, things are different. Ghulam Rasul, director-general of the Meteorological Department, said the winter drought appears to be the result of an unusual high pressure zone over Central Asia that has driven rain clouds over northern Pakistan and beyond without letting rain fall.
Rasul says the drought is a consequence of the El Niño phenomenon, but that the effects are much harsher now than the last time the weather phenomenon affected Pakistan, in 2009. The most recent El Niño has also caused severe droughts in Africa and devastating floods in Asia-Pacific countries.
The winter drought comes on the heels of a monsoon that receded in early September, almost three weeks earlier than expected.
Apart from holding back the onset of winter rains across Pakistan, El Niño is also causing large fluctuations between day and night-time temperatures, Rasul added - another headache for farmers.
Muhammad Tariq, director of the state-owned Rain-fed Agriculture Research Institute in Chakwal, said wheat requires temperatures of 21 to 25 degrees Celsius for effective germination.
"This winter, during the peak wheat-sowing months of October and November, the temperature remained around 30 degrees," he said.
The unusually high temperatures have forced farmers to delay wheat sowing in Islamabad and its suburban areas such as Rawat, Gujar Khan, Taxila, Attock and Rawalpindi.
"Although drought-tolerant wheat varieties have been introduced in the rain-fed areas, these varieties also need water," Tariq said.
In Rawat, Bilal Khan is confident his vegetables will sell quickly when he takes them to market in February and March. He predicts he will make as much money as he would have from a wheat crop.
"The forecast has been a big help as it has saved my investment of almost $3,000 going down the drain had I cultivated wheat this time," he said. (Reporting by Saleem Shaikh and Sughra Tunio, editing by James Baer, Megan Rowling and Laurie Goering; Please credit Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers humanitarian news, women's rights, corruption and climate change. Visit news.trust.org)
Pakistan: Pakistan: Afghan Refugees and Undocumented Afghans Repatriation (1 January to 26 November, 2016)
UNHCR Voluntary Repatriation Centre in KP continued to process scheduled families only. Repatriation of registered refugees to Afghanistan decreased by 66% during the week of 20 - 26 Nov. compared to the previous week. The Voluntary Repatriation Centre is expected to stop processing from 1 December. According to IOM, the return of undocumented Afghans also decreased by 18% from the previous week’s total of 5,056.
World: Frontiers of CLTS: Innovations and Insights - CLTS in Post-Emergency and Fragile States Settings
This issue of Frontiers of CLTS explores the potential, and some of the recorded learning, on how CLTS, as a community-based, collaborative approach to sanitation behavioural change, can be applied successfully in contexts of fragility and displacement, leading to communities more convinced and prepared to maintain and develop safe sanitation practices.
561 Meeting of the Strategic Advisory Group of Experts on immunization, October 2016 – conclusions and recommendations
583 Monthly report on dracunculiasis cases, January– October 2016
561 Réunion du Groupe stratégique consultatif d’experts sur la vaccination, octobre 2016 – conclusions et recommandations
583 Rapport mensuel des cas de dracunculose, janvieroctobre 2016
PESHAWAR: The district administration has claimed to have reduced refusal cases by parents against polio vaccination amid complaints by health workers that they are forced by people to show their children as ‘vaccinated’ in the record without administering them the vaccine.
“In this way the parents, who don’t want to give oral polio vaccine to their children, avoid arrest by police. The workers also apply blue ink on the small finger of left hand of the child out of fear. Finger-marking is the only evidence to determine if a person is vaccinated but in the process refusal prevails,” health workers told Dawn.
They said that parents managed to remain unnoticed by the administration despite refusing OPV to their children. “Recently, a person aimed a pistol at a health worker, who was trying to vaccinate children in Yakatoot. The man was opposed to OPV and didn’t want to immunise his child,” they added.
The health workers said that it created fear among the vaccinators as they were being warned by parents in case they were booked under the MPO on their complaints.
“We are looking after polio campaigns and refusals and covering missed and inaccessible children through involvement of community. Last year, Peshawar had 10,000 refusal cases which have now been reduced to less than 1,000,” Shahid Mahmood, the additional deputy commissioner of Peshawar, told Dawn.
He said that they focused on Shaheen Muslim Town where environmental sample collected from sewerage of 17 union councils had been tested positive for poliovirus.
“The district administration closely watches polio drives and obtains reports about children from the field workers. We deploy teams to convince parents to administer anti-polio drops to their children,” said the official.
He said that committees formed by the administration were consisted of religious scholars, elected people from the community and health officials, who met the parents to woo them in the light of Islam about the significance of vaccination and address other misconceptions held by people about vaccination.
“Causes of refusing vaccines are different and we employ different tactics to prevail upon them that OPV is meant to protect their children against poliomyelitis,” said Mr Mahmood.
He said that they were close to end refusals by parents completely and eradicate the poliovirus from the province by end of the current year. “Our workers remain in the field for 28 days to ensure that all children get vaccinated,” he said.
The official said that in the November’s anti-polio campaign, no one was arrested. He said that administration ordered arrest of 70 parents, who refused to vaccinate their children. They were freed soon when they got their children vaccinated, he said.
“During the last campaign, we vaccinated above 100 children, who remained inoculated in the past one and half year,” said the official.
Sources said that community-based approach paid off because health department had not been able to deal with refusal against OPV. They said that the province recorded 30,000 refusal cases and 100, 000 children remained inaccessible that posed threats to 5.6 million immunised children in Khyber Pakhtunkhwa.
“Anyone reported as ‘refusal’ is arrested by police to establish writ of government. We are dealing with people for threatening health workers,” said the deputy commissioner of a southern district.
He said that polio programme was run by government and the parents were bound to administer vaccines to their children. “Use of force can also enrage people, therefore, a professional approach has been adopted by the district administration in the province to cope with the people, who oppose polio eradication campaign by showing complete defiance,” he added.
Published in Dawn, December 1st, 2016
SYED ALI SHAH
There are more than 600 people in Balochistan who are registered as HIV/Aids patients with the number of non-registered patients deemed to be more alarming.
The number of non-registered patients is more alarming," said Dr. Noor Qazi, Chief of Balochistan Aids Control Program.
Qazi was speaking at an event held in Quetta to mark the World Aids Day 2016.
The program has registered 638 HIV/Aids patients belonging to various parts of the province so far, of which only 407 are getting medicines regularly, Qazi added.
Most of the patients registered by the programme belong to the Makran and Zhob divisions of the province.
Many of the them live in Gulf and other countries, Qazi revealed.
"A lot of them are also suffering from drug addiction and are also incarcerated."
"Patients inside prisons are a matter of serious concern," said the chief of the provincial Aids program.
Additionally, the programme head said a large number of coal miners are also suffering from Aids but are refusing treatment.
Balochistan health department has also established two Aids control centres in Quetta and Turbat in order to provide treatment to patients suffering from the disease.
"Only precaution can protect people from catching this disease," Dr KD Usmani, head of the Quetta AIDS control centre, said, adding a lot needs to be done to create awareness about the illness.
SYED ALI SHAH
Around 16,000 children were not provided polio vaccine during the recent campaign in October in Balochistan, Chief of Emergency Operation Cell (EOC) Syed Faisal Ahmed told DawnNews.
According to Emergency Operation Cell's data, around 16,000 kids below the age of five year remained deprived of polio vaccine
About 11,000 children could not be provided polio vaccine because they were not at home during the campaign during the campaign conducted in October this year in Balochistan.
"Approximately 5,000 children were not able to get polio vaccine as their parents refused to get them vaccinated for polio virus. Among them 30-40 per cent people refused polio vaccine for their kids on religious basis," said Faisal Ahmed.
Faisal Ahmed further informed that more than 2.4 million children below the age of five years were provided polio vaccine in Balochistan during the campaign.
The Balochistan government had formed committees on district level to convince the parents for provision of polio drops to their children and address the issue of chronic refusals. The committees comprise of religious scholars and people belonging to various walks of life.
In Balochistan, this year only one polio case has been reported from Quetta. However, last year seven cases were reported in the province. Most of the cases are reported in Quetta block comprising Pishin and Killa Abdullah.
PESHAWAR: While putting the number of HIV/AIDS cases in the country at around 97,400, health minister Shahram Khan Tarakai on Wednesday said his government would continue supporting such patients in their treatment and rehabilitation.
He told reporters at the Peshawar Press Club that his department was ensuring provision of free antiretroviral medicines and testing facilities to patients at two HIV centres in Peshawar and Kohat districts.
The minister said the department had got Rs500 million in the last provincial Annual Development Programme to launch a mega project for the control of HIV, hepatitis and thalassaemia.
He said the money was being used to develop infrastructure and human resources, logistics, procurement of equipment, and provision of laboratory facilities.
Minister promises continued support for such patients
Mr. Tarakai said the government had planned to establish healthcare centres and laboratories in every divisional headquarters in near future to provide HIV/Aids screening, advocacy and counseling to control the serious disease.
He said the country had around 16,000 HIV patients with 2,584 registered in Hayatabad Medical Complex Peshawar and Kohat Hospital and 485 in the Federally Administrated Tribal Areas. The minister said around 1,450 HIV patients were under treatment. He said 235 HIV cases were foreigners, mostly Afghan refugees.
Mr. Tarakai said a recent survey put the number of unregistered HIV/Aids patients at around 0.1 million, including 16,000 from KP.
He said the health department was in contact with the prison department for the treatment of prisoners suffering from HIV and that the government had allocated Rs7 million for the purpose.
The minister urged society at large to fully cooperate with HIV/Aids patients in leading a normal life instead of stigmatising them. He said patients should inform doctors about the disease, which didn’t necessarily spread through unlawful sex and rather, it was caused mostly by transfusion of untested blood and contaminated injections.
Mr. Tarakai said HIV had affected 35 million people around the world.
He said according a survey conducted in 2011, Pakistan was in a concentrated phase of HIV epidemic.
“HIV is concentrated among certain population groups including injecting drug users 27.2 per cent, transgender persons 7.2 per cent, male sex workers 1.6 per cent and female sex workers 0.6 per cent. HIV prevalence among general population is still below 0.1 per cent,” he said.
The minister said according the latest HIV estimates, there were around 97,400 HIV/AIDS cases in the country. He said the people registered with the National AIDS Control Programme for HIV treatment across the country totaled around 14,500 necessitating measures to address the disease.
Published in Dawn, December 1st, 2016
In West Africa, regional staple food production during the 2016/17 marketing year is expected to be similar to 2015/16 and well above average. International rice and wheat imports continue to support regional market supplies. Markets remained disrupted throughout the Lake Chad Basin and in parts of Central and Northern Mali. The recent depreciation of the Naira has led to price increases across Nigeria. High prices along with local policy measures created incentives for expanded grain production, but has also led to reduced purchasing power for Sahelian livestock and cash crops.
In East Africa, staple food prices were mixed, seasonally increasing or remaining stable in surplus-producing Uganda and Tanzania as the lean season started, while seasonally declining in Sudan, South Sudan, Kenya, and Ethiopia with the start of harvests. Prices remain above average across the region, and are especially high in South Sudan. Markets remain disrupted by insecurity in Yemen.
In** Southern Africa**, regional maize availability is currently adequate, despite consecutive years of well-below average regional production. Maize prices are above their respective 2015 and five-year average levels region wide. Imports by South Africa and Zimbabwe from well-supplied international grain markets have offset a portion of the regional deficit, while maize export restrictions in Zambia remained in place. Prices remain high and variable in Mozambique, which is experiencing supply constraints and where other factors contribute to food trade and price dynamics.
In Central America, maize and bean supplies from the Primera harvest continued to supply markets across the region. Maize and bean prices seasonally declined or were stable. Hurricane Matthew destroyed crops and market infrastructure across much of southwestern Haiti. Market activities resumed in the major markets of Les Cayes and Jeremie, but varies considerably across smaller markets.
In Central Asia, average regional harvests and above-average stocks sustained adequate supplies. Prices are below 2015 levels in Kazakhstan and above-average in structurally-deficit Tajikistan. Prices continued to be near average in Afghanistan and Pakistan.
**International **staple food markets remain well supplied. Regional price indices reflect high prices in East Africa. Rice and soybean prices fell while wheat and maize prices stabilized in October. Crude oil prices remained well below-average.
Global Overview NOVEMBER 2016
November saw violence escalate again in Syria, Myanmar, the Democratic Republic of Congo (DRC) and Cameroon. Attacks by pro-regime forces on rebel strongholds in Syria resumed, causing significant civilian casualties. In Myanmar’s Rakhine state intensifying violence displaced tens of thousands of Rohingya Muslims, while a major attack by armed groups near the Chinese border threatened to undermine the country’s fragile ethnic peace process. In DRC, violence rose in the east and the regime continued to repress dissent, underscoring the risk that renewed protests, likely in December when President Kabila’s second term officially ends, could turn violent. In Cameroon, Boko Haram stepped up its attacks in the Far North and minority English-speakers clashed with security forces in the North West region. The victory of Donald Trump in the U.S. presidential election on 8 November created uncertainty about possible shifts in future U.S. foreign policy priorities and positions, including on a number of conflicts and prominent geostrategic arenas – among them the future of the historic multilateral nuclear accord with Iran.
Polio this week as of 30 November 2016
The Global Polio Eradication Initiative (GPEI) is initiating a call for nomination of experts, to serve on the Polio Research Committee (PRC). The deadline for submission of nominations is 31 December 2016. The PRC provides guidance to the GPEI on unanswered scientific priorities in poliovirus eradication. As the eradication of polio approaches, the PRC has shifted its focus from research on the acceleration of poliovirus eradication to areas such as the development of new poliovirus vaccines, new administration methods of inactivated poliovirus vaccines, assessment of tools for poliovirus outbreak response, and anti-polio antibody seroprevalence surveys as program evaluation tools. For more on the PRC, and process for submitting nominations, please click here.
A review of ongoing and past field studies has provided additional insights into the effectiveness of fractional dose inactivated polio vaccine (fIPV). Various studies have shown that two doses of fIPV are better than one full dose of IPV at boosting not just humoral immunity, but also mucosal immunity in OPV-primed populations (mucosal immunity is critical to interrupting virus transmission in a community). Fractional dose IPV alongside OPV has also been shown to be an effective tool in outbreak settings and can be operationally implemented even in supplementary immunization activities. Finally, new evidence suggests that fIPV does offer some level of mucosal immunity to type 2 poliovirus in children primed with bivalent OPV. Further investigations on this point are ongoing, as it would be a significant finding (given that bivalent OPV contains only types 1 and 3 vaccine strains).
This evidence gives further weight to the recommendation of the Strategic Advisory Group of Experts on immunization (SAGE), for countries to consider adopting fIPV in both their supplementary and routine immunization activities. This approach could significantly improve the global IPV supply situation which is currently constrained, by reducing the volume of IPV needed to cover a population. Countries are increasingly using fIPV, both in routine and vaccination campaigns.
New US$ four million Japanese grant to procure Inactivated Polio Vaccine
Islamabad - 29 November 2016: The Government of Japan, Japan International Cooperation Agency (JICA) and the United Nations Children's Fund (UNICEF) signed today an agreement of Japanese Yen 404 million (US$ 4 million) grant for “the Project for the Control and Eradication of Poliomyelitis”.
This latest grant will support the procurement of 3.9 million doses of the Inactivated Polio Vaccine (IPV) and associated items; sufficient to vaccinate 3.3 million children between 4 to 23 months of age in the highest risk districts of the polio virus in Pakistan.
Speaking at signing ceremony, Senator Ayesha Raza Farooq, Prime Minister Focal Person for Polio Eradication said: “The current polio virus picture for Pakistan is the best ever seen. We are most definitely at a crossroad now - we are close but we will need everyone’s commitment to reach our goal. I take this opportunity to extend the appreciation and gratitude to Government of Japan for its unwavering support to Pakistan’s effort to reach every missed child, and to end polio forever”.
H.E. Takashi Kurai, Ambassador Extraordinary and Plenipotentiary of Japan to Pakistan was optimistic about headway in polio control. “We are hopeful that the use of IPV in vaccination campaigns will ensure any emerging immunity gap among the new born and other children younger than two years in areas that continue to harbour the polio virus is quickly closed”, said the Japanese Ambassador
Mr. Yasuhiro Tojo, Chief Representative, JICA in Pakistan said “There has been real progress in reducing the number of new infections in Pakistan. Now is the time to make the final push to eradicate polio. We hope this investment will ensure future generations will no longer have their lives blighted by this crippling disease”.
Ms. Cristian Munduate, Deputy Representative of UNICEF Pakistan says “Japan is a time-honored and trusted supporter of the children of Pakistan. UNICEF is thankful to Government and people of Japan for their generous contributions to Pakistan Polio Programme. This grant represents a major commitment by Japan to the health of children in Pakistan”, she said.
Pakistan is making significant progress in the fight against polio. Last year, Pakistan achieved an 82% reduction in the number of children paralyzed by polio down to 54 cases compared to 306 in 2014. During the current year Pakistan has shown further improvement by bringing down the number of cases from 45 in November 2015 to 18 so far in 2016.
Note to Editors:
The Government of Japan has supported the Polio Eradication Initiative in Pakistan since 1996. Approximately JPY 23 billion (US$ 216.53 million) has been delivered to date, for procurement of oral polio vaccine (OPV) and Inactivated Polio Vaccine (IPV), strengthening vaccine management and cold chain system.
Pakistan’s Polio Eradication Programme has added inactivated polio vaccine (IPV) to vaccination campaigns in 2016 in the highest risk districts of Sindh, Balochistan, Khyber Pakhtunkhwa and some agencies of FATA to boost individual immunity of children. In 2015 it was introduced into the routine schedule across the country as well. Combining OPV and IPV provides stronger protection against polio.
Polio (poliomyelitis) is a highly infectious disease caused by a virus mainly affects children under 5 years of age. It invades the nervous system, and can cause total paralysis in a matter of hours. The virus is transmitted by person-to-person spread mainly through the faecal-oral route or, less frequently, by a common vehicle (for example, contaminated water or food) and multiplies in the intestine.
For further information, please contact:
Sajid Hussain Shah, Public Relation Officer MoNHRS&C, 03006305306, firstname.lastname@example.org
Sajid Abbasi, Embassy of Japan, Phone: +92-51-907-2500, Email: email@example.com
Zubair Muhammad (Public Relations), JICA Pakistan Office, +92 51 924-4500,
348,664 arrivals by sea in 2016
published 09:00 CET 29 November
1,011,712 arrivals in 2015
World: Global Climate Risk Index 2017: Who Suffers Most From Extreme Weather Events? Weather-related Loss Events in 2015 and 1996 to 2015
Who Suffers Most From Extreme Weather Events? Weather-related Loss Events in 2015 and 1996 to 2015
The Global Climate Risk Index 2017 analyses to what extent countries have been affected by the impacts of weather-related loss events (storms, floods, heat waves etc.). This year’s 12th edition of the analysis reconfirms that, according to the Climate Risk Index, less developed countries are generally more affected than industrialised countries. Regarding future climate change, the Climate Risk Index may serve as a red flag for already existing vulnerability that may further increase in regions where extreme events will become more frequent or more severe due to climate change. While some vulnerable developing countries are frequently hit by extreme events, there are also some others where such disasters are a rare occurrence.
The most recent data available – from 2015 and 1996–2015 – were taken into account to produce the following key messages:
According to the Germanwatch Global Climate Risk Index, Honduras, Myanmar and Haiti were the countries most affected by extreme weather events between 1996 and 2015.
In 2015, Mozambique, Dominica as well as Malawi were at the top of the list of the most affected countries.
Altogether, more than 528 000 people died as a direct result of nearly 11 000 extreme weather events; and losses between 1996 and 2015 amounted to around 3.08 trillion US$ (in Purchasing Power Parities). The host region of the UN climate summit 2016 – the continent of Africa – is severely affected by climatic events with four countries ranking among the 10 countries worldwide most affected in 2015 – Mozambique (1st), Malawi (3rd), Ghana and Madagascar (joint 8th position).
Precipitation, floods and landslides were the major causes of damage in 2015. A high incidence of extreme precipitation supports the scientific expectations of accelerated hydrological cycles caused by climate warming.
Most of the affected countries in the Bottom 10 of the long-term index have a high ranking due to exceptional catastrophes. Over the last few years another category of countries has been gaining relevance: Countries like the Philippines and Pakistan that are recurrently affected by catastrophes continuously rank among the most affected countries both in the long term index and in the index for the respective year for the last six years.
Of the ten most affected countries (1996–2015), nine were developing countries in the low income or lower-middle income country group, while only one was classified as an upper-middle income country.
The climate summit in Marrakesh is giving the “go-ahead” on developing the “rulebook” for the Paris Agreement, including the global adaptation goal, adaptation communication systems, and finance assessment systems for building resilience. A review of the UNFCCC’s work on loss and damage provides the opportunity to better detail the next 5-year’s work on loss and damage, in relation to the climate regime, as well as to better understand exactly how loss and damage should be taken up under the Paris Agreement. View
Afghanistan - “It feels like I’ve been dropped from the sky back into Afghanistan. I came here with almost nothing, not even a pillow. I need land and a job and I need medical treatment.” These are the words of Khargul, a 45-year-old widow, who crossed back into Afghanistan with her two young boys at the Spin Boldak border point this week after 10 years in Pakistan.
As of 26 November, a total of 236,724 undocumented Afghans like her and her sons have spontaneously returned or been deported from Pakistan through the Spin Boldak border in Afghanistan’s southern Kandahar province, and the Torkham border in eastern Nangarhar province. This is more than double the number of returns from Pakistan in all of 2015.
In response, IOM has begun giving humanitarian aid to undocumented returnees like Khargul at Spin Boldak, in an expansion of the support IOM has provided to returnees at Torkham since 2012.
Undocumented returnees arriving at Spin Boldak border are now met by staff from IOM and the Afghan Directorate of Refugees and Repatriation at IOM’s reception centre on the border. Based on their needs and eligibility, they are then offered a range of services at IOM’s transit centre in Kandahar city.
Since IOM’s reception operation in Kandahar started on 14 November, over 1,500 spontaneous returnees and deportees have been provided with basic medical care, referral for additional treatment, assistance for those with special needs, temporary accommodation, household and kitchen supplies, hot meals and onward transportation to their final destination in Afghanistan.
Of the roughly 31,000 undocumented Afghans who have returned through Spin Boldak since the beginning of the year, nearly one third are deportees. Some were caught by the Pakistani authorities while trying to enter Iran through the country’s vast desert border with Pakistan.
“I was trying to go to Iran to find work to support my family,” said Sayed Hassan, a 22-year-old deportee currently staying at IOM’s transit centre in Kandahar. “The smuggler tricked us and stole our money. Then the police caught us and put us in jail for a month before we were deported. It was a terrible experience, and I would never wish it on another person.”
Beyond their immediate needs when they arrive at the border, many undocumented Afghans have lived outside Afghanistan for decades and will need help reintegrating in a country already challenged by widespread conflict and displacement.
The expanded aid programme is supported by the governments of Germany, Japan, Sweden, Norway, Switzerland and the Czech Republic.
IOM has appealed for USD 21 million to provide life-saving assistance to the most vulnerable undocumented Afghans returning home from Pakistan before the end of 2016. The Appeal is currently only 50 percent funded.
“These people are massively vulnerable,” said Laurence Hart, IOM’s Special Envoy and Chief of Mission in Afghanistan. “They need help as soon as they cross the border, and will need it for a considerable time to come.”
For further information, please contact Matthew Graydon at IOM Afghanistan, Email firstname.lastname@example.org, Tel +93 729 229 129.