K-P’s hopes for eradicating polio hang in the balance

Despite there being no cases of the wild poliovirus in Khyber Pakhtunkhwa (K-P) for more than a year now, its existence in the environment threatens all efforts of the provincial government in eradicating the virus.

No case of disabling and life-threatening disease has been reported in the province since July of 2020 but recently in December environmental samples from two districts Bannu and Tank have come back positive which has dampened the spirits of those associated with the anti-polio campaign in the province. Therefore, officials have now diverted their focus towards the two districts.

“We have to stop the circulation and we have prioritized these areas since the samples have tested positive which could infect anyone anytime,” said Zameen Khan, Deputy Coordinator for the Emergency Operation Center K-P, “most of the virus, following genetic sequencing, was found to have traveled from the neighboring Afghanistan so now border points in Northern Districts and South Waziristan are being focused upon.” K-P has a past history of being engulfed by the crippling virus; for instance back in 2014 when a total of 306 cases were reported from across the country, 241 cases were from the province alone.

Back then the figures triggered massive vaccination campaigns amidst the volatile law and order situation which also claimed the lives of polio workers and police personnel deployed to protect the workers. In Pakistan’s context, who along with its neighbor Afghanistan are the only two countries in the world where polio is still endemic as per the World Health Organization (WHO), the cases went down from 306 in 2014 to 54 in 2015; 20 in 2016 and 8 in 2017. However, a drastic upsurge was witnessed when the cases rose to 12 in 2018 all the way up to 147 in 2019. In 2020, a downward trend was seen as 84 cases were reported across the country and in 2021 only 1 case was reported from all over the country.

Officials who have been associated with the province’s efforts to combat the virus feel that environmental samples testing positive for the virus should keep everyone on their toes as it is a threat that a potential outbreak looms.“The virus has a history of disappearing and then rearing its head again.

Therefore despite there being no case for the past 17 months we have to tread carefully as it is still present in the environment,” a senior health official who is part of K-P’s anti-polio campaign informed The Express Tribune under the condition of anonymity. The official said that it was a small win for their current efforts as they had never gone for so long without a case being reported.

“The polio virus has now become localized and historically speaking, it has never been so in the past,” he said. However, the official conceded that no reported cases was not a cause for celebration but rather an indication that current efforts to combat the virus should continue. “For complete eradication of the virus you need to go at least three consecutive years without any case being reported and then we can claim that the virus has been eliminated and the country has become polio-free,” the official informed.

According to Zameen Khan, fake finger marking, where parents instruct campaign workers to mark the fingers of their child without giving the polio drops to dupe the other health department officials who come to check the inoculation status of the child, has been the achilles heel of the campaign in the province. ‘We have lodged cases against all those found involved in fake finger marking and will hopefully overcome the issue now,” Khan informed The Express Tribune.

Published in The Express Tribune, March 20^th, 2022.