November 30, 2002	Saturday	Ramazan 24, 1423

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MULTAN, Nov 29: Resistance in children against poliomyelitis virus has been diminishing, perhaps, due to excessive vaccination.

This was observed by a senior paediatrician when asked to comment on an alarming number of polio cases in length and breadth of the country, especially in Khairpur (Sindh), Dera Ismail Khan (NWFP) and Dera Ghazi Khan, Rajanpur and Sahiwal (Punjab).

The paediatrician who has a vast experience in the field of preventive health care wanted not to be named though, he said, his views and note of dissent were known to the health authorities as he had brought everything in black and white against the flaws in the polio eradication drive.

He said Pakistan had tried to follow the Chinese model in polio eradication without realizing that China opted for oral polio vaccine only when it had developed immunity against polio among 80 per cent of its targeted children through injectable polio vaccine in routine coverage.

But to fetch foreign aid, Pakistan’s health authorities presented concocted data before donor agencies, including WHO and Unicef, to show that like China they had also immunized 80 per cent of children through routine coverage, and that now special efforts were required to completely root out the menace from the country.

He said the donor agencies which were already impressed with the Chinese experience took no time to give a nod to the request of Pakistani health authorities and the country observed its first national immunization day (NID) for polio in 1994. But, the results were rather discouraging.

He said none of the national and international health agencies could interpret the outcome of the first NID as cases of acute flaccid paralysis were pouring in from here and there after the immunization day. The local health authorities excused for this being their first experience.

However, the results of the following NIDs made no difference, and the donor agencies soon realized that they were presented with a fudge data regarding the routine coverage. But, on the other hand, the local health administrators took refuge under the pretext of lack of logistic facilities like cold chain equipment to carry on the vaccine in far-flung areas with its efficacy remained intact.

He said donors dumped in millions of rupees to remove this hitch as well to run the anti-polio campaign successfully, but to no avail. Instead, he said, the funds and cold chain equipment were misappropriated, and it was no secret that the health authorities in Punjab were sitting on the inquiries of embezzlement in polio funds.

He said the dilemma for the donor agencies in their pursuit to eradicate polio in Pakistan had been that despite discouraging results, they could not now leave the programme midway both in terms of technical and moral aspects of the drive. Resultantly the country had been observing NID every year since 1994, and the children had been administered so much quantity of polio vaccine down the years which in a civilized world could hardly be imagined. “Excessive vaccination has battered the immune system of our children drastically,” he regretted.

He also criticized the donor agencies for what he termed their ill-conceived approach towards polio eradication besides succumbing to the pressure of local health authorities while making appointments.

He said poliomyelitis which caused through the virus was also a water born disease, but the donor agencies had not so far paid attention to ensure supply of clean drinking water, especially in Dera Ghazi Khan and Rajanpur where safe water was available only to five per cent of the population. He said more than half of the polio cases reported this year were found in Dera and Rajanpur.

He said neither donors nor the local health authorities were giving importance to the routine immunization coverage of polio. Contrary to China, the routine coverage in Pakistan was hardly 45 per cent.

On the merit violations in appointments, he said this always proved fatal to the projects. The policy of favouritism was the guiding principle of WHO while posting coordinators in DG Khan and Rajanpur. On the other hand, Unicef had gone an extra mile by appointing a lady health visitor against the post of coordinator in Dera, while the basic requirement for the post was MBBS and a vast experience in running campaigns in the health sector.

Moreover, he said, none of the WHO or Unicef coordinators who ‘served’ in Dera and Rajanpur belonged to these far-off districts despite the availability of professionals who fulfilled the criterion.