WHO donates 500 vials of antitoxin as unprecendented rise seen in diphtheria cases

ISLAMABAD: Following an unprecedented rise in diphtheria cases across Sindh, the World Health Organization (WHO) has donated 500 vials of Diphtheria Antitoxin (DAT) to the province to be handed over to the Sindh Infectious Diseases Hospital (SIDH) in Karachi today, officials said on Sunday.

The Drug Regulatory Authority of Pakistan (DRAP) has also announced plans to issue a No Objection Certificate (NOC) for importing additional DAT within 24 hours to ensure timely availability of the critical treatment in the country.

“We have received 500 vials of Diphtheria Antitoxin (DAT) donated by the WHO, which will be delivered to the Sindh Infectious Diseases Hospital (SIDH) Karachi on Monday. Efforts are also underway to procure more DAT through provincial resources to provide treatment for diphtheria patients,” an official from the Sindh Health Department told The.

As the number of diphtheria cases continues to surge across Sindh, the SIDH Karachi has emerged as the only hospital in the province treating these patients. Despite the growing demand for treatment, the hospital lacks sufficient DAT and has been relying on the Sindh Institute of Child Health and Neonatology (SICHN) for its supply. The SICHN holds a limited stock of DAT and distributes it to other public health facilities on request.

“Patients from all over Sindh, including cities like Sukkur, Larkana, Nawabshah, Mirpurkhas, Hyderabad, and different areas of Karachi, are being referred to SIDH Karachi for treatment,” said a health department official. “We have trained pediatricians and infectious diseases experts in other cities, but the burden is falling disproportionately on Karachi’s hospitals.”

The official confirmed that the 500 vials donated by WHO would be distributed at SIDH Karachi. However, the key concern remains the alarmingly low levels of routine immunization.

“Hundreds of thousands of children have missed their routine immunizations, which is the primary reason for the resurgence of diphtheria and other vaccine-preventable diseases,” the official added. A complete overhaul of the Expanded Program on Immunization (EPI) in Sindh is reportedly under consideration.

DRAP, in response to the crisis, has also expressed its concerns. Chief Executive Officer Asim Rauf stated that they are prepared to provide an NOC for the import of DAT within 24 hours to ensure its availability across the country. “In Punjab, there are hundreds of vials available at Children’s Hospital Lahore, and they can be distributed where needed. We are taking steps to make sure that DAT is readily available for treating children,” he said.

Asim Rauf acknowledged that Pakistan had effectively eliminated diphtheria, leading to a diminished need for DAT in the past. “But now, with this resurgence, we are working to ensure that treatment is available throughout the country. We also urge parents to get their children vaccinated without falling prey to conspiracy theories,” he added.

So far this year, dozens of children have died from diphtheria in Karachi and rural areas of Sindh and Balochistan due to declining routine immunization rates, according to infectious disease experts. In Karachi alone, over 100 children have died from the disease, compared to the 52 children who succumbed to it last year at a single public hospital.

However, the Sindh Health Department has reported a lower death toll of 28 for the entire province, including 10 deaths in Karachi, out of 166 confirmed cases.

The situation has become increasingly dire because of the limited availability of DAT, the only known treatment for diphtheria. Health experts, including Prof. Jamal Raza, Executive Director of SICHN, have expressed deep concern over the surge in cases.

“We’ve never seen so many cases in a single year. It’s possible that a new or invasive strain of diphtheria is behind the rise, but we still don’t know for certain,” said Prof. Jamal Raza.

He emphasized that diphtheria is a vaccine-preventable disease, and the rise in cases reflects the province’s poor immunization coverage. “When diphtheria starts spreading, along with other vaccine-preventable diseases like measles and polio, it signals that many children are missing their routine vaccines under the EPI,” Raza said.

Public health officials have also called for a national-level investigation into the resurgence, with a focus on conducting genome sequencing of the current diphtheria strain. They hope to identify preventive measures and bolster vaccination efforts to curb the spread of the disease.

Meanwhile, senior health experts at Aga Khan University have warned that patients arriving in Karachi from rural areas of Sindh and Balochistan are often in critical condition by the time they reach hospitals. “Diphtheria is entirely preventable with timely vaccination, but by the time these children get to us, it’s often too late. Once the disease affects the heart and other organs, the mortality rate is nearly 100%,” said Dr. Qalab e Abbass.

In an effort to address the crisis, Dr Abbass recommended a three-pronged strategy: annual vaccination campaigns in affected regions, early detection training for healthcare providers, and expedited DRAP approval for the import of DAT, particularly for rural areas.

As Pakistan grapples with the resurgence of diphtheria, health authorities are under increasing pressure to strengthen immunization programs and ensure a consistent supply of the life-saving antitoxin to treat those already infected.