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Why polio continues to be a health risk in Pakistan | Asia | An in-depth look at news from across the continent | DW



Saira Qadir was only 11 months old when she contracted the polio virus. Now 44 years old, she lives in the town of Rawalpinidi, near the capital Islamabad.

Qadir told DW that when they were children, all of her siblings received the polio vaccine except her. Apparently, it was a case of parental neglect that led to her becoming infected with the crippling disease.

Last month, the African Regional Certification Commission (ARCC) for Polio Eradication officially declared that all 47 countries in the African Region of the World Health Organization (WHO) of the United Nations were free from the virus, no cases have been reported for four years.

“This is an important milestone for Africa. Future generations of African children can now live without wild polio,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.

Read more: Polio eradication in Africa highlights challenges ahead

The disease is now only present in two countries, Afghanistan and Pakistan, the latter struggling to cope with an increase in cases in recent months. The Muslim-majority South Asian country has recorded 68 cases of polio since the start of the year.

The disease, which mainly affects children under the age of five, can infect the spinal cord, causing paralysis.

Campaign hampered by activism

Pakistan launched its first national polio eradication campaign in 1994. At the time, the country had an average of 20,000 polio cases per year. By 2004, ten years after the campaign began, the number of cases in the country had fallen to just 30 per year. Health experts have called it a major achievement.

However, the campaign lost momentum after the September 11, 2001 attacks and the deterioration of the security situation in the years following the US invasion of Afghanistan. The US-led war on terror in the Afghanistan-Pakistan region has made it difficult for authorities to focus on polio eradication.

“By the mid-2000s, the security situation in the Afghanistan-Pakistan region had hit the countryside hard,” Dr Rana Safdar, national coordinator at Pakistan’s National Emergency Operations Center (NEOC), told DW. .

Read more: Amid Taliban threats, Pakistan records record polio cases

The Taliban say polio eradication campaigns are used by the West to cover up espionage. They claim the campaigns are similar to a hepatitis vaccination program led by jailed Pakistani doctor Shakeel Afridi, who allegedly helped the CIA track down former al-Qaeda leader Osama bin Laden. Bin Laden was killed by US special forces in his hiding place in Abbottabad in May 2011.

Islamist activists regularly carry out violent attacks against polio workers in northwest Pakistan.

Policy issues

Besides activism, experts also attribute the persistence of polio in Pakistan to flawed government policy.

Islamabad-based infectious disease and public health researcher Dr Adnan Khan says poor governance is one of the reasons for the failure of Pakistan’s polio eradication program.

“Polio campaigns are basically part of cleanup strategies; they are used to fill the gaps left by routine vaccination (vaccines given to children at birth). But in Pakistan, door-to-door polio campaigns invariably take more time and resources as compared to routine immunization, ”Khan told DW, adding that field teams often cannot cover. the whole population in specific areas, so some children are left behind.

Health officials complain that many people in Pakistan do not want their children to be vaccinated at birth.

The government says it has adopted a new strategy to tackle the threat of polio by inviting community and religious leaders to work with them. According to Dr Safdar, this strategy has been effective in reducing polio cases to a level as low as eight in 2017 and 12 in 2018.

However, things have changed since Prime Minister Imran Khan took office in 2018. In 2019, cases rose to 148 from 12 the year before.

COVID-19 is a priority

Any hope of pushing the numbers down in 2020 was dashed with the onset of the coronavirus crisis in March. Experts fear Pakistan will experience no more polio cases in the coming months as the government suspended national polio campaigns between April and July to focus on efforts to reduce COVID-19.

Ahsan Ali, a polio eradication program manager in the southern port city of Karachi, told DW in May that his immunization work had not been well received amid the pandemic.

“My role has been changed and people do not tolerate us for fear of being potential carriers of the coronavirus due to our door-to-door work,” he said.

Responding to an investigation into the suspension of vaccination campaigns in Pakistan, GPEI spokesperson Sona Bari told DW that the WHO had “repeatedly noted that services such as vaccination were suffering from impacts of COVID-19 on health systems “.

Look ahead

Nationwide polio eradication campaigns finally resumed last month. Authorities say about 40 million children across Pakistan will be vaccinated by December.

“The National Emergency Operations Center plans to invest in regular vaccinations as well as health and nutrition programs for vulnerable children in targeted areas. We hope to show progress in 2021,” said Dr Safdar .

But Dr Khan says it will be difficult to contain transmission of the virus without identifying problem areas and vaccinating everyone, including adults.

Read more: How far is Pakistan prepared to go to fight polio?

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