PESHAWAR, March 4: The World Health Organization (WHO) has failed to stem the tide of polio virus in the NWFP and Federally Administered Tribal Areas (Fata), owing to lack of proper strategy and coordination with the health department.
According to officials, the world health agency, which had started Polio Eradication Initiative (PEI) programme in the Frontier province in 1994 with a view to providing technical and financial support to the health department at the provincial and district levels to do away with the crippling ailment of polio, had been facing an uphill task of checking the disease.
"It kept on changing strategies to cope with the situation, but its lack of coordination with the directorate of health is the main cause of problem which has been hindering its attempts aimed at eradication of the disease," said a source at the health department.
It carried out supplementary immunization activities annually apart from observing two national immunization days (NID) since 1994 to 1997. The PEI has been conducting a total of eight rounds of immunization annually in the Frontier province and adjacent tribal areas.
The basic objective of the WHO/PEI was to coordinate the activities with the directorate of health and Expanded Programme of Immunization (EPI) and provide technical support to its activities in the NWFP and Fata to do away with the ailment by December 2004, said an official, adding that ground realities showed that the people would continue to suffer because of polio.
"Lack of coordination between the WHO/PEI and EPI's provincial chapter has been the basic cause of the failure. We have infrastructure, but need finances," said an EPI official.
He suggested that the health department had more than 1,000 staffers to reach in all parts of the province and Fata to administer the polio drops.
"We need transportation and other facilities to reach the children in the remotest regions," he said. According to him, the WHO/PEI was doing things itself, which was why the results weren't forthcoming.
"We do not have the transport to reach inaccessible areas in Fata, which had more than a dozen cases last year," said an official at the directorate of health, Fata. The WHO/PEI has not been able to achieve success up to the desired level, despite having the services of highly-paid staff consisting of 56 members.
An official said most of the staff was based at the district level to provide support and technical assistance to the district health team, through its six international consultants and 15 surveillance officers (SOs) mainly appointed in high-risk districts, like Peshawar, Nowshera, Charsadda, Swabi, Khyber Agency, Mohmand Agency, Bannu, North Wazirisatn, Lakki Marwat and D.I. Khan.
Consultants and SOs had reportedly been hired against handsome salaries, a source revealed. In every polio campaign round in NWFP/Fata, WHO provides financial support of approximately Rs10 million and Rs2 million to district support team, who provides added support to the districts in preparation, monitoring/supervision and post-campaign evaluation EPI activities.
Officials said a total of Rs53 million were being spent on every round, of which 80 per cent went to human resource (teams and supervisors), 18 per cent on transportation and fuel cost and two per cent on miscellaneous.
The monthly cost of the WHO/PEI provincial office is about Rs600,000, of which 50 per cent went to fuel and maintenance of 24 vehicles, 20 per cent for drivers' wages, 10 per cent for telecommunications and 20 per cent for stationary, equipment maintenance.
Officials said Peshawar and Bannu regions had been accorded top priority in the polio eradication campaign. They said special strategies for high risk populations, plan for covering missed children with improved recording, focus on vaccination of the children below the age of one year, reduction in number of refusals and improved quality of monitoring third party monitoring were steps taken by the WHO/PEI to put brakes on the disease.
The Frontier province reported 136 polio cases in 1999, 56 in 2000, 31 in 2001, 33 in 2002 and 32 in 2003. Two cases have been reported this year, so far. Officials said though the government was committed to eradicate polio by the end of this year, going by the track record of the WHO/PEI and health department, the ailment would continue to haunt the children.