IN recent months and years, news reports about the discovery of new polio cases have been trickling into the public domain with increasing frequency.
People are aware that the virus is enjoying a resurgence in Pakistan which, along with Nigeria and Afghanistan, is one of the last three polio-endemic countries in the world. And everybody, I imagine, knows the challenges being faced by the country in its polio vaccination efforts.
Not only is misinformation about the vaccination deliberately put out by mischief-makers, causing harm, there is also the matter of tribal elders and the Taliban declaring that access to vaccination teams will be curtailed unless drone strikes are halted, or until material benefits such as electricity are provided to communities in remote places.
The effort to put an end to the anti-polio drive is also seen in the terrifying spate of targeting polio workers, many of whom have been killed in recent days.
All these regressive stances have made much, much harder what was already a formidable task: making sure that the vaccination teams managed to reach every single child in the country.
Meanwhile, there’s another angle to the polio story that has not really caught the public’s attention. Over the past few months, from time to time there have been murmurs from various quarters abroad calling for a polio-related travel ban on Pakistan.
In other words, any Pakistani wishing to travel abroad must be able to prove that he has been vaccinated, or face denial of entry into another country. With much of the rest of the world polio-free, other countries are, with some justification, worrying that travelling Pakistanis may reintroduce the virus in their communities.
In July came the news that the World Health Organisation (WHO) had communicated its concern about the polio situation in Pakistan in view of the different challenges: the rise in the number of cases discovered, the targeting of vaccination teams or the vaccination refusal rate, and the reported problems about cold-chain procedures etc that compromise the effectiveness of the vaccine.
The international body indicated to local authorities that if the situation wasn’t brought under control by 2013, in the worst-case scenario, a travel ban could be imposed.
Talking at a meeting organised by Unicef in late March, WHO’s Dr Wahab Alanesi underscored the fact that in terms of polio, there is poor performance all around, on part of anti-polio campaigners, officials, the media as well as politicians.
In July, this matter was talked about on the floor of the Senate, but we saw no accelerated action.
Now, in early December, the Global Polio Eradication Initiative’s (GPEI) independent monitoring board has also recommended that it be made mandatory for Pakistanis intending to travel abroad to produce a certificate proving that they had been vaccinated against the crippling virus. The world anti-polio body has called for such a restriction from March 2013.
This is serious business, and it was taken as such by one group of people i.e. Karachi’s business community. On Dec 13, some representatives of this sector and export-oriented industry in particular called upon the government to take the matter up with the GPEI on a priority basis.
These few voices are right. The threat of a travel ban ought to be taken far more seriously. The challenges notwithstanding, Pakistan had better improve its performance on the polio front.
The ban hasn’t been imposed yet, but it may well be. If I lived in a country where polio had been eradicated, I too would be seriously concerned about potential carriers coming to my city or my locality; consider, after all, that 95 per cent of polio-infected people never show any symptoms and are therefore never diagnosed, but can infect others.
A carrier of the virus can contaminate food and liquids with poliovirus which will then infect the consumer. You can contract it by touching contaminated surfaces or objects and then putting that hand in your mouth, or being sneezed on or touching a surface that has been coughed on by an infected person. There is also evidence that flies can passively transfer poliovirus from faeces to food.
If such a ban were imposed, it would add formidable challenges to our anti-polio efforts. In terms of the individual, you and I would have one more hassle to contend with while applying for a visa. Before embarking on a journey, either we’d have to dredge up that vaccination card of decades ago, or we’d have to go to a doctor, get ourselves vaccinated again and be issued a certificate as proof.
But in terms of the state’s anti-polio efforts, significant paperwork and a relevant administrative structure would have to be created. It would not be enough to merely send a vaccination team into the ghettos of Karachi or to a remote mountaintop and have the children lined up for the drops and their houses marked.
Logically, the state would also have to keep a permanent record, on paper — a copy of which would have to be provided to citizens upon application — of every child vaccinated, every follow-up dose administered, and every child not vaccinated, for whatever reason.
Further, presumably adults who have no proof of having been vaccinated as children would have to be re-vaccinated, and records kept as well as certificates issued of that.
Paperwork means people, which means more money, closer coordination and a campaign that is much more complex in structure. All this in a country where polio is already on the rise and the vaccination campaign is already under more stress than it can handle.
We cannot afford this ban, but it may well be imposed given the stark seriousness of the virus. Is anyone going to do anything?
Can anyone do anything?
The writer is a member of staff.