ISLAMABAD: Before the health ministry and the Prime Minister’s (PM) Polio Cell had recovered from Bill Gates’ phone call to PTI chief Imran Khan appreciating the polio programme in his province, the World Health Organisation (WHO) unleashed another surprise by extending international travel restrictions.

In November 2014, following the spread of Pakistan’s poliovirus to Afghanistan, Pakistanis were restricted from travelling abroad without a document certifying that they had received a dose of polio vaccine prior to travel.

Also read: Bill Gates praises KP’s anti-polio campaign

According to a statement posted on the WHO website, the fourth meeting of the Emergency Committee under the International Health Regulations (IHR) regarding the international spread of wild poliovirus in 2014-15 was convened via teleconference on February 17. Pakistan, Cameroon, Equatorial Guinea and Syrian Arab Republic submitted an update on the implementation of the temporary recommendations since the committee last met on November 13, 2014.

The committee noted that the international spread of wild poliovirus had continued with a new case of Pakistan’s poliovirus being exported to Afghanistan after November 13, 2014.

The committee assessed the risk of the poliovirus from Pakistan spreading internationally. It appreciated Pakistan’s vaccination plan for low-transmission season, establishment of national and provincial emergency operation centres and continuation of campaigns in North and South Waziristan. However, it noted that the principle factors underpinning the international spread of wild poliovirus from Pakistan have not changed sufficiently since the third meeting of the Emergency Committee on November 13, 2014.

The committee observed the situation had worsened with the expansion of conflict zones particularly in the Middle East and Central Africa.

It expressed concern over incomplete implementation of the temporary recommendations in all affected countries, many of whom are affected by regional conflicts.

The committee concluded that the spread of polio remains a public health emergency of international concern and recommended the extension of temporary recommendations from November including travel restrictions for another three months.

New risk stratification was issued for the 10 countries and Pakistan was put in the category of ‘States currently exporting wild poliovirus’, along with Cameroon, Equatorial Guinea and Syrian Arab Republic.

The committee suggested that these countries officially declared poliovirus transmission as a national public health emergency. In countries where emergency had already been declared, it should be maintained.

It was further suggested that all residents and long-term visitors be given a dose of oral polio vaccine between four weeks and 12 months prior to international travel.

Those who have not received the vaccine and are undertaking urgent international travel should ensure that they receive vaccine before departure. These countries were instructed to ensure that all travellers are carrying an International Certificate of Vaccination or Prophylaxis as proof.

The committee urged these countries to intensify cross-border coordination and enhance surveillance for prompt detection of poliovirus and substantially increase vaccination coverage among refugees, travellers and cross-border populations.

The countries have been told to maintain these measures until six months have passed without new exportations and there has been documented high quality eradication activity in all infected and high-risk areas. If there is no documentation, the committee recommended that countries maintain these measures till 12 months had passed without the virus being exported.

Based on the advice of the committee, the reports presented by states and other available information, the director general accepted the committee’s assessment and decided to extend the declaration of the international spread of wild poliovirus a Public Health Emergency of International Concern (PHEIC).

According to the WHO’s statement, the director general endorsed the committee’s recommendations and extended the temporary recommendations under the IHR 2005 to reduce the international spread of wild poliovirus.

On May 5, 2014, the WHO declared it mandatory for Pakistan to give one dose of vaccine to all residents and long-term visitors travelling internationally.

Published in Dawn March 5th , 2015

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