LAHORE: Prime Minister’s Focal Person for Polio Eradication Babar Bin Ata has directed the Punjab health authorities to place Lahore in tier-2 category -- a high-risk district of the province in respect of reporting polio cases and spreading the virus.

Mr Ata issued instructions to upgrade risk rating of the provincial capital from tier-3 to 2 on the recent reports that 60 union councils have been found high-risk for poliovirus hub, posing serious threats of its circulation to the other districts/cities as well.

According to the globally defined pattern of evaluating the poliovirus status in the districts, there are four categories -- tier-1 to 4. The tier-1 category districts are defined as core reservoir districts, tier-2 as high-risk districts, tier-3 as vulnerable and tier-4 as low risk districts.

Mr Ata was on a visit to the provincial capital where he was scheduled to chair a high-level meeting with the Emergency Operations Center coordinator Salman Ghani and partners staff from Unicef and the World Health Organization (WHO).

According to the Global Polio Eradication Initiative, polio remains endemic in three countries Afghanistan, Nigeria and Pakistan. It declared that until poliovirus transmission is interrupted in these countries, all countries would remain at risk of importation of polio, especially vulnerable countries with weak public health and immunization services and travel or trade links to endemic countries.

Speaking to Dawn, Mr Ata hinted at accountability of the staff responsible for the circulation of poliovirus in the provincial capital.

“Lahore is still having a large number of children missed out in every campaign and to have them vaccinated we need to change strategy and think out of box at the earliest,” said the PMFP for Polio Eradication. He believes that the poliovirus circulation can be curtailed in Punjab by eliminating it first from Lahore.

“I have directed the EOC coordinator to seek support of partners staff and move the officials from non-high-risk districts to Lahore so that the virus is eliminated,” Mr Ata said.

He said he had conveyed the authorities that the prime minister office on polio eradication was all support for Punjab in this regard.

“I have asked the EOC coordinator that instead of working on general approach, we need to focus on high-risk drainage union councils,” the PMFP stressed.

After remaining polio-free for six years, Lahore reported a polio case in the beginning of 2019 when a child living in urban slum union council of Shalamar Town was paralysed for life, he said.

The provincial and district government had launched extensive efforts to prevent the virus from affecting children when the polio virus was detected from the sewerage sites of Outfall and Multan road pumping stations in June 2018, indicating presence of poliovirus in the city.

But despite all efforts, he lamented, the virus affected the child mainly due to the reason that he had not received any dose of routine immunization. The OPV history of the child was also found to be questionable, he said.

About Rawalpindi which has had history of operational challenges and issues of reluctance from caregivers, he said the said district was also a source of worry for the programme.

“We are having a lot of operational issues like unavailability of staff and missed children and we have raised the age-limit for vaccination of children from five years to 10 to 12 years in super high-risk union councils of Rawalpindi to counter the risk,” he added. “A new independent mechanism is being devised to ensure that results of the campaign are not manipulated,” Mr Ata said.

The PTI government has taken this initiative to maintain high level of transparency in line with the commitment to eradicate polio from the country. Punjab completed 2016 without a polio case, he said, adding that it was quite unfortunate that a four-month child from Lodhran ended Punjab’s streak of 14 months without a case in 2017.

In 2018, he said, no polio case was reported in Punjab. This year, however, six polio cases were reported in Pakistan including four in Khyber Pakhtunkhwa and its tribal districts, one in Sindh and one in Punjab.

Published in Dawn, April 18th, 2019