PESHAWAR: As Khyber Pakhtunkhwa is set to start on Nov 30 vaccinating around 6.4 million children under five years of age against poliomyelitis, new polio cases continue to emerge.

Chief Secretary Dr Kazim Niaz on Friday inaugurated the vaccination campaign at the Police Services Hospital where he urged the parents to ignore the anti-vaccine propaganda and save their children from disabilities.

A WHO report said that KP had recorded five circulating vaccine-derived poliovirus type 2 (cVDPV2) cases in 2019 and 42 in 2020. Last year, three districts were infected against 11 now. KP accounted for 42 of 81 cases recorded countrywide.

With regard to wild polio cases, the province has made progress as it has reported only 22 cases this year so far, compared to 66 during this period last year.

However, experts say the collection of still samples has decreased due to engagement of polio staff in Covid-19 activities. WHO-run polio surveillance system sends stool samples from the children with the slightest doubt of paralysis for lab analysis, but due to Covid for half of the year the health facilities were non-functional or semi-functional only focusing on Covid-19. Cases of paralysis weren’t brought to the facilities which caused performance slump.

This resulted in a smaller number of Acute Flaccid Paralysis (AFP) cases reported this year compared to the previous year. Last year, of 15,216 AFP cases 93 were positive and this year so far around 9,473 AFP cases have confirmed polio in 81, which means positivity ratio is higher compared to last year.

Chief secretary inaugurates vaccination drive

Experts point out that Pakistan has fared poorly than Afghanistan where only 53 cases have so far been reported. They said the story of polio eradication has remained a never-ending tale of promises, reassurances and status quo.

In a recent meeting of provincial task force, the chief secretary was told that polio programme was on a “winning trajectory” since July 2020, notwithstanding the fact that only one small scale campaign has since been conducted. The experts in the country are amazed at this logic as to how cases could be reduced when there is no full-scale campaign.

The Independent Monitoring Board’s report in July 2020 had warned against celebrating reduction in cases and termed polio programme in Pakistan “Too forgiving of itself”.

Experts said the UN-led polio programme model had proved too costly and ineffective and wanted the government to be in lead role to eradicate the crippling ailment.

Dr Rana Mohammad Safdar, coordinator of the National Operation Centre (NOC) for polio eradication, told Dawn that they had a surveillance dip in Covid-19 months, but detection was not seriously compromised as all districts stayed above the global standards of 2/100,000 and national standards of 6/100,000 non-Polio AFP rates.

“We opted for extensive contact sampling in cases with slightest doubts of stool adequacy. Epidemiologically case decline is encouraging, but not forgetting that when ultimate goal is zero, even one is too much,” he said.

The transmission is widespread in Pak-Afghan block, but Afghanistan’s wild polio cases are up from 29 in 2019 to 54 so far while Pakistan has reported 81 so far against 147 in 2019.

Dr Safdar said that amid Covid-19 pandemic they had taken a bold initiative to restart routine immunisation in May and polio campaigns in July with precautions.

Published in Dawn, November 28th, 2020