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Polio: the national cost

Published Dec 22, 2013 08:05am

THIS year, Pakistan has recorded at least 77 polio cases compared to 58 in 2012. Pakistan’s rising polio count is not only problematic for the state but also poses a tremendous threat to the international community.

With 1.5 million Pakistani children at risk of polio, since June 2012, the polio vaccination ban in North and South Waziristan has deprived close to 290,000 children from receiving the vaccine. Since July 2012, more than 30 people, including polio workers and security personnel have been targeted and killed for administering the vaccine that is increasingly viewed with suspicion. The inaccessibility of areas as well as intensifying polio reservoirs in Fata, Karachi, the Quetta block and parts of KP further complicate Pakistan’s slow efforts to eradicate polio.

While refusal cases are largely demand-based and exist in communities faced with abject poverty, misperceptions deeming the vaccine ‘un-Islamic’ are also rampant. However, the CIA strategy to run a fake vaccination campaign, initially perceived to be an anti-polio campaign, to hunt down Osama bin Laden has perhaps been the single most harmful factor impeding the tireless efforts of the global health community.

Health workers are increasingly viewed as CIA operatives and the fallout of such an uninformed and ill-advised strategy has dealt a devastating blow to polio eradication efforts in Pakistan.

The issue however, has now extended beyond the boundaries of the state. Pakistan’s inability and disinterest in eradicating polio no longer only affects its own children but also the global population. In the past two years, poliovirus strains from Pakistan are reported to have been exported to other countries leading to serious health concerns.

In January 2012, 21 people in China were affected by a poliovirus strain emanating from Pakistan. The same strain was detected in Egypt, Palestine and Israel prompting immediate anti-polio campaigns in all three countries. Seventeen cases of polio in Syria have also been linked to Pakistan, causing international concern.

Polio exportation prompted the World Health Organisation to declare that if Pakistan failed to eradicate polio by 2015, its citizens could be facing international travel bans.

Most recently, in order to prevent the crippling virus from returning, India became the first country to issue a ban on Pakistanis wishing to travel after January 2014. Pakistani visitors will have to provide a certificate of vaccination proving that they have received the oral polio vaccine in order to enter India.

This is perhaps exactly what is needed. The state has taken its responsibility of eradicating polio far too lightly. The virus occurs in areas that face abject poverty and is essentially a poor man’s burden. Lady Health Workers who bravely administer vaccines in high-risk areas have not received their salaries for the past six months.

While the state remains uninterested and ineffective, the private sector too is largely absent from health efforts because frankly, polio does not affect them. Eradicating polio is a responsibility of all stakeholders. The private sector and NGOs are faced with a tremendous opportunity to serve as a pressure group and get involved with not only greater understanding but also dedicated commitment. By involving different stakeholders, sustainable efforts illustrative of an informed and sensitive strategy are urgently needed.

Only when influential Pakistanis are directly affected and will face travel bans from the US or UK, be prevented from taking summer vacations in Thailand or planning destination weddings in Turkey, will they take the eradication of polio more seriously. However, eradicating polio should be more than just another golden star, a fist pump, a Nobel Prize or a shining trophy. The state has done little to address the security situation, the polio ban in Waziristan, or the problem of inaccessible areas and remains mum when facing Taliban threats.

Previous media strategies to create awareness and garner support have backfired. Involving religious scholars to issue fatwas has also shown limited progress. The involvement of such influential actors is imperative to create awareness but perhaps a more revised, cohesive and wider strategy along with greater political will is needed.

One hopes that the newest entrant in the field, Imran Khan, will remain cognizant of the various challenges facing polio eradication and not simply build castles in the air. For one thing is for sure, Pakistan may have been able to afford a political experiment but efforts to eradicate polio, simply khan not.

India successfully eradicated polio in 2011 and will be declared polio-free next year. None of the 11 cases recorded in Afghanistan this year are indigenous; all emerge from the Eastern region, closer to Pakistan’s border and are linked to cross-border transmission. In the next few years, Pakistan may very well be the only remaining Asian polio-endemic country finding itself between two neighbours, both of whom are successfully polio-free.

If for nothing else, Pakistan should strive to eradicate polio out of just pure competition.

The writer is a journalist.

arslajawaid@gmail.com