Towards polio eradication?

After almost reaching the cusp of polio eradication, Pakistan has seen a new spike in polio cases

After almost reaching the cusp of polio eradication before being severely derailed in April, Pakistan has seen a new spike in polio cases. However, international experts, including the regional head of Unicef, have expressed confidence in Pakistan’s ability to once again set a realistic target for eradication — the end of 2023. This is because the path towards eradication was already set when security issues and natural disasters created some cracks in the road. However, those cracks appear to have been fully paved over, as cases of the deadly virus have bottomed out again.

After going 15 months without a case, the country registered 13 cases in the three months from April to July, and 20 for the year to date. However, along with the decreasing trend since July, it is worth noting that all 20 cases were in Khyber-Pakhtunkhwa. When weighed in light of that fact, Punjab and Sindh have been polio-free for over two years, and Balochistan has reported only one case — the one in 2021 — over the last two years.

There has also been a notable decline in vaccine-derived poliovirus (VDPV), which is when a combination of poor sanitation and low community vaccination rates lead to unvaccinated or immunocompromised children getting the virus from vaccinated children. There have been zero VDPV cases this year, even though the number —counted separately from the better-known wild poliovirus figure (WPV) — was often higher than WPV figures as vaccination coverage improved over recent years. The decline in VDPV cases can at least in part be attributed to better vaccination coverage and improved sanitation, which also supports the federal and K-P governments’ arguments in this regard. At the same time, Islamabad and Lahore, both major cities, declared polio-free in March 2021, reported polio in sewage water as recently as August.

There is also a legitimate concern that those repaved cracks could reopen. As history shows, every year in which new cases have taken a significant dip has been followed by one with a major spike. Whether this was due to complacency or just bad luck, the fact is that it isn’t over till it’s over.

Published in The Express Tribune, December 6^th, 2022.

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