ISLAMABAD: The inevitable has finally happened. To prevent the possible spread of the polio virus from Pakistan to other countries, the World Health Organisation (WHO) decided on Monday to impose strict travel restrictions on the country.
The decision was taken on the recommendation of the emergency committee of WHO, which had met on April 28 and suggested imposing travel restriction on Pakistan because of the continuous increase in polio cases in the country.
An official who works for WHO said that last year 60 per cent polio cases were a result of the international spread of the wild poliovirus. There was evidence that adult travellers contributed to this spread, he added.
Although polio only affects children, adults can be carriers of the disease.
The Minister of State for National Health Services, Saira Afzal Tarar, said that the government would try to address the concerns of the WHO so that by the next assessment (the decision will be reviewed in three months), the travel restrictions are reversed.
She said that the restrictions had been imposed on Syria and Cameroon along with Pakistan, while seven countries were warned to control the virus.
“I tried to avoid the ban by suggesting that the sanctions should be applicable on the Federally Administered Tribal Area, but the WHO said that it only dealt with international boundaries.”
Pakistan’s polio problem
The spread of polio in Pakistan has been a big worry for the past few years.
The virus strain of polio found in the country has affected as many as five countries over the past two years, becoming a serious threat to other countries.
Individual countries had already taken steps to stop the spread.
In February, India had banned the entry of travellers from Pakistan unless they had taken Oral Polio Vaccination (OPV) at least six week before the visit.
Saudi Arabia had back in 2000 made it mandatory that every Pakistani (children and adults) had taken OPV at the time of entry in that country.
Within Pakistan, each successive year has witnessed a higher number of children diagnosed with polio.
For example, in the first four months of the current year, 59 cases of polio have been recorded. The corresponding period last year witnessed only eight cases.
There is no single reason for the spread of the disease; the factors range from irrational fears to a limited campaign to militancy.
Many people appear to believe that the polio vaccine can cause fertility problems or that it is against Islam. The inefficacy of the drugs being used to vaccinate is also a problem as is the internal displacement due to which children have missed doses.
The problem was compounded by the killing of Osama bin Laden on May 2, 2011 – Dr Shakil Afridi is seen to have helped traced Osama through a fake polio vaccination drive, which too prejudiced people against the campaign. And since the incident, the Taliban and other militants have also opposed the polio vaccination campaign more aggressively.
All these factors have ensured that the government efforts remain sketchy at best.
An official of the ministry of national health services said that despite all the efforts of the ministry to raise awareness about the Extended Programme of Immunisation (EPI) in December last year, 47,099 children were missed all over Pakistan because their parents refused the vaccination.
And the resistance by the militants can be gauged from the fact that 40 polio workers and security officials have been killed during polio campaigns.
According to an official statement issued by WHO, the April meeting was attended by representatives of Pakistan, Afghanistan, Cameroon, Equatorial Guinea, Ethiopia, Israel, Nigeria, Somalia and Syria.
Calling the spread of the disease an ‘extraordinary event’ and a public health risk, the Emergency Committee of WHO said that “During 2014, international spread of wild poliovirus is being done from three of the 10 states that are currently infected. In central Asia, the virus is travelling from Pakistan to Afghanistan; in the Middle East it is travelling from Syria to Iraq and in central Africa it is travelling from Cameroon to Equatorial Guinea.”
It then recommended that “all residents and long-term visitors (less than four weeks) receive a dose of OPV or IPV between four weeks and 12 months prior to international travel”.
The meeting also pointed out that seven states – Afghanistan, Equatorial Guinea, Ethiopia, Iraq, Israel, Somalia and Nigeria – were infected with Wild Poliovirus, but they were not exporting the virus.
The WHO approved recommendations on Monday and decided to reassess the situation after three months.
Logistics to be worked out
It is already evident that is going to be a logistical nightmare to ensure Pakistani travellers have taken the drops before proceeding outside the country.
The government will not only have to set up a system of administering the vaccination but also issue a certificate. In addition, it will have to ensure that this facility is available to all those who use different exit points across the country.
Not everyone is convinced that the government has the resources to do this.
Dr Waseem Khawaja, a health expert, said that it would not be easy for already overburdened government hospitals to issue polio vaccination certificates to travellers. “Additional human resources and counters will be required.”
He pointed out that a majority of travellers, especially those going to the Middle East, would have to be educated and informed about the issue.
The health minister explained that she had called a meeting on Wednesday to formulate a strategy to deal with the travel ban.
“Certificates of polio vaccination will be issued from every hospital. We will also try to make arrangements to give the vaccine to people at airports as they are proceeding abroad. I am trying my best to ensure that no fee is charged for these polio certificates,” she said.
According to the minister, the restrictions would be implemented as soon as possible but not on those who had already reserved their seats.
She said that the government would try to start polio vaccination in Fata.
Meanwhile, Foreign Office spokesperson Tasnim Aslam said that Pakistan was in contact with WHO over the travel restriction.