IVI and Pakistan

 

IVI Member State

On December 23, 1996, Ambassador of Pakistan to the United Nations, H.E. Ahmad A. Kamal signed the Establishment Agreement of the International Vaccine Institute at UN headquarters in New York.

On July 13, 2000, the National Assembly of Pakistan ratified the IVI Establishment Agreement.

Over 27 Pakistani health officials have received training in IVI’s Annual Vaccinology Course.

 

Antimicrobial Resistance (AMR) Surveillance

In 2019, IVI initiated a program to study the prevalence of AMR in Pakistan. The program, part of an IVI-led consortium known as CAPTURA, or Capturing Data on Antimicrobial Resistance Patterns and Trends in Use in Regions in Asia, works closely with Aga Khan University, DAI Pakistan, and Health Security Partners (HSP) in Sindh Province. CAPTURA aims to increase the volume of data available to improve spatiotemporal mapping of AMR and antimicrobial use (AMU); assess the quality of data and provide meta-data to give regional and inter-regional context; undertake analysis of the data; and ensure findings are disseminated locally, regionally, and globally. The project will identify gaps in data and areas for quality improvement that can be addressed in future initiatives to strengthen surveillance capacity. Finally, the information resource generated by the project will improve awareness, advocacy, policy, and interventions needed to combat AMR and antimicrobial misuse.

 

Typhoid Program: Disease Surveillance, Vaccination Campaigns, Vaccine Tech Transfer

From 2000 to 2004, IVI carried out its first global program, the Diseases of the Most Impoverished (DOMI) disease burden study. As part of the DOMI program, IVI worked with partners in Bangladesh, China, India, Indonesia, Pakistan, and Vietnam to determine the burden of typhoid fever in Asia and to demonstrate the effectiveness of typhoid vaccination.

Working with the Department of Microbiology at Aga Khan University, IVI established disease surveillance sites at local healthcare facilities in the low-income Karachi communities of Hijrat Colony, Sultanabad, and Bilal Colony. IVI also worked with community healthcare workers to offer free typhoid diagnosis and treatment during their household visits. Nearly 42,000 children aged 2 to 15 were enrolled in the study, which discovered high incidence rates of typhoid infection (573.2 annual cases per 100,000 people) in children under 5 years old.

Following this surveillance study, IVI and Aga Khan University conducted a vaccination efficacy study in 2004 in Sultanabad, Hirjat Colony, and Bilal Colony to demonstrate the effectiveness of the Vi-PS typhoid vaccine. Approximately 30,000 children aged 2 to 16 years old received either a Hepatitis A vaccine or Typhoid vaccine in the randomized trial, which demonstrated a high degree of protectiveness in children 5-16 years old.

In 2008, as part of the Vi-based Vaccines for Asia (VIVA) Initiative, IVI transferred the technology for the Tybar Vi-PS typhoid vaccine from India’s Baharat Biotech to Pakistan’s Amson Vaccines & Pharma (Pvt.) Ltd, enabling Pakistan to manufacture the typhoid vaccine domestically.

In 2010-2011, based on the success of the Vi-PS vaccine demonstration in Karachi, the government of Sindh Province agreed to pilot test the introduction of typhoid vaccines in a school-based setting. IVI, Aga Khan University, and the Sindh Province Ministry of Health conducted the campaign, providing 116,635 students in the Gulshan-e-Iqbal and Jamshed towns the Amson-produced Vi-PS vaccine. The vaccine demonstration used an innovative funding method (cross-subsidization) which involved charging a vaccine user fee to students from private schools in high-income neighborhoods to subsidize no-cost vaccinations for students from less wealthy areas.

 

Shigella Surveillance

From 2000 to 2004, As part of the DOMI Program, IVI investigated the burden of Shigella in Bangladesh, China, Indonesia, Pakistan, Thailand, and Vietnam.

In Pakistan, IVI and Aga Khan University established four treatment centers and research sites in the low-income Karachi communities of Rehri Goth, Sherpao Colony, Hijrat Colony, and Sultanabad.  From 2002 through 2003, roughly 60,000 people participated in the study, which uncovered nearly 400 cases of Shigella infection, 73% of which were in children under 5 years of age.  Data from this research revealed that shigella imposes a heavy health and economic burden on both public-sector institutions and private households. Public surveys identified high demand for a vaccine to protect children against Shigella dysentery.

An Urdu-language summary of the DOMI: Shigella study may be read here: PDF Link

The results of the Shigella study in Pakistan have significantly influenced the ongoing development of IVI’s shigella vaccine.

Click here to learn more about IVI’s Universal Shigella Vaccine Program

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