Since the launch of the programme, the implementation of immunization activities has been carried out by the provinces themselves. However, Federal Government acted as a nucleus to coordinate, monitor and supervise provinces and areas in the implementation process of the provincial programmes. The role of then federal EPI cell (now Federal Directorate of Immunization) was implementation, provision of policy and technical guidelines, coordination for international assistance, surveillance and monitoring. Additionally, the programme also facilitated provincial health departments by procurement and supply of requisite vaccines and other logistics.
In pursuance of 18th Constitutional Amendment, Ministry of Health was abolished and vertical Programmes including EPI were devolved to provinces. However, the Council of Common Interests (CCI) in its meeting held on 28th April 2011 inter-alia decided that the Federal Government will continue to finance these programmes till the next National Finance Commission (NFC) award. Accordingly, the federal EPI cell (now Federal Directorate of Immunization) continues to be financially supported through the federal PSDP regularly at the 2010-11 levels. The resources provided therein are primarily used to procure and supply the vaccines, syringes, safety boxes and other logistics needed by the provincial and areas to vaccinate their target populations. Nevertheless, the provinces and areas through respective EPI programme units are themselves responsible to manage the operational cost of the immunization activities at the provincial and district levels.
EPI in Pakistan is coordinated at Federal Directorate of Immunization under the Ministry of National Health Services and Regulation Coordination (NHSR&C). The Federal Directorate of Immunization is headed by a Director General supported by a team of technical and administrative staff from government and development partners. (WHO,UNICEF). The EPI at Provincial (Balochistan, Khyber Pakhtunkhwa, Punjab, Sindh) and areas (Azad Jammu & Kashmir, Gilgit Baltistan ,FATA, CDA and ICT) levels have Provincial /Area EPI cells under respective Departments of Health and managed by Provincial/Area EPI managers and other staff. The EPI at district level is managed and supported by staff at district level and the EPI services are provided at Union council level through Fixed Centers, Outreach Vaccination sites and mobile if applicable.