LAHORE: With a record 25 new positive environmental samples reported across the country, the World Health Organisation (WHO) foresees Pakistan as a polio-endemic state in 2020 as well.

With disturbing reports continuing to emerge regarding poliovirus getting out of control in Pakistan, the WHO has suggested the authorities show high-level commitment to make the world polio free.

For the first time, Pakistan has reported more than two dozen positive Wild Poliovirus 1 (WPV1) environment samples across the country. According to the Independent Monitoring Board (IMB), out of the 25 samples, 12 were reported from Punjab, 11 from Sindh and two from Balochistan.

The samples were collected between Nov 1 and 18 from all the provinces for analysis and the reports were released this week.

Meanwhile, the WHO report states that increased instances of polio cases in Pakistan in 2019 as compared to 2017 and 2018 highlights the continued geographic spread of the virus.

Suggests high-level commitment for its eradication on the part of authorities

“The gaps in strategic implementation of vaccination activities in Pakistan mean a high likelihood that the number of cases will continue to increase and that transmission will continue well into 2020,” reads the WHO executive board report.

After meeting in the first week of this month following presentation of the Global Polio Eradication Initiative Polio Endgame Strategy 2019-2023, the board released its report a couple of days ago.

The report provides an update on the status of polio eradication against the three key goals of the strategy and summarises the remaining challenges to securing a polio-free world. The WHO states that Afghanistan and Pakistan are the only countries that continue to confirm transmission of WPV1 with the latter reporting 94 cases in 2019 -- the highest in a year so far.

In 2018, Pakistan reported 12 WPV1 cases, a 50 per cent increase from eight in 2017, as well as a 31pc increase in the proportion of WPV1-positive sites under environmental surveillance (sampling of sewage to detect poliovirus).

Highlighting a perspective of spread of polio, the report stated cross-border endemic virus transmission between Afghanistan and Pakistan in two corridors: the first links eastern Afghanistan with Khyber Pakhtunkhwa in Pakistan, and the second southern Afghanistan (Kandahar and Helmand) with Quetta as well as Karachi.

In both countries, the WHO states, the focus for the second half of 2019 was to conduct an in-depth analysis of all aspects of the programme, and put in place new emergency measures to improve operations by the start of the low transmission season at the end of 2019 and early 2020.

“The key to fully identifying area-specific challenges and implementing the solutions is a high-level commitment to polio eradication on the part of the newly-elected authorities,” it said.

In the perspective of increase in polio cases in Pakistan and Afghanistan, the Global Polio Eradication Initiative partnership has launched a “hub” of experts based in Amman, Jordan, to provide dedicated, rapid and coordinated support and expertise to these countries.

Published in Dawn, December 11th, 2019