Why Pakistan could not Finish Polio Yet?

Malayika Khan Jogezai
At global level, there have been three endemic countries – Afghanistan, Pakistan and Nigeria, where wild polio virus cases have been reported. There have been countries in Africa like Sudan, Tanzania, Kenya and Somalia, where presence of polio virus is there.
Pakistan has been struggling for decades to eradicate polio from here, nevertheless the number of wild polio virus has decreased tremendously from thousands happening in 1980s to just 8 cases in 2018. Wild polio virus has been detected in the sewage water sample 35 times from the total 640 samples taken (19%), which is kind of alarming situation. Historically we are only left with only one type of wild polio virus-1, as types 2 and 3 have not been detected by the laboratory. WPV-2 has been eradicated since decades, similarly WPV-3 last case was reported in 2012. Hence we have achievement, but war against WPV-1 continue, therefore paralyzing our children.
This polio virus mode of transmission is through oral route i.e virus goes through mouth (water, food and droplets) replicates in the pharynx and goes to the intestine and excrete in the form of feaces. Therefore cycle continue. All human beings can carry the polio virus, but susceptible group is the children under five years, in this group immunity is low, especially under nourished children, which is alarming in Pakistan, due to high number of frequent birth by the mothers.
Government of Pakistan has imposed national emergency in 2011 to eradicate polio virus by 2013, but security situation has become worse in former FATA, where military operation was launched against the Taliban militants groups, therefore millions of FATA resident fled the areas and settled in Camps and local population of Khyber Pakhtunkhwa and migrated to Karachi, since there were no polio vaccination drives for years, therefore huge polio outbreak happened in 2012 to 2013.
There have been lack of government support to the national emergency polio eradication program like ownership, oversight and accountability, therefore poor interest has been happening at field level. There have been communities refusing OPV drops due the demands from the government like improve road infrastructure, ensure availability of medicines, vaccines for other disease, health staff, improve sanitation and provide water supply, which are the basic human needs and fundamental rights given by UN assembly.
This will be the second disease after small pox, which was eradicated by human being in 1979 from earth with support of vaccine, therefore there have been countries which are polio free like America, Europe, China, Australia and some Middle Eastern countries. They have finished through successful mass polio vaccine program. I would like to say that, why small pox vaccination program eradicated or wiped the deadly disease, because its mortality rate was 100%. In case of polio, such scare has not been there, which is one of the reasons, parents are not worried and scared with polio, though it is paralyzing and can cause respiratory system failure, but do not have terror like small pox, which is the reason, parent do not give importance to the polio vaccination.
There have been challenges like hundreds of thousands of children, who have not been receiving oral polio drops in the campaign in Pakistan, reasons are many, and parents have been hiding children from the polio workers, simply lack of trust on polio vaccine. This may be sterilizing children, an early puberty, haram contents in the vaccine (process through monkey tissue cell, therefore Haram for the Muslim. The Highest number of refusals to polio vaccines comes from Pashtun ethnic population residing in Khyber Pakhtunkhwa, Karachi, Killa-Abdullah and Quetta.
There have been missing children in the mass polio vaccination program, as our front-line workers did not go there, I mean this is door to door vaccination campaign. Therefore child under five years deprive of receiving Oral Polio Drops, in other instances front line worker reach their home, but missed the child inside the houses, there have been security compromised areas and places in Khyber Pakhtunkhwa tribal districts like Waziristan, Khyber, Mohammad and Bajour other like Dera Bugti, Kohlu, Kech, Awaran, Washuk and Panjgur in Balochistan, where front line workers don’t have access to carry out polio vaccination drives, therefore immunity gaps happened.
In Pakistan essential immunization program coverage has been weak, this is also one of the reasons that, Zero Dose of OPV at child birth and subsequent two drops at the age 6, 10 and 14 weeks have not been receiving, hence immunity to polio virus has become weak.
Across the Durand line Afghanistan, there have been around million children under five have been deprived of polio drops, due to no go areas, where Taliban militants have taken control of districts. They are not allowing polio vaccination campaign since more than year, there have been frequent cross border population moment, therefore polio virus comes here and go back, and last year Afghanistan has reported 21 polio cases.
Mr. Bill Gates in annual letter of 2018 said that, he did not predict polio eradication will be so hard, security compromised areas have been a very challenging for us to reach in accessible children. I would like to remind to the reader that, Mr. Bill Gates philanthropic organization BMGF has been giving billions of dollars for polio eradication initiative since many years, he would like to see polio free world. There have been other organizations like W.H.O, UNICEF, Rotary international, USAID, JICA and countries like UAE, Canada and Germany, which have been giving grants and donation for polio eradication.
The author is a Student of Mass Communication, BUITEMS. She can be reached at malayikajogezai007@gmail.com.
DisclaimerViews expressed in this article are those of the author and Balochistan Voices not necessarily agrees with them.
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