PRAISE from the Unicef and the WHO for Pakistan’s efforts to eradicate polio in the country is reassuring. This, coupled with that fact that last year Pakistan saw just one case of WPV1 or wild poliovirus, means that the end of a very long battle of several years is finally in sight. But it has also been reported that eight cases of cVDPV2 — or vaccine-derived poliovirus — emerged in Pakistan during the year. Which means that vaccination efforts must be intensified further, considering that the transmission of vaccine-derived polio is attributed to inadequate immunisation rates. Pakistan must locate and inoculate the ‘invisible children’ – those whose parents are averse to the vaccine, who are out of school or whose name is not to be found in official records. This is crucial to successfully traversing the “last mile” before being declared polio-free. The difficulties remain: just a few days ago, the country lost another policeman guarding a polio vaccination team a day after a nationwide anti-polio drive was launched.

The other challenge is synchronising national anti-polio efforts with those in Afghanistan. Pakistan and Afghanistan are often referred to as the two remaining countries that are not polio-free. However, as immediate neighbours, they comprise “a single epidemiological block”. It is only by coordinating closely that they can defeat the virus. But the turn of events in Afghanistan after the Taliban takeover last August has cast a shadow over anti-polio efforts. The Taliban themselves might back anti-polio drives but Afghanistan’s healthcare system is in a shambolic state and the politics of relief for the beleaguered residents has led to despair and uncertainty. Hence, while Afghanistan, like Pakistan, had shown progress in the polio eradication journey, it is too soon to say that polio cases will not re-emerge there. This could have implications for Pakistan in view of migrating Afghan families anxious to escape conditions across the border. These challenges should prompt action by the wider international community if they want a polio-free world.

Published in Dawn, January 30th, 2022