Pakistan’s Polio Problem

Pakistan has a polio epidemic. The number of polio virus cases in the country grew to an alarming 119 in 2019 from just eight in 2018, laying bare the utter failure of the Pakistani government to carry out a successful immunization drive.

Polio Is Wiped Out Worldwide: Except In Pakistan And Afghanistan

There are only two countries in the world where polio cases are still being reported: Pakistan and Afghanistan. The border region between the two countries has become a breeding ground for polio. The remote area, which is inaccessible due to its harsh mountainous terrain, has become a challenge for the government’s immunization drive.

Just last week, a 22-month-old child died from the virus. In another case, two separate cases of a 15-month-old and a 17-month-old were reported in the media as well. The cases are being reported from all across Pakistanin the south and north. The reason: failure of the government to implement a successful polio vaccination program.

‘Matter Of Shame’

Last month, Pakistan kicked off a three-day National Immunization Campaign where Prime Minister Imran Khan urged parents to ensure their children are vaccinated and termed the presence of the virus as a “matter of shame” for the country. The campaign targeted around 39.6 million children.

The country’s National Institute of Health claimed the drive achieved its desire objectives and successfully immunized around 99 percent of the targeted children. However, within weeks of this announcement, four more cases of polio were reported across the country, challenging the government’s claims.

The Curious Case Of Pakistan

The World Health Organization lists lack of infrastructure, remote locations, population movement, conflict and insecurity and resistance to vaccination as some of the major hurdles to eradication of polio in Pakistan.

Despite the challenges, the country has made tremendous progress in immunization over the last two decades. Pakistan was successful in bringing down the number of polio cases from 30,000 in the year 2000 to just eight in 2018. But the virus is currently making resurgence across the country.

Notwithstanding the government’s concerted efforts, various hurdles continue to hamper complete immunization. In the northern most areas, the government faces challenges in the face of remoteness, misinformation campaigns run by the militant organizations, poor infrastructure and harsh climate.

In Khyber Pakhtunkhwa, the province bordering Afghanistan – a region infamous for being the hotbed of polio in the region—many parents refuse to vaccinate their children. Families in rural communities believe the vaccines are harmful to their children and some even argue that vaccinating a child is against the teaching of Islam, a claim negated by Islamic scholars. This trend, however, is limited to rural areas where the government has had to take extraordinary steps to persuade parents to ensure their kids are vaccinated.

On the other hand, lack of government control in tribal agencies bordering Afghanistan and the presence of terror outfits in the past has also posed challenges. The situation is different in south where widespread malnutrition among children has reduced the effectiveness of anti-polio vaccines.

In addition, the Technical Advisory Group (TAG) on Polio Eradication in Pakistan highlights the administrative failures. In a report released last year, it said the “increased cases and positive environmental samples are symptoms of a program in crisis. There are serious problems in coordination and implementation and to-date unresolved issues with campaign quality, monitoring, accountability and community engagement.”

As per the findings of TAG, the major causes for failure include inadequate arrangements for supportive supervision, lack of careful analysis on the district and union-council levels, poor focus on super high-risk union councils and irrational utilization of resources.

But most importantly, the report points out the Pakistani government’s inability to build community trust which is further worsened by the administrative issues as it states, the “performance management is ineffective, and micro planning is reported to be underutilized as a key program tool for reviewing target populations at local level in order to maximize systematic coverage.”