1. Introduction

The Allergy Centre of the National Institute of Health Islamabad is a well known and prestigious centre of its kind in the country and is playing a pivitol role in providing allergy immunodiagnostic and immunotherapeutic services to the patients suffering from different allergic problems. It is the key and sole provider of allergy vaccine for desensitization and is providing health care delivery services for the last twenty nine years and during this period approximately more than 2.8 million patients have been benefited.

The idea of establishing the allergy centre was conceived in the early 80’s.The background was to  take necessary diagnostic, preventive and curative measures for decreasing the allergy morbidity and  mortality in the country and improve the quality of life, which was  affecting most of the patients  in their peak productive years of life.

Due to the adoption of westernized life style by the people and increasing urbanization the allergy situation in Pakistan was not much different from the global situation.

Keeping these facts in view, a number of trails to test the patients suffering from seasonal allergy, extrinsic bronchial asthma, perennial allergic rhinitis, hay fever and spring catarrh were under taken in the year 1979 – 80. After the successful completion of the trails, formal allergy vaccine production started in 1981 under the auspicious supervision and able guidance of late Maj. Gen. M.I. Burney at the  National Institute of Health, Islamabad. From 1981 onwards NIH started providing Allergy vaccine immunotherapy to the patients suffering from allergic disorders and thus NIH emerged as a pioneer in this field.

Due to significant increase in the number of allergy patients, the Allergy Centre was shifted from the Public Health Division of NIH to the building of Clinical Research Division, situated outside and opposite to the premises of NIH in the year 1989. With the passage of time, the number of patients which initially were in hundreds has now risen to thousands per year and thus every year approximately more than 80 thousands patients are treated at this centre. The Allergy Centre is the only centre of its kind in the public sector providing allergy vaccine immunotherapy to the patients coming to it from all over Pakistan including Afghanistan and other countries. The patients are tested with  aero and food allergen extracts available in concentrated form  prepared at NIH.

2. Objectives

General

To treat and provide allergy vaccine Immunotherapy to the patients suffering from  nasal , respiratory tract, skin , gastrointestinal  tract and food related allergy problems.

Specific

	To diagnose allergy through skin prick test using aero allergens of pollen, dust, paper mulberry, thresher and raw cotton and food  allergens prepared from protein extracts of animal meat, sea food, poultry  and cereal. These are  beef, mutton, fish, chicken, egg and  rice etc. The allergy vaccines are developed  against these antigens in different combinations and concentrations.
	To recommend special allergy vaccines containing single allergens of all the routinely used aero and food  allergen extracts  including wheat and house dust mite and different combinations of  allergy vaccine of strength 10-2  in selected  cases.
	Creation of awareness among the general public and allergy patients on allergy  causal factors and its prevention, by making use of print and electronic media, development of IEC material  and provision of counseling in the allergy OPD’s.
	Collaboration with CDA, Meteorological department and other  concerned departments/institutions involved in taking  allergy control measures.
	Up gradation and extension of the present centre
	Establishment of a new state of the art Allergy Centre with  diagnostic and curative facilities at NIH.

3. Mission

Is to improve the quality of life of patients by decreasing the morbidity associated with allergic diseases, through provision of preventive guidelines on allergy and curative therapy using diagnostic test for allergy identification and allergy vaccine immunotherapy for desensitization.

4. Set up

Allergy Centre is housed  in one small portion of the Clinical Research Division building since 1989.There are three male OPD’s, one female OPD, a diagnostic and emergency room, two waiting halls for male and female patients along with a prayer corner, vaccine issue room, reception , cash receiving counter, and admin . The setup needs extension and up gradation for providing better health services to the patients, and a better working environment for the doctors and staff till the time the new allergy centre is established.

5. Performance/Achievements

The patients visiting the allergy Centre are mainly suffering from bronchial asthma, seasonal allergic rhinitis, perennial allergic rhinitis, allergic conjunctivitis, skin rashes, urticaria,  angioedema, and other dermatological problems not related to allergies etc. The centre receives an average of 300-350 patients on daily basis, however, this number rises up to 500-600 patients per day during peak pollen, wheat harvesting and summer monsoon season (March- April,  May-June, July- September)

During the fiscal year starting from July 2007 - to June 2008 and July 2008- to June 2009 the total number of patients who were desensitized at the Allergy Centre were 79,701 and 88,727 respectively. The maximum peaks of patients observed in 2007 and 2008 were during the month of August i.e 9145 and 8943 patients.

Allergic rhinitis, Allergic bronchial asthma and mixed cases of allergic rhinitis and bronchial asthma were the common problems for which the patients received allergy vaccine immunotherapy. Peaks were seen for allergic rhinitis with figures of 24.69% and 27.87% respectively during 2007 and 2008.

Not only the patients are treated at the Allergy Centre but the centre also  actively participates in imparting /providing health education to the allergy patients through counseling in the OPDs, pasting/hanging of wall posters, distribution of informative leaflets on allergy and make use of electronic media through disseminating useful and healthy information to its patients through providing Frequently Asked Questions and Informative Booklet in Urdu on the NIH website. Allergy Centre also actively participated in the Health Expo 2006 organized by the Federal Ministry of Health.

Allergy Centre also keeps liaison with Islamabad Capital Territory (CDA) in the free allergy camps arranged at Aabpara every year and make use of the meteorological department weather forecast information on pollen for its patients convenience during pollen season especially those patients who come from the twin cities of Rawalpindi and Islamabad and surrounding vicinities. Beside all this, allergy Centre is also generating and contributing to the NIH budget a revenue of more than 40% from its clienteles every year through conduct of allergy test and sale of allergy vaccine on affordable rates and within the reach of even a very poor person.

6. Programs & Projects

A PC-1 for the establishment of an allergy centre costing Rs.39.876 million with  diagnostic facilities at the NIH was approved by the DDWP on 2nd Jan., 2008. Work will start as soon as the funds become available.

7. Collaboration with other Institutions/Organizations

During the year 2005-2008, assistance was provided to the students of

	Hazara University.
	Barani College.
	Azad Kashmir University.
	Comsats Institute of Information Technology.

8. Future Plan

In order to cater for the needs of allergy patients of provinces, there is a proposal for establishing four satellite allergy centers in all the provincial capitals of the country for patients convenience. This will also help in reducing the load/burden of patients on Allergy Centre NIH, Islamabad.