Pakistan’s failure to stem the spread of polio triggered global emergency health measures on Monday, with the World Health Organisation (WHO) recommending all residents to show proof of vaccination before they can leave the country.
The emergency measures also apply to Syria and Cameroon, which along with Pakistan are seen as posing the greatest risk of exporting the crippling virus and undermining a UN plan to eradicate it by 2018.
The statement issued by WHO Assistant Director-General (DG) Dr Bruce Alyward is based on recommendations of the Emergency Committee and is effective from May 5.
“This has been recommended under International Health Regulations so it will be mandatory on all countries to seek certification of anti-polio vaccination from all Pakistanis travelling to their lands,” the WHO chief coordinator for polio eradication in Pakistan, Dr Elias Durray, told The Express Tribune.
According to the statement, the governments of these three countries shall ensure that all residents and long-term visitors (even foreigners) visiting for more than four weeks should receive a dose of the OPV or inactivated poliovirus vaccine (IPV) between four weeks and 12 months prior to international travel.
The heads of state should officially declare that the interruption of poliovirus transmission is a national public health emergency.
The government must also ensure that individuals undertaking urgent travel (within four weeks) who have not received a dose of OPV or IPV in the previous four weeks to 12 months, receive a dose of the polio vaccine at least by the time of departure.
It must also ensure that such travellers are provided with an ‘International Certificate of Vaccination or Prophylaxis’ to record their polio vaccination and serve as proof.
Govt caught ‘unawares’
While the possibility of international travel restrictions loomed for days before Monday’s announcement, the government appears to be largely unprepared for the situation – a predicament evidenced by officials’ cluelessness regarding vaccination of people who will be travelling following these restrictions.
“Currently, Pakistan has no plan to facilitate polio vaccinations for those travelling or any details about locations where certificates can be obtained. Therefore, it is too early to talk about it,” National Manager of the Expanded Programme on Immunisation (EPI) Dr Ejaz Khan said.
He is of the view that Pakistan cannot eradicate polio from the country unless it strengthens routine immunisation and merges it with the National Polio Eradication Programme.
A senior official at the Ministry of National Health Services, Regulation and Coordination (NHSRC) who requested anonymity said, “Like always, this time, too, Pakistan has not planned anything beforehand although it had a clue that travel restrictions would be placed on the country.”
The official said the restriction gives a clear message to the government to get serious and start working on polio eradication on practical grounds.
“At present, Pakistan has polio vaccines in stock for the national and supplementary anti-polio drives but do not have supplies for vaccinating every single person who will be going out of the country,” said the official.
He said that vaccine procurement is a lengthy process and will take time to acquire.
Furthermore, in each district of the country there is a need to have adequate health facilities where people could get vaccinated against the crippling disease, which could be conducted at tertiary hospitals, basic health units (BHUs) or rural health centres (RHCs), said the official.
“Currently, Pakistan does not have trained people who can issue certificates for polio vaccination which meet international standards,” he said.
International wire agencies quoted Saira Afzal Tarar, the deputy minister for health, as saying that she had called a meeting of health officials to consider how to respond to the new travel measures, and in particular how to ensure the supply of vaccine and health workers to administer the drops.
An emergency meeting is being held today (Tuesday) with all provincial ministers for the introduction of special measures following the restrictions.
The measures will include the establishment of mandatory immunisation counters at all airports, on border crossings and at seaports, and health officials will ensure that every single person going out of Pakistan has been given polio drops.
WHO national campaign coordinator in Pakistan, Zubair Mufti, said: “It is worrisome that travel restrictions have been placed on Pakistan due to the continuous surge in the number of polio cases.”
“The Pakistani government should immediately formulate a mechanism regarding vaccination for people going out of Pakistan,” he said.
Implications for travellers
• The government must ensure that all residents and long-term visitors receive a dose of the polio vaccine (IPV) between four weeks and 12 months prior to international travel
• Those who are leaving the country within four weeks must receive a dose of the vaccine at least by the time of departure
• Travellers must be given an ‘International Certificate of Vaccination or Prophylaxis’ to record their vaccination as proof
• It is mandatory for all countries to ask travellers from Pakistan to show proof of polio immunisation
• PM must officially declare that the interruption of poliovirus transmission is a national public health emergency
Published in The Express Tribune, May 6th, 2014.
COMMENTS (39)
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I dont understand , why always to compare between india and pak. Pakistan has its own circumstances to fight with and india has its own. Learn from each other in +ve areas and let us make this as better place to live.
Pakistan's main hurdle iis that militants restrict polio workers, accusing them of spying for the U.S. government.
It is important for the government to enforce polio eradication program on war footing. It must make a time bound commitment for achieving this objective. It should also announce what the Pakistani students should do who reside abroad for education and have to visit home for short duration during the holidays.
@Kepler-8B that's one big problem: we don't have any Minister for Health
If there is any such thing in Pakistan. Minister of Health should resign.
bwahahaha.......... poor pakistan...... they got nuclear missiles....and all that chinese junk which they keep on buying from the aid money.... but bear 20 hours loadshedding in a day....and have embarrassed themselves today to a new level.... with so much poverty,terrorism and polio all over pakistan i seriously think pakistan should top the list of failed states....their misplaced priorities regarding kashmir is laughable and exposes their ignorance.... pathetic ......
@Abbas
India did not win its polio free status by intimidating journalists and preventing them from reporting polio but by putting in humumgous effort to do so. http://timesofindia.indiatimes.com/home/opinion/interviews/Indias-success-in-polio-eradication-is-a-model-to-the-world-Dr-Nata-Menabde/articleshow/32680701.cms
http://world.time.com/2013/01/13/how-india-fought-polio-and-won/
@Humayun "" Poverty in india "" plz check on wikipedia!! polio finishing in india is also a sign that indian people are less poor now....& acco to World bank 2014 report last week there are only 11.8% poors are present....& back in 2012 only 21% poor are there!
Alas...we are investing on buying arms and F-16's but not on our medical facilities....very unfortunate for Pakistan
@Pakistani: Dear fellow citizens, Times are tough getting testing and tougher for us, but its about time that we bounce back and better times roll over all again. Keep your chins up and believe that we will overcome all this mess very soon
I appreciate your optimism and confidence. Just one question; regarding the latest policy statement by the Chief - Pakistan will overcome this mess by banning Jung group, by pleading to Taliban to not attack the army, and by announcing that Kashmir is Pakistan jugular vein ?
http://en.wikipedia.org/wiki/ListofcountriesbypastandfutureGDP(PPP)percapita
Per capita income listed on the Wikipedia page for India and Pakistan for 2014 are: USD 4307 and 3231 respectively.
Even accounting for inaccuracy in estimates, the difference is so big that the data should be enough to shut all Pakistanis up.
@Humayun:
"Wondering how do Indian and Chinese govt’s manage with such huge population size esp. India with the poverty levels"
India poverty levels are actually lower than Pakistan. It is a myth propagated by your media that India is somehow poorer than Pakistan.
http://data.worldbank.org/country/india
http://data.worldbank.org/country/pakistan
India poverty as per 2012 is 21%, while Pakistan's 2006 record shows its 23%.
But, since Pakistan's GDP is growing at 2 or 3% per annum, the poverty rate has doubled to 43%, as per ADB calculations.
Pakistan is not releasing its poverty figures since the Civilians have taken over.
Read the entire report here.
http://tribune.com.pk/story/181361/economic-survey-2010-11-has-the-real-poverty-rate-hit-43/
@Abbas:
"Poverty head count ratio at $1.25 a day (ppp) (% of population) India 32.7 % 2010-2011 Pakistan 21 % 2008-2009"
Incorrect.
Pakistan has not realised poverty figures since a VERY LONG TIME and poverty has increased to 43% as per Asian Development Bank.
http://data.worldbank.org/country/pakistan
http://data.worldbank.org/country/india
India - 21% (2012) Pakistan - 22% (2006)
Here is the report which says Pakistan's poverty has jumped to 43% owing to stagnant Economy.
http://tribune.com.pk/story/181361/economic-survey-2010-11-has-the-real-poverty-rate-hit-43/
So, Pakistan's Poverty has doubled in 8 years, while poverty all over the world, especially India is decreasing.
No wonder Polio cases have also correspondingly increased.
@Abbas: "if you have new data please do provide the link before stating baseless allegation." +++++++++++++++++++++++++++++++++++++++++++++++ Mr Abbas in your enthusiasm for pontificating you seem to have forgotten to follow your own advice. Where is the link to your statements?:) U must be Pakistani.
Dear fellow citizens, Times are tough getting testing and tougher for us, but its about time that we bounce back and better times roll over all again. Keep your chins up and believe that we will overcome all this mess very soon. InshaAllah.
pak should overcome this quickly..
poor pak..
And yet another Guinness world Record, Thank u Sharif Brothers
@Abbas: You believe what you want. That is what is holding you guys back, you don't admit there is a problem. Yes India is five or six times larger, but they put in ten times the effort to eradicate Polio. Education (not madrassa education) is the key.
There should be ban on both going out and coming in Pakistan
Remember when 4 months ago India started requiring Pakistani citizens with Polio certificates, you guys still didn't' get the point, now no one in the World wants to interact with Pakistanis.
@Indian reader: I don't believe your information is correct please give a reference from where your getting your information from. At the moment according to WHO
Poverty head count ratio at $1.25 a day (ppp) (% of population)
India 32.7 % 2010-2011 Pakistan 21 % 2008-2009
if you have new data please do provide the link before stating baseless allegation.
Thanks
@Abbas: I personally think WHO should have stepped up to help Pakistan "" +++++++++++++++++++++++++++++++++++ WHO helps those who help themselves.Get the message?
Isn't the Government negotiating with the very people who have brought this isolation and disgrace to Pakistan? Just wondering what happens to all of PIA's international schedule?
I guess I won't be visiting Pakistan any time soon.
Ultimate Shame for PM during his UK Visit ++++++++++++++++++++++++++++ All the hype is washed away by this WHO travel ban!.
@Humayun: Indian poverty levels are lesser than Pakistan Now. Please check the latest reports. Our governments concentrate more on the betterment of their own people
Dear ET
The recommendations oblige countries exporting (i.e. Pak for one.) to ensure vaccination before letting its citizens depart. There is NO onus on receiving countries to check vaccination documents (though some may certainly opt to do so; Georgia is an example). So this statement about "It is mandatory for all countries to ask travellers from Pakistan to show proof of polio immunisation" does not apply........ at least for now.
I cut and paste the recommendations from the IHR committee (also published in your paper)
"Pakistan, Cameroon, and the Syrian Arab Republic pose the greatest risk of further wild poliovirus exportations in 2014. These States should:
officially declare, if not already done, at the level of head of state or government, that the interruption of poliovirus transmission is a national public health emergency; ensure that all residents and long-term visitors (i.e. > 4 weeks) receive a dose of OPV or inactivated poliovirus vaccine (IPV) between 4 weeks and 12 months prior to international travel; ensure that those undertaking urgent travel (i.e. within 4 weeks), who have not received a dose of OPV or IPV in the previous 4 weeks to 12 months, receive a dose of polio vaccine at least by the time of departure as this will still provide benefit, particularly for frequent travellers; ensure that such travellers are provided with an International Certificate of Vaccination or Prophylaxis in the form specified in Annex 6 of the International Health Regulations (2005) to record their polio vaccination and serve as proof of vaccination; maintain these measures until the following criteria have been met: (i) at least 6 months have passed without new exportations and (ii) there is documentation of full application of high quality eradication activities in all infected and high risk areas; in the absence of such documentation these measures should be maintained until at least 12 months have passed without new exportations.
(from http://www.who.int/mediacentre/news/statements/2014/polio-20140505/en/)
I just wanted to add a note about ET's coverage of this whole situation; the repeated use of the word "ban" for all travel from Pak was fairly dismal.
The sheer magnitude and challenge of this public health tragedy cannot be overstated. However one does expect Pakistani newspaper to provide adequate (and correct) information at this point in tie to facilitate travelers and the public at large rather than spurring panic through misinformation
Humayun : You have showed your ignorance and have not understood the reason for the failure of Polio vaccination in Pakistan. 1. It is not the poverty level which matters. 2. It is the work by the govt and organizations like Rotary(of which I am a proud member) who undertook yeomen efforts to vaccinate the population. 3. Indians had to overcome the religious jealots who issued fatwas against vaccinations, but sure we did. 4. The general involvement in vaccination on the Polio plus day , a few years ago was unimaginable, Major railway stations, bus terminals were full of OPV vaccinators in addition to Polio booths set up in primary schools thru out India who did the job
Roshan Pakistan but only in Raiwind
Good news: Pakistanis can now stay at home!
Wondering how do Indian and Chinese govt's manage with such huge population size esp. India with the poverty levels
Embarassing inaction indeed.
Govt will not do any thing
immigration staff at airports will create nuisance for travellers
medical practionterners and Protectorate office / ministry of overseas pakistanis will make money out of this embarassment
Pakistan should be less concerned about "embarrassment" and more concerned about ensuring it's children don't get polio.
Seriously, Poilio is only the second reason for travel curbs on Pakistan. Terrorism is the primary reason.
What is embarrassing is that we have crippled children because we are unable to eradicate a disease the rest of the world has. Not the travel ban,
Ladies and gentlement, Roshan Pakistan.