ISLAMABAD: The International Health Regulations Emergency Committee, which has been advising director general of the World Health Organisation (WHO) on efforts to stop the spread of poliovirus across the planet, has extended the travel restrictions imposed on Pakistan for three months.

At a meeting on April 24, the committee said that even though the number of polio cases reported in Pakistan was declining, the country posed considerable risk vis-a-vis spread of the disease across the world.

However, the Pakistani health authorities are describing the committee’s decision as a positive one because as opposed to two earlier meetings when the restrictions were imposed for six months each time this time they have been extended for “only three months”.

At its April 24 meeting, the committee noted that nearly one year since the declaration that the spread of polio constituted a Public Health Emergency of International Concern (PHEIC), considerable progress had been made by countries in response to the temporary recommendations issued by the WHO’s director general.

“No cases of wild poliovirus have been reported in Africa for eight months; in 2015 Pakistan and Afghanistan have reported less than half the number of cases that were reported during the same period in 2014; there has been no export (of the disease) from Pakistan since October 2014; and the number of persistently missed and inaccessible children is declining in Pakistan,” the committee said.

The number of inaccessible children had declined from an estimated 300,000 to 50,000 in the Federally Administered Tribal Areas (Fata), it pointed out.

Pakistan continued to implement the temporary recommendations and since November an average of 370,000 international travellers per month were vaccinated before departure.

However, the committee noted that during the last 12 months the spread of wild poliovirus continued, with three new cases of export of the disease from Afghanistan to Pakistan occurring late last year.

The committee was of the opinion that Pakistan and Afghanistan were part of the same “epidemiological block” having frequent population movement, which accounted for the ebb and flow of the virus in both directions.

The committee said that in Pakistan a reduction of cases occurred during the “low season” and the performance of the eradication programme had improved.

Nevertheless, 21 of the 22 cases reported so far this year — or 95 per cent of the cases worldwide — were reported in Pakistan. Thus the key factors contributing to the international spread of poliovirus from Pakistan, although improving, had not changed sufficiently since the meeting of the committee on February 17.

Published in Dawn, May 8th, 2015

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