Fresh cases put question mark on polio eradication plan

Updated February 17, 2020

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The hue and cry by international and national organisations over the recently notified vaccine-derived poliovirus type 2 (VDPV2) has once more put to question the Pakistan’s polio eradication programme as continuous emergence of cases has upset the health authorities regarding the source of the strain of virus, eradicated from the world in 1999, according to sources. — AFP/File
The hue and cry by international and national organisations over the recently notified vaccine-derived poliovirus type 2 (VDPV2) has once more put to question the Pakistan’s polio eradication programme as continuous emergence of cases has upset the health authorities regarding the source of the strain of virus, eradicated from the world in 1999, according to sources. — AFP/File

PESHAWAR: The hue and cry by international and national organisations over the recently notified vaccine-derived poliovirus type 2 (VDPV2) has once more put to question the Pakistan’s polio eradication programme as continuous emergence of cases has upset the health authorities regarding the source of the strain of virus, eradicated from the world in 1999, according to sources.

Last month the VDPV2 were detected in Peshawar, Bajaur and Khyber districts of Khyber Pakhtunkhwa to bring the total number of cases to 25 as 22 cases were diagnosed last year.

Sources said that Pakistan had been using OPV till 2016 that was stopped when the World Health Organisation recommended that no case had been reported since 1999 and also verified that no vial of OPV existed in the country.

Following the WHO’s recommendations, Pakistan began administering Bivalent (P1 and P3) instead of Trivalent (P1, P2 and P3) to the children because P2 was withdrawn from vaccine schedule in April 2016.

“We are at loss to understand the source of VDPV2 because it is derived from vaccination, which has been stopped in 2016 and the WHO verified that Pakistan did not have the stock,” said sources.

Health authorities upset about source of type 2 virus strain

They said that Pakistan recorded 17 polio cases from September to December that included nine from Khyber Pakhtunkhwa one each from Gilgit-Baltistan and Islamabad.

However, the cases weren’t notified due to which Pakistan was accused by the international community of covering up the cases.

WHO is mainly responsible for surveillance system regarding poliovirus and duly manages such eventuality from acute flaccid paralysis (AFP) case identification to collection of stool sample, dispatching to National Institute of Health, Islamabad.

The whole dirt for non-notification of the cases was thrown at Babar Bin Atta, the former focal person for polio education.

The issue was also discussed in Senate few days ago where members demanded Babar’s arrest.

However, sources said that the WHO could have notified cases from its offices located in Geneva and other international offices that received all information from all countries the same day, if notifying the cases from Pakistan was that difficult.

It was moral, technical and ethical responsibility of WHO to inform other sources in the government of the gravity of the situation but it didn’t, they added.

“Moreover, now one person is being made a scapegoat for all the ills.

Why there was a pin drop silence from WHO when VDPV2 cases were detected back in August 2019,” they questioned.

Source said that historically the government of Pakistan was held accountable for the wrong policies and strategies by the international actors such as WHO and others but surprisingly the key government functionaries were tightlipped or rather provided space to those powerful lobbies to escape.

Even the government didn’t ask WHO as to why the virus once eradicated reemerged in Pakistan when the P2 vaccine were withdrawn from the programme.

Sources said that actually WHO was the technical lead agency on the subject and should have come up with valid explanation to untangle the issue at that time.

The WHO chief in Pakistan didn’t respond to telephone calls and messages to seek his comments.

National Polio Coordinator Dr Rana Mohammad Safdar said that polio type 2 had been eradicated from the world since 1999and no case was reported afterwards from anywhere in the world including Pakistan.

“VDPV2 is mutated virus that has caused outbreaks in over 20 countries of the world since OPV switch in April 2016.

“It is a global challenge and besides multiple other countries, Philippines and Malaysia in Asia have recorded recent cases as well,” he said.

Like other countries, Pakistan is also responding to the VDPV2 detection as per global guidelines and SOPs using special OPV2 vaccine rounds.

Sources said that Pakistan was at the centre stage of the polio eradication due to emergence of most cases of P1 in 2019 and 2020 but the reemergence of P2 cases also put question mark on the WHO’s role.

Published in Dawn, February 17th, 2020