THE continued emergence of polio cases from North Waziristan district in Khyber Pakhtunkhwa indicates that the vaccine refusal phenomenon extends to more than just a handful of families. The 12th case of wild poliovirus surfaced earlier this week after a 21-month-old boy experienced loss of movement in his right leg. This latest case is the ninth one to emerge from the Mir Ali union council in North Waziristan district. But news reports quoting health officials have revealed that other places in KP also remain at risk. They include South Waziristan, Dera Ismail Khan, Bannu, Tank and Lakki Marwat. Though no case has emerged from these areas in recent months, according to reports, environmental samples have indicated the presence of the poliovirus there.

The aggressive resurgence of polio in this area was surprising as zero cases had been reported in the previous 15 months. Such a high number of cases in a short span of time — the first polio case was reported in April from Mir Ali — should be viewed as a call for urgent action. Subsequent reports about the two initial polio patients in Mir Ali had revealed that both were cases of silent refusals. The affected children had, thus, remained unvaccinated and susceptible to the virus. In fact, both had fake markers on their fingers. Indelible blue ink is used by vaccinators to distinguish vaccinated children from the rest during door-to-door campaigns. The fingers of these children had been marked by their parents to evade the vaccine dose. Subsequent reports revealed that this phenomenon was also common elsewhere. Now that the emergence of new cases has shed light on the persistent issues in the management of vaccination campaigns, increased scrutiny by polio officials and other health workers is necessary so that the various deficiencies in the programme can be addressed and long-standing problems that are often pointed out by international health bodies are removed. It may be wise to shift the focus of anti-polio efforts from mass vaccination to targeted interventions in high-risk areas.

Published in Dawn, July 16th, 2022