Pakistan and Afghanistan: last battlegrounds of Polio eradication

Pakistani and Afghanistan may the last places on Earth where the Polio Virus still survives. Polio eradication is an 'all or nothing' battle.

polio eradication

As recently as 30 years ago, wild poliovirus paralysed more than 350 000 children in more than 125 countries every year. Today, the virus has been beaten back to less than 30 reported cases in 2018 in just two countries – Afghanistan and Pakistan – and the world stands on the cusp of an unprecedented public health success: the global eradication of a human disease for only the second time in history.

WHO and partners in the Global Polio Eradication Initiative are committed to fully support the Governments of Afghanistan and Pakistan to tackle polio in its last strongholds and get rid of this debilitating disease for good.

Polio eradication requires high immunization amongst population

Polio eradication requires high immunization coverage everywhere, worldwide, to block transmission of this extremely contagious virus. Unfortunately, children are still missing out on vaccination for various reasons including lack of infrastructure, remote locations, population movement, conflict and insecurity and resistance to vaccination.

Read more: “West’s Anti-Vaxxers” and Pakistan’s “Anti-Polio Mullahs”?

“Pakistan which currently stands at the top in the last three polio-endemic countries in the world for housing big wild poliovirus (WPV) reservoirs, will be the last place on earth in which polio exists,” is a piece of disturbing information shared at a meeting of the Strategic Advisory Group of Experts (SAGE) held in the first week of this month in the World Health Organisation’s headquarters at Geneva.

SAGE is the principal advisory group to the WHO for vaccines and immunisation.

A senior government official told Dawn that a brief of the meeting, released this week, depicted the level of concern of the world about the persistent emergence of the wild poliovirus in Pakistan.

Eradication is an ‘all or nothing’ effort

But eradication is an ‘all or nothing’ effort. Because the virus is so highly infectious, failure to eradicate polio from these last remaining strongholds could result in a resurgence of the disease, with as many as 200 000 new cases worldwide every year, within 10 years.
That is why the Governments of Pakistan and Afghanistan have mobilized every sector of public and civil society, every community and religious leader, every vaccinator, every mother and father, to eradicate this disease once and for all.

Giving comparison of the cases with the last years, the report said, one polio case was reported in Pakistan by the end of April in 2011, two in 2012 and 12 cases in 2013 but the cases reported in the same months in the current year were hundred times more.

Rawalpindi has been forecast second ‘Peshawar’ for housing a large number of migrant families who come from Fata, Bajaur Agency, North and South Waziristan, Mohmand Agency and Afghanistan.

Read more: Who killed two polio workers in Swabi?

Peshawar had again been declared a major reservoir for poliovirus transmission.

According to the WHO the densely-populated Peshawar valley is considered to be the main ‘engine’ of poliovirus transmission, alongside North Waziristan, due to large-scale population movements through Peshawar from across this region, and into other areas of Pakistan.

The officials were shocked to learn that out of the total 50 children who were paralysed by the wild poliovirus in Pakistan so far, 44 were reported with zero-dose.

Number of unvaccinated children have shot up

Forty-one of the cases were reported from Fata, eight from Khyber Pakhtunkhwa, and three from Sindh. Balochistan and Punjab reported no polio case.

In the report, Unicef and the WHO noted that the number of unvaccinated children in Pakistan had shot up to an unexpectedly high level. The calculations showed that KP reported 700 refusal cases, Punjab 404, including 250 in Rawalpindi, Sindh 386, Fata 269 and Balochistan reported 251 refusal cases during the last round of polio vaccination.

“There is no reason why we should not be able to finish this job, we are nearly there,” says Professor Helen Rees, Chair of the Emergency Committee on Polio Eradication under the International Health Regulations (IHR).
“But we have to keep at it. We have achieved this before with smallpox. The world is a much better place without smallpox. If we stop what we are doing, we could go back to a situation where we have 200 000 or 300 000 children paralysed every year.”
On 1 January 2019, WHO Director-General Dr Tedros Adhanom Ghebreyesus took over the Chair of the Polio Oversight Board, which guides and oversees the Global Polio Eradication Initiative, as a clear sign that the eradication of this disease is a priority for the organization.
GVS News Desk

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