Polio’s last refuge
The WHO has issued a fresh warning that Pakistan is still at risk of a polio outbreak because of gaps in vaccination coverage. A WHO panel earlier this month notes the main risk comes due to gaps in polio eradication in Peshawar and Karachi, and neighbouring Afghanistan. Although Pakistan has only seen two polio cases this year — both in Bannu town of Khyber-Pakhtunkhwa — there have been at least 15 positive environmental samples in different parts of the country, reflecting the widespread presence of the virus. We also cannot ignore that last year’s 20 cases were also a 20-fold increase over 2021, when a single case was recorded.
The WHO panel has also noted that despite vaccination successes in areas such as southern K-P, where an additional 160,000 children were vaccinated, gaps remain visible in several areas, and not just far-flung ones, because of old and new factors such as political instability, security and greed. Also, some “communities” are demanding services in return for allowing vaccination campaigns to proceed in their areas.
Read Anti-polio drive targets 2.7m children in K-P
However, the caretaker government has tried to reassure people that the ongoing vaccination campaign will be successful enough and by December, “endogenous circulation” of the polio virus will have been addressed. However, exogenous circulation from across the border remains a significant risk. All five cases reported in Afghanistan this year were in Nangarhar province, which borders K-P. The virus is also widespread in Nangarhar, with positive environmental samples emerging from at least five districts of the province.
Although only two genetic clusters of the virus have been detected this year — down from three last year and five in 2021 — the number of transmission chains leaves open the possibility of further slippages through coverage and monitoring gaps. Couple this with continuing security and government service delivery problems in Afghanistan, and there is legitimate concern that an outbreak in Afghanistan would spill across the border and, for the umpteenth time, send us back to square one.
Published in The Express Tribune, August 30th, 2023.
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