KARACHI, Dec 23: The Expanded Programme for Immunization (EPI) needed to be reviewed in the light of new ground realities so that polio could be eradicated from the country by the end of 2005.

This was pointed out by several speakers at a meeting held to discuss the recent failures and successes in the ongoing fight against the debilitating disease, Dawn learnt on Thursday.

The meeting was chaired by Prof Noshad A. Shaikh, the provincial health secretary. Dr Hadi Bakhsh Jatoi, the director-general (health), was also present. At the meeting, Raana Syed of Unicef Sindh said extra efforts were needed to stamp out the disease from the province.

She was of the view that something was amiss which had turned the rather achievable target of attaining the status of zero polio cases by the end of 2004 into an unattainable one.

Ms Syed said Unicef had already embarked upon a programme to improve routine coverage in the Thatta, Khairpur and Larkana districts and Keamari, Gadap, Korangi, Saddar and Gulshan-i-Iqbal towns of Karachi.

"Under this initiative," she said, "90 motorcycles and 275 cycles had been given to the vaccinators so that mass immunization could be undertaken in a short period of time in these areas."

The provincial chief of Unicef said it would be instructive to draw lessons from this effort, if possible. "If we managed to make progress in the areas mentioned the initiative could be replicated in the other parts of the province as well."

Speaking on the occasion, Dr Hadi Bakhsh Jatoi said the total number of polio cases for 2004 had shown a decline when compared to last year. "However, there is still a lot of room for improvement."

He said he favoured giving to the EDOs and other senior staff the powers to hire and fire vaccinators. "I have told all my EDOs that if they did not like the performance of the people who they had hired, they should fire them so that coverage may improve."

It was worrisome that of the 44 cases of polio that had been reported this year from the country as many as 26 belonged to the areas falling in Sindh, said the health secretary.

Prof Noshad Shaikh said the coverage was poor in the same areas where polio cases had been reported from. "This is ironic and smacks of insincerity on the part of some officials."

He was of the opinion that without sincerity and devotion not much progress could be made in the struggle against polio. He agreed that some changes might have to be made in the EPI initiative.