Embarrassment: Pakistan faces global travel curbs

Emergency meeting called to draw up a response.

ISLAMABAD/ LAHORE:

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 6^th, 2014.