“Close to 450,000 children under five die annually in Pakistan — a rate only second to Afghanistan in the region. One-third of these deaths, that is 150,000, are due to vaccine preventable disorders. At least close to 90,000 child deaths can be prevented every year by universal immunization,” Dr Zulfiqar A. Bhutta
According to the World Health Organization, polio, known as poliomyelitis, is an infectious viral disease that typically affects young children. The virus is transmitted through contaminated water and food. It multiplies in the intestine to invade the nervous system.
Pakistan has come a long way in its struggle to eradicate polio. In the early years of the 1990′s the annual incidence of polio was estimated at more than 20,000 cases a year, but over the past 5 years an average of only 100 cases per year have been reported. The national polio eradication effort has made major strides in reaching out to children with immunization in all parts of the country over the past 15 years. However, the tremendous progress towards the eradication of polio in Pakistan is threatened by certain factors.
Pakistan’s polio crisis represents one of the last big hurdles in a 23-year campaign run by the World Health Organisation. The fact that Pakistan has the highest rate of prevalence of polio in the world today despite receiving huge foreign funding and carrying out more than a dozen nation-wide campaigns for countering polio over the years points to the hard fact that there have been some serious lapses in state’s efforts in addressing the issue. Pakistan`s persistent failure in obliterating polio reflects the acute lack of commitment and obligation on part of the government and society towards saving children from the scourge of this devastating disease. Increased awareness of polio and a coordinated strategy involving relevant public and private institutions are crucial to eradicate the disease.
The continued persistence and transmission of poliovirus in Pakistan has become a national emergency. Pakistan is now at a risk of becoming the last and the only home of the poliovirus in the world, and the last hurdle in achieving global polio eradication. Since the launch of the Global Polio Eradication Initiative in 1988 the number of reported cases worldwide have fallen from 350,000 to 1,968 – a decrease of over 99%. Pakistan is now reporting more cases than the combined total cases of the other three endemic countries: Nigeria, India, and Afghanistan. Polio eradication is at a critical juncture in Pakistan and any interruption or complacency at this point may lead to huge outbreaks of poliomyelitis, the impact of which may be felt in areas far beyond the regions where polio still persists. Last year, Pakistan reported 144 cases of polio in 2010, the highest number of cases since 2000.
Climate, population density and other factors provide the polio virus an excellent breeding ground in Pakistan. Immunization rates and surveillance are weak. Last year’s floods displaced millions of people, spreading the virus and undercutting vaccination efforts. Poor security and religious opposition in the country’s Federally Administered Tribal Areas may partly explain low vaccination rates there, but even Karachi is greatly affected. Nearly three out of every four cases (69%) are from conflict affected parts of the FATA (74 cases) and associated areas of Khyber Pakhtunkhwa – KP (24 cases). The total number of cases reported for 2011 are already 40. There was a special sweep operation in Peshawar where more than 5,100 children were found unvaccinated.
Despite the challenges, Pakistan is very much capable of addressing the issues that fail us in reaching out to the children with vaccine. Pakistan needs to revise its strategy to address the implementation bottlenecks including: ensuring access to the affected population in security compromised areas, improving campaign quality, enhancing routine immunization coverage, addressing social and cultural constraints, and working closely with Afghanistan in border areas. Pakistan is working with multiple international aid agencies and non-governmental organizations to snub polio throughout the country. The history of polio eradication in Pakistan shows that with a strong sense of responsibility and direction, the Government and the people can tremendously help save children from being permanently crippled or dying from polio.