ISLAMABAD: Though Pakistan has completed one year without a case of polio, health experts believe that the country cannot become polio free unless the virus is eradicated from Afghanistan as both countries have been put in one block.

They also believe that sick refusals, either genuine or as a pretext to avoid vaccination, were a major reason for the failure to vaccinate 100pc children. Moreover, positive environmental samples are also a major challenge.

However, Special Assistant to Prime Minister (SAPM) Dr Faisal Sultan said it was a conjecture that Pakistan can only be declared a polio-free country along with Afghanistan, adding the world would have to listen when time would come to issue the certification.

On January 27, Pakistan completed one year without detection of a polio case. The only case in 2021 was reported from Balochistan and all other federating and administrative units of the country remained polio free last year.

According to international requirements, a country needs three years of no case to attain a polio-free status. Currently, Pakistan and Afghanistan are only two countries reporting polio cases. However, the virus has been detected in environmental samples of different cities.

If a polio virus is found in sewage, the sample is called positive. Sample of sewage from the area is the basic parameter to see if polio campaigns are being done successfully or not. A polio case can be reported in any city because of frequent movement of people to it from other areas but if the virus is found in the sewage it means that polio campaigns in the area could not achieve the target. Moreover, the presence of poliovirus in sewage also shows that the immunity level of the children in the area has decreased and they are at the risk of the disease.

Expert on public health, Dr Nadeem Jan, while talking to Dawn, said that it was a major achievement that the country did not report any polio case for a year.

“However, environmental samples are still being found positive. It means that the virus is spreading through children or adults. We are not getting cases of paralysis because immunity of children has been boosted due to the repeated polio campaigns. I suggest that the polio programme should ensure that over 95pc children are vaccinated during every campaign and the momentum should continue,” he said.

When asked about the challenges, Dr Jan said refusals were the major reason for failing to eradicate the virus.

“A large number of people either refuse to get their children vaccinated or say their children are sick. We need to develop a mechanism to ensure that if a child is sick he/she should be vaccinated after a few days. It is a fact that there is resistance against vaccination in Pakistan and same is the case in Europe, America and Africa as people are refusing to vaccinate themselves against Covid-19. We need to ensure that no case is reported for the next two years and environmental samples also remain negative,” he said.

“Another challenge is that Pakistan and Afghanistan have been put in one block due to which there is an impression that we cannot become polio free unless the virus is eradicated from neighbouring country. We will have to convince the world and the the polio certification committee to look at us with a different lens and issue the polio eradication certificate to Pakistan. We also need to engage religious figures, politicians, district administrations and others to ensure maximum coverage during polio campaigns,” Dr Jan suggested.

Dr Sultan, while talking to Dawn, said: “Every country has different epidemiology and we can convince the world that we should be considered as polio-free country. However, it is a fact that we have a lot of traffic from Afghanistan and there will always be a risk of transportation of the virus to Pakistan. Our primary responsibility is to eradicate polio within the country and then we will have to keep an eye on ensuring that the virus is not transported from the neighbouring country to Pakistan. We have also started coordinated polio campaigns along with Afghanistan,” he said.

Published in Dawn, February 6th, 2022