PESHAWAR, Sept 25: Donor agencies, including World Health Organization, have expressed concern about Pakistan's failure to wipe out polio and identified illiteracy, lack of awareness and vaccinators' inability to reach some children as the main reasons hindering their efforts.
"We have to eradicate polio by December 2004. We are doing all we can, but the problem lies mainly with the people who insist on keeping their children away from immunization," Dr Khalif Bile Mohamud, WHO's Representative for Pakistan said.
"Last year, a local cleric in Khyber Agency had instructed his followers against polio drops, arguing that it made the recipients impotent," he said.
Dr Bile said 85 per cent of the 23 polio cases that have so far been detected belonged to poor and illiterate parents. World health agency was facing an uphill task to persuade the people to administer anti-polio vaccine to children.
Several polio victims, like one in Khyber Agency, had been given about 10 doses of anti-polio drops. Health officials at the Ministry of Health wondered how the child got the disease after having had so many doses.
"There is a possibility that the child may have had diarrhoea when he was administered anti-polio drops. More often the drops remain ineffective when the recipients are either malnourished or suffer from low-immunity", said Waheed Khan, deputy director of the EPI.
The break-up of the prevalence of polio in the previous years is quite disturbing for the donor agencies. The country reported 119 cases in 2001, 88 in 2002 and 103 in 2003, while the number of cases so far detected is 23.
Experts say that children suffering from diarrhoea, low- immunity and malnutrition should either be treated before administering vaccines to them or be put in category of high-risk groups to be handled by special polio vaccinators.
Ineffectiveness of the vaccines also sparked a debate in the National Assembly with the opposition calling for probing the efficacy of the vaccines.
Health department officials said that problems in keeping the vaccine cold might decrease its efficacy.
Efforts were now being made to involve religious scholars to convince people to administer anti-polio drops, WHO's official said.
WHO began its Polio Eradication Initiative (PEI) programme in 1994 to provide technical and financial support to the EPI programme, which started its operation in early eighties.
WHO stands accused of failure despite spending 65 per cent of its budget on PEI for its lack of coordination with the health ministry. The PEI in collaboration with the EPI has been conducting eight rounds of immunization annually, besides supplementary rounds, but the disease is haunting the all parts of the country. It has spent over $3 billion on the campaign so far with its annual expenditure run over $ 20 million.
Pakistan will receive an amount of one billion rupees as grant-in-aid Bill Gates-sponsored Global Alliance for Vaccine and Immunization to strengthen its infrastructure.
Dr Bile says that at the start of the campaign, polio was prevalent among 3,50,000 children in 125 countries, with 1,000 cases being reported every day. At present there are only 700 polio-stricken children in only six countries-Pakistan, Afghanistan, India, Egypt, Nigeria and Niger-which indicates 99 percent success rate, he said.