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POLIO Eradication & Pakistan

Polio is increasingly becoming an enigma for the Pakistanis as no government policies yet have been able to produce tangible results to curb this crippling disease. All endeavours and efforts to make Pakistan polio-free have ended up in smoke. The situation looks embarrassingly grimmer when in its latest report, the WHO has said that Pakistan is the only country to let polio virus move outside its borders. There is no presence of polio even in the developing countries like Bangladesh, Sri Lanka, Nepal and Myanmar, let alone the developed ones. Even our next-door neighbour India — the second most populated country in the world with nearly 1.3 billion people — has been declared polio free. On the contrary, Pakistan is still being crippled by this contagious disease.

World at War with Polio

Polio has been one of the most feared diseases in the world. In the early 20th century, industrialized countries were falling prey to it. During these years hundreds of thousands of children paralysed every year. But, thanks to the introduction of effective vaccines in the 1950s and 1960s, governments were able to effectively control this killer disease and through concerted efforts, they practically eliminated its existence in their respective countries.

It took somewhat longer for polio to be recognized as a major problem in developing countries. Lameness surveys during the 1970s revealed that the disease was also prevalent in developing countries. As a result, during the 1970s, routine immunization was introduced worldwide as part of national immunization programmes, helping to control the disease in many developing countries.

In 1988, when the Global Polio Eradication Initiative began, polio paralysed more than 1000 children worldwide every day. Since then, more than 2.5 billion children have been immunized against polio in more than 200 countries of the world. This success has been possible only after a long struggle that spanned more than two decades. At present, only 3 countries — Pakistan, Afghanistan and Nigeria — are polio-endemic.

Polio and Pakistan

Although Pakistan saw a significant reduction of poliovirus cases, in late 90s and early 2000s, yet its redux has baffled and perplexed the state machinery. They are now groping in the dark because it has become extremely difficult to control polio in an environment where the country is fighting a war against terrorists and extremists whose fanaticism and bigotry has helped this virus spread unchecked. A brief look at the facts and figures reveals that by the end of 2012, a total of 58 cases were reported in the whole country compared to 198 at the same time in 2011. In 2014, another ignominy came to haunt us as Pakistan broke its own record of polio cases in the country with the number reaching as high as 237 as these lines were being written, with the number still increasing.

Why Polio Eradication Failed

As mentioned earlier, Pakistan is among the only three countries where polio is still paralysing people. Here is a brief account of the obstacles that has failed government efforts to get rid of this menace:

1. Opposition by Religious Fanatics

It is a sad fact that in Pakistan there are many fundamentalist mullahs, especially in the remote areas of the country, who not only strongly oppose polio vaccination but also fan the flames of hatred against this noble duty. Despite numerous edicts by Council of Islamic Ideology and many notable national and international religious scholars, people do not get their children vaccinated.

2. Opposition to Oral Polio Vaccination

The oral polio vaccine (OPV) was developed in 1961 by Albert Sabin. It consists of a mixture of live, attenuated (weakened) poliovirus strains of all three poliovirus types. OPV produces antibodies in the blood to all three types of poliovirus. In the event of infection, these antibodies protect against paralysis by preventing the spread of wild poliovirus to the nervous system.

The disadvantages of OPV rarely appears yet some Pakistani professionals discourage the usage of OPV due to which the people become reluctant to accept OPV as their benefactor.

3. Precarious Law and Order Situation

In 2014, there have been more than two dozen attacks on polio workers in Pakistan in which more than 32 people have lost their lives. The attacks are only escalating in lethality and violence — in 2013, there were 29 attacks against polio workers, killing 22 people.

Polio vaccinators are working for a noble cause, but some despicable elements in the society are dead against their services. That is the reason why these workers are being targeted and killed.

Due to the US-funded activities of Dr Shakil Afridi, who helped trace Osama bin Laden in Abbottabad, polio workers are working in an environment that is highly precarious. These workers are accused of being CIA operatives, thus the campaign has suffered an incalculable damage. Volunteers are fast dropping out of the campaign leaving Pakistani children more vulnerable to the disease.

4. Fallacies about Vaccination

Some Pakistanis refuse to get their children vaccinated because they believe that it is “Un-Islamic”. They term it an American ploy to sterilise the children of Muslims in order to thwart the expansion of Muslim Ummah. There are countless conspiracy theories about health workers’ activities with claims that they mark houses to be targeted by the US drones.  These totally baseless and false beliefs are responsible for the failure in curbing polio in Pakistan especially in tribal areas.

5. Reluctance of Parents

A recent research report reveals that in Pakistan more than 47000 parents do not want their children to be vaccinated. There are various causes of their denial or reluctance to the vaccination. Influenced by the speeches of mullahs, people in many rural areas of the country, believe polio vaccination against Islam and/ or detrimental to the health of their children. That’s why they do not allow the polio workers to administer polio vaccine to their children.

How to Fix the Situation?

The government must undertake all-out efforts to counter the rising threat of this disease as it has not only paralysed hundreds of young children but has also tarnished the image of the whole nation. Following suggestions can be helpful in this regard:

1. A comprehensive strategy must be chalked out to include non-government organisations (NGOs), religious scholars, political leaders, civil society activists, educationists and school teachers, human rights activists, security personnel, media houses, journalists and anchorpersons and local administration along with provincial and federal government officials.

2. There should be awareness campaigns to convince parents, especially those who have apprehensions regarding this campaign.

3. The help of doctors and medical professionals can also be sought to assure people about the non-use of any alleged ingredients so that the confidence of the people can be restored.

4. Opinion leaders such as actors, famous celebrities, philanthropists and sports personalities can do this much better than the government.

5. Many working groups can be formulated in this regard to reach out to the people living in far-flung areas.

Conclusion

If all of us join hands to eliminate this menace from our country, then there is no reason why we cannot be successful. If there are groups still adamant to stop the vaccination campaigns, use of force is justified to safeguard the national and humanitarian cause as ignorance cannot be allowed to keep the whole nation hostage any longer. Besides, there is a dire need to restore confidence of health workers with the improved security arrangements for them. Local health authorities must also show a greater commitment to monitor the immunization drives and conduct them on a more regular basis, especially in the most backward areas of Pakistan.

Any delay in formulation of concerted efforts to incorporate all the stakeholders will be tantamount to criminal negligence. Every one of us must volunteer for this national cause that has actually rung alarm bells to give us a wake-up call. Right now, nothing is more important than overcoming this socioeconomic crisis as we cannot afford to falter on this front any more.

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