Donor Meeting: Health Donor Meeting: Health UpdateUpdate

14th June, 2011

Health Sector Response Health Sector Response Total Beneficiaries – estimated 25 MillionTotal Funds Used – US$ 156 MillionActivities:

◦ Communicable Disease Surveillance and Response

◦ Essential Medicines◦ Health Sector Partners Operations◦ Disease Case Management - targeted 24/7◦ Logistics, Coordination and Information

Management◦ Laboratories◦ Social Mobilization◦ Special Needs (Malaria, Leishmaniasis)◦ Vaccines (gap filling)

2

1818thth Amendment & Amendment & DevolutionDevolution

MAJOR COMPONENTSAll 10 vertical programs devolved

◦Federal government will provide funds till 2014

National EPI program devolved◦Federal government will provide funds

till 2011Only Strategic guidelines and

minimum essential standards will be maintained by federal level

Disrupted Health SystemsDisrupted Health SystemsNo Health and Nutrition Policy and

Planning Regulatory body at the federal level

Planning for vertical programs continue at the federal level

Disrupted health system - issues in health system at the provinces due to devolution:◦Policy/Strategy Formulation◦Financing◦Human Resources◦Pharmaceutical Areas◦Health Service Delivery◦Management Systems◦Equity

Pakistan Health Budget 2011 - Pakistan Health Budget 2011 - 1212

Budgetary allocation for health is nearly 15% less than that of the last year◦ Not more than 0.5% of GDP for health (for most developing

countries is 5%)

No allocation for the prevention of disease outbreak◦ Epidemics of malaria, dengue, hepatitis and

several other communicable diseases.◦ TB ranks at 8 in 22 “high burden” countries ◦ Top on the polio list in the region/world

Year Per Capita for Health

Comments

2001 US$ 17/capita Target Achieved

2007 US$ 34/capita Target NOT Achieved

2010 US$ 18/capita Inclusive of humanitarian interventions

2015 US$ 38/capita Target

Communicable Communicable Disease Surveillance Disease Surveillance and Response (CSR):and Response (CSR):

Disease Early Warning System Biggest: Weekly reporting system:

• 42 weekly bulletins published• 76 Surveillance Officers • 95 districts / 3 agencies (67 partners)• Averages 1m total consultations /

week • more than 3,000 health facilities • 29 million consultations since the

Floods

• Shared in Cluster Coordination

One of the best response systems in the world:

Integrated, Sensitive, Prepared, Responsive

Integrated

Communicable Disease Surveillance:

Water-borne diseases (diarrhea, AWD, dysentery, typhoid, hepatitis A&E),

Vector-borne diseases

(malaria, dengue, Leishmaniasis)

Vaccinable diseases (polio, measles, pertussis, diphtheria, tetanus)

Sensitive:

Since Flood, detected 1783 alerts;

Now, more than 100 alerts per week

Prepared:

Trained >3,000 HCPs including experts for ARI,

◦ 65 DTC Rapid Response Teams

Essential Medicine, supplying diarrhea kits, ARI kits, RDT, ACT, ADS, Ribavirin, TIG

Responsive:

7

DEWS Response Responded to 90% alerts within 24 hrs

738 Measles Alerts, 69 outbreaks

65 deaths were recorded out of 2108 cases (CFR 3%)

326 AWD Alerts, 110 outbreaks

with confirmed V. cholera

363 Samples172 +V. cholera (47%)(47%)

Estimated 69,000 treated cases of diarrhea with some level of dehydration at DTCs (64 deaths, CFR 0.1%)

PunjabBaluchistan

Sindh

KP

Environmental HealthEnvironmental Health

Tested 3,500 water sources >85% contaminated

1,250,000 individuals reached -provided household treatment:◦ Aqua tabs, Hygiene Kits, water

filters, Chlorinators, rapid water testing kits,

◦ Wagtech portable water testing kits for TMAs/PHED and DOH

Trained 1,416 personnel

Details for Grants and Demands of Health Components Under 2011 – 2012 Federal Budget (Planning Commission)

Contraceptive Requirement and Distribution (CRD) 477,035,000

National Program for Family Planning & Primary Health Care

8,000,000,000

National Maternal, Neonatal and Child Health Program (MNCH)

2,280,833,000

Expanded Program on Immunization (EPI), Control of Diarrheal Diseases (CDD), NIH

2,716,261,000

Enhanced HIV/AIDS Control Program 246,932,000

Roll Back Malaria Program 123,466,000

National TB Control Program 123,466,000

National Program for Prevention and Control of Blindness

246,932,000

National Program for Prevention and Control of Avian Pandemic Influenza

37,040,000

Prime Minister’s Program for Prevention and Control of Hepatitis

600,000,000

Strengthening National Tuberculosis Control Program 81,488,000

Grand Total (Pakistani Rupees) 14,933,453,000

Pakistan Health Budget 2011 - Pakistan Health Budget 2011 - 20122012

Total Health Expenditure in PKR

2,646,000,000 Percentage

Medical products, appliances and equipment

0 0%

Hospital Services 2,435,000,000 92%

Public Health Services 140,000,000 5.35%

Research & Development Health 0 0%

Health Administration 70,000,000 2.65%

Funding for Health

USD

Capacity Building and Provincial Technical Support in the Devolution Process (18 months)

42,000,000

Outbreak Response Contingency Planning (includes cholera outbreak response July 2011/ 6months)

9,500,000

Relief Funded Stock Available (3,950,000)

Total Funding Gap $47,550,000