Polio: bottom of the list

Updated Aug 25 2013


TWENTY-FIVE years ago when eliminating polio became a priority, close to 350,000 people in the world, mostly children under the age of five, were affected by the disease. Today, through concerted efforts carried out by the global health community, aided largely through private enterprises, the global polio count stands at 192 for 2013. The Global Polio Eradication Initiative’s ambitious Polio Endgame and Eradication Strategic Plan aims to eradicate polio by 2018. However, recent outbreaks in declared polio-free countries have complicated the crisis. Already this year, Kenya, Ethiopia and Somalia have recorded 121 cases of polio outbreak whereas Pakistan, Nigeria and Afghanistan remain the last three polio endemic countries. Pakistan’s case is troubling at best. Polio remains a vicious predator, incurable and in some cases fatal, preying on children. Amongst other donors like Rotary International and the Gates Foundation, the Islamic Development Bank recently disbursed $32.6 million to help eliminate the disease in Pakistan, as the first instalment of its $227m pledge. Despite exorbitant global investment, the real work and political will must come from within Pakistan. Close to 34 million children under the age of five remain susceptible to polio. The anti-polio campaign has been hampered due to a number of different factors, which include poor performance of the teams and the traditional benchmark that views the campaign as a ‘back-door family planning programme’ that aims to sterilise children. In other cases, the negative perception emanating from the CIA’s ‘polio vaccination’ campaign to hunt Osama bin Laden (actually a Hepatitis B campaign), and America’s unapologetic attitude has done more to fuel resentment, instil suspicion and harm the anti-polio drive here than anything else. In a country that harbours strong anti-US sentiments, many families refuse the drops due to anger with the US, or the belief that either the drops may harm the child or the white-chalk markings outside the house may make it easier to be targeted by drones. Fata remains the major poliovirus reservoir and 24 cases of wild polio virus 1 from across the country have already been reported for 2013. Of these, 14 have been reported in Fata and five in KP. For the same time period, last year, Pakistan recorded 29 cases and 58 cases in total for 2012, a marked 71pc decline from the 198 cases the country recorded in 2011 (the highest in the world that year). Further complicating the problem is the Taliban threat. Since June 2012, local leaders have suspended the immunisation campaigns in North and South Waziristan, depriving close to 260,000 children of the vaccine. Approximately 28 people, including polio team members, NGO workers and police personnel have been targeted and killed, with the threat most pronounced in KP and Fata. While reports claim that the Afghan Taliban support anti-polio drives and refrain from attacking polio workers, the same cannot be seen in Pakistan. Religious scholars from the Pakistan Ulema Council have condemned the killing of polio workers as “inhumane” and “un-Islamic”. Deeming the polio vaccination as safe and healthy, statements from clerics play a strong role in alleviating suspicion and fear. While the Prime Minister’s Polio Monitoring and Coordination Cell has set up vaccination camps in mosques, much more needs to be done to engage local communities and battle the principal handicap of the eradication campaign: the issue of missed children in KP and the adjoining tribal areas. Religious scholars can play a critical role in negotiating with the Taliban and participating in grass-root level advocacy, which the KP government must use to its advantage. Furthermore, a number of national immunisation days have been delayed due to elections and the monsoon rains. The growing cases of polio do not bode well for a country that sees a sharp spike soon after the monsoon season is over, leaving innumerable children susceptible to the virus. It will be imperative for Imran Khan’s party to demonstrate diplomatic muscle and deem polio eradication a priority. More than often, ‘softer’ issues like education and health pale in comparison to drones, energy and terrorism where negotiations are concerned. While it is commendable that the Pakistan Tehreek-i-Insaf (PTI) government has, for all intents and purposes, furthered a welfare budget, it remains to be seen whether it covers real ground and goes beyond rhetoric. It will certainly be an uphill task for the provincial government to effectively invest almost Rs8 billion in health. Services and accountability must be improved and the government should stress upon reaching missed children. Better management and coordination between law enforcement agencies is required. Pakistan is close to eradicating polio. Strong and sustained political will to stamp out the virus is urgently required. Although Rs320m have been released for the salaries of Lady Heath Workers throughout the province, the threat to workers’ lives remains serious. Much is riding on PTI’s ability to distinguish itself from the politics of the past. While both external mishaps and internal mismanagement have hampered the anti-polio campaign, the PTI is in a unique position to adopt a firm stance on the issue from the outset. The provincial government would be well advised to be more vocal, whether it requires pushing the agenda during negotiations with the Taliban or condemning violence and demanding stringent security measures. The real issue that plagues efforts in KP revolves around negotiations and the PTI must be prepared to push through, if it is committed to the cause. The World Health Organisation has already hinted at travel restrictions on Pakistanis if polio continues unabated in the country. India eradicated polio two years ago and remains just one year away from being declared ‘polio-free’. If for nothing else, perhaps embarrassment and competition could force the anti-polio drive to be taken more seriously in Pakistan. n

The writer is a journalist covering foreign policy and development.