Once again International Monitoring Board
suggested more hard international travel restrictions on Pakistan.
Independent Monitoring Board (IMB) is the board which suggested
international travel restrictions on Pakistan and World Health
Organisation (WHO) implemented it. Most alarmingly, Pakistani government
has failed to implement the recommendations of IMB. It is pertinent to
mention that IMB works on behalf of the international donor agencies and
it issues reports regarding performance of the countries after every
six months. In November 2012, IMB recommended that travel restrictions
should be imposed on Pakistan and finally those recommendations were
implemented on May 5. Over 200 polio cases have been registered in
Pakistan in the year 2014 more than previous year, still few months to
go to reach 2015. With 500,000 children yet to be vaccinated, Pakistan
stands at a deplorable position on this year’s World Polio Day where it
adds 85 percent of polio cases to the world. Such escalation of the
disease creates many doubts about the stat’s measures and their outcome.
Pakistan has been the major contributor to confirmed polio cases in
2013 as compared to Nigeria and Afghanistan – the only three remaining
endemic countries. The polio eradication campaigns in Pakistan have been
suffering from continuous setbacks as 27 polio workers have been
assassinated since December 2012 during anti-polio immunization
campaigns. Lack of an efficacious regime to tackle this pandemic was not
enough, there had to be a conspiratorial element to further depreciate
all the efforts. According to the 2013 World Health Organization report,
74 polio cases have been reported in Pakistan. However, 51 (69%) of the
polio confirmed cases are from Federally Administered Tribal Areas
(FATA), identifying it as the single major poliovirus reservoir in
Pakistan. Moreover, the polio immunisation teams whose workers carry out
door-to-door vaccinations should be killed as they are part of this
sinister conspiracy against Muslims. Since this narrative got out, a
series of attacks have been carried out targeting polio teams and
killings dozens of health workers, mostly in the troubled areas of
Khyber Phakhtunkhwa, Federally Administered Tribal Areas and
Balochistan. As a result of which the most challenging issue for the
government is how to retrieve the lost public trust where people in
these areas now refuse to get their children immunised. The Government
of Pakistan has highlighted multiple reasons for the growing polio
endemic in Pakistan citing primarily militancy and ‘refusal families’.
Militancy, especially in the Federally Administered Tribal Authority
(FATA) and North Waziristan areas of Pakistan, may have compounded the
polio campaign further by putting many children at risk. In spite of
multiple supplementary immunization campaigns, the majority of confirmed
polio cases identified in Punjab, Sindh and Khyber Pakhtunkhwa
provinces in 2013 were from zones considered as low-violence areas.
This observation strongly contradicts the perception of militancy alone
as an impediment for polio eradication in Pakistan. Lack of accurate
polio vaccination coverage estimates and unaccountability of responsible
officials are major reason for new polio cases in areas unaffected by
violence. The example of measles epidemic in the southern part of Sindh
(considered violence free zone) also contradicts the poor security
viewpoint and highlights the failure of public health preventive
strategies as the primary culprit. The 306 deaths and 14000 reported
cases attributable to measles in 2012 highlights the poor immunization
infrastructure, fraught with incorrect reporting. In 2012, Egypt health
authorities found polio virus strains in two of its sewerage systems.
Samples of this polio virus were traced to the environmental samples in
Sukkur in Northern Sindh province of Pakistan again a low violence area.
In 2013, the same strain from Pakistan found its way both, in the
Palestinian and Israeli sewerage system via Egypt. Recently, 17 polio
cases detected in four major cities of the war affected country of Syria
have also been linked to the wild poliovirus strain from Pakistan.
A report suggests that all of the six polio
cases reported from Quetta were solely because of their parents’ refusal
to get their children vaccinated. Despite many edicts being issued by
different clerics and religious scholars to unequivocally endorse the
necessity of these immunisations, no adequate narrative seems to be in
place and after having all these alarming facts in front of us, one
wonders why the government has not adopted an effective policy on a war
footing. Its contagiousness poses a threat to the rest of the world that
is polio-free. Surely, we do not want to isolate ourselves from the
rest of humanity. It is not only for our own sake but in order to be an
active member of today’s dynamic global world that we need to get rid of
this affliction as soon as possible.
Specific strategies related to anti-polio
immunization campaigns in security compromised areas are urgently
needed, close monitoring of anti-polio immunization campaigns is
essential to ensure accountability and to overcome factors behind poor
coverage.
