The Andhra Pradesh government has launched an action plan to plug the holes in the children immunisation programme in the state in the light of the raging virus fever that has claimed 112 lives officially. The state has a vigorous immunisation programme in association with Melinda and Bill Gates Foundation, covering full immunization (all the six vaccine-preventable diseases), DPT (diphtheria, petusis and tetanus), and oral polio vaccine (OPV). But independent surveys have found several gaps of critical importance.

The chief minister formally launched The Action Plan (with the theme: 'Protect Today for a Secure Tomorrow) on World Population Day on July 11. The programme aims at improving the coverage, quality and reach of immunisation by the end of 2003, designated as the Year of Immunisation.

Some of the gaps that came to the fore in the surveys were poor session implementation, inadequate management of vaccines in terms of stocks and storage in cold chain, compromise on injection safety (usage of improperly sterilised injection needles and syringes), issuance of immunisation cards to only some children and mothers and poor involvement of community representatives, jananis. In the much-publicised polio vaccine drive too, certain gaps were found.

According to J Laxminarayana, Joint Commissioner, Department of Family Welfare, there were certain other concerns too. For instance, though AP remained polio-free since December 1999, thanks to intensive pulse-polio campaign, fresh polio cases had been transmitted from the neighbouring Nanded district in Maharashtra and Bellary in Karnataka. The threat of transmission of polio virus from the border areas of the state cannot be wished away.

According to the surveys, the coverage rate was 66.6 per cent for full immunisation and 77 per cent for DPT and OPV. The action plan would aim at taking the coverage rate from 66.6 per cent to 85 per cent for full immunisation by delivering vaccines with assured safety and potency, covering all children above 9 months of age with measles vaccine and achieving 100 per cent injection safety by exclusive and mandatory use of auto disable syringes or properly sterilised glass syringes. To maintain the quality and potency of vaccines, throughout the supply chain, new cold chain stores are to be set up in the districts.

The Department will ensure that the immunisation action plan reaches all the PHCs, all the beneficiaries - children and ante-natal mothers -- get the immunisation cards and the 'janani' teams are activated to take up social mobilisation of outreach sessions in the villages. The three-month drive from July 14 to October 13 will involve all the primary health centres, urban health and family welfare centres, area hospitals, district headquarter hospitals and medical college hospitals. The programme will be through the regular immunisation sessions on Wednesdays and Saturdays and not on the campaign mode.

The programme will be supervised by district-level programme officers, PHC medical officers and the faculty of medical colleges. For intensive monitoring one state-level officer is being allotted to each district. There will a special reporting arrangement on weekly, fortnightly and monthly basis.

Meanwhile, four more children succumbed to the viral fever on Tuesday taking the official toll to 112. Of the four deaths, three were reported from Karimnagar Government Hospital and one from Khammam.

The five-member expert committee set up by the Chief Minister to study the situation could not find any evidence that could throw fresh light on the virus. In its interim report submitted on Tuesday, the committee recommended the setting up of a full-fledged virus diagnostic laboratory in the state.