The rise in international travel and trade is directly correlated with the risk of epidemics. Pathogens can cross borders and continents without requiring a visa. For timely risk identification, outbreak detection, and subsequent mitigation and structured response, respectively, a robust public health infrastructure with relevant professionals and expertise is essential. Starting at the community level and working its way up to tertiary care hospitals and institutes, Pakistan has an extensive network of health infrastructure.
Female health workers (LHWs), outreach vaccinates, communicable disease control (CDC) supervisors, and other health personnel are employed at the community level. Over a hundred thousand regular outreach workers in the health sector are employed in Pakistan. By established procedures, these workers visit local communities and households.
There are approximately 5,500 basic health units (BHU) and 700 rural health centers (RHCs) staffed by medical and para-medical personnel at the primary healthcare (PHC) level. Clinical services are provided by approximately 1,200 hospitals at the secondary and tertiary levels of healthcare. Every tertiary emergency clinic is connected to a clinical school or college. Tertiary care also includes facilities like special schools.
In epidemic situations, each category of the aforementioned service delivery levels plays a distinct role. LHW, CDC supervisors, sanitary inspectors, and dengue fever workers, for instance, regularly carry out community-level surveillance. During the Covid-19 outbreak, these outreach workers were instrumental in surveillance and raising awareness.
The immunization program's vaccinates are in charge of keeping an eye out for diseases that can be avoided with vaccines. The secondary and tertiary levels of hospitals provide clinical care for active epidemic cases, while PHC facilities and hospitals provide outdoor services. Disease surveillance and response are primarily the responsibility of the provincial Institutes of Public Health (mph)and the National Institutes of Health (NIH). The National Command and Operation Center (NCO) and the Center for Disease Control (CDC) are based at the NIH. Additionally, it serves as the focal point for Pakistani activities related to the Global Health Security Agenda (GSA).
A powerful two-year preparation program is likewise shown to the NIH to prepare clinical experts in scourge readiness and reaction, as a team with the CDC USA. Since its inception, this Field Epidemiology and Laboratory Training Program (FELT) has produced over 200 graduates. The National Institutes of Health (NIH) publishes a national list of diseases that must be reported and reported.
These cases must be reported following a complex protocol by every health worker and health facility. Depending on the disease, reporting intervals range from "immediate" to "weekly." It is expected of all health professionals to be familiar with these diseases, their definitions, and the procedures for reporting them. There is still a great deal of work to be done in the area of epidemic preparedness, even though the health infrastructure and professionals are fairly distributed across the nation.
Our general pattern is a postponed reaction and quick firefighting on an infection-to-illness premise. Particularly at the provincial and district levels, our health system's capacity to identify and promptly report notifiable diseases is subpar. To be able to provide district-level staff with the necessary training and equipment, the provincial Institutes of Public Health need to improve their capabilities.
The health-security preparedness of ports of entry (airports, seaports, and border crossings) is an essential component of epidemic preparedness. Disease, pathogens, and vector transmission are controlled in a health-secure port by screening incoming visitors, food supplies, and all containers and cargo for vectors like mosquitoes, rats, and others.
Our airports, particularly seaports and ground crossings, lack the infrastructure and human resources necessary for such screenings. At most ports, there is usually nothing more than a ceremonial screening counter. Pakistan's overall response to the Covid-19 crisis was notable, despite the epidemic's vulnerability. In contrast to some nations with similar demographics and health systems, our track-and-trace strategy helped keep the disease contained. The government was able to establish a system quickly.
Within a few months of the outbreak, various ordinances were passed in each province to establish or update epidemic control laws. However, these laws and ordinances were drafted after the pandemic had already begun to spread. To be better equipped and prepared for future epidemics, such laws, rules, and regulations should be in place. Epidemic preparedness involves more than just having the right resources in the right places. It's important to take every health concern seriously.
For instance, screening the temperature of approaching travelers could give off an impression of being a minor step and thus barely noticeable. In a similar vein, the process of sanitizing and disinfecting containers might appear to be time-consuming and pointless. However, if these seemingly minor steps are not taken, they run the risk of quickly developing into catastrophic events, resulting in the loss of health and valuable resources.
It's important to teach responsibility and attention to detail. The establishment of appropriate infrastructure and the availability of trained human resources are responsibilities of the government. In addition, it is the responsibility of the public to adhere to the specified screening protocols and standard operating procedures. Governments alone cannot prevent pandemics and epidemics; As global citizens, we all have a responsibility in this regard.
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