Prime Minister Nawaz Sharif turned the talking points on polio into far-reaching action on Thursday when he ordered the compulsory pre-travel vaccination of all children venturing out of the Federally Administered Tribal Areas (Fata).
At the same time, the prime minister declared a polio emergency in the country and called upon the Chief of Army Staff (COAS) General Raheel Sharif to ensure security of polio teams by deploying the army at all Fata borders.
Under the premier’s instructions – which were delivered in a statement – children from high-risk Fata – where immunisation campaigns had been halted for two years – will be barred from crossing provincial peripheries if they are not inoculated.
The premier’s order is seen as a bid to regulate the movement of vaccinated people from the tribal areas into the settled areas. PM Nawaz also ordered to convene the meeting of National Task Force on polio as soon as possible.
The directive comes in the week after the World Health Organisation (WHO) put Pakistan on the list of countries that are exporting the crippling virus, and imposed travel restrictions for residents going to other countries.
From the distressing 62 polio cases reported out of Pakistan this year, 48 emerged from Fata – the largest number surfacing from any region in the world. Earlier this year, WHO had termed Peshawar the ‘largest reservoir of polio’ as 90 per cent of the current polio cases were genetically linked to Khyber-Pakhtukhwa’s provincial capital. Officials working to stamp out polio in the north-west region of Pakistan say that a major challenge to aggressive campaigns is the population movement from the tribal areas to K-P.
WHO’s Acting Country Representative in Pakistan Dr Nima Saeed Abid said, “The more children in Pakistan that get vaccinated, the more relieved we will be – especially in the area where there is an extensive circulation of poliovirus.” He said the prime minister’s move to make inoculation of internally traveling tribal children mandatory is a positive step towards eradicating the scourge from the country.
A senior official working closely with Pakistan’s polio eradication programme shared the details of the briefing given by the National Coordinator for Polio Eradication Ayesha Raza Farooq to Nawaz on Thursday at cabinet meeting.
“Karachi, Fata and Peshawar are three areas that brought embarrassment for the entire nation in a form of travel restrictions imposed on the country by WHO,” the official quoted Farooq as saying.
She said polio cases are mostly clustered in Fata’s North and South Waziristan and adjacent FR Bannu, adding that 93 per cent polio cases this year have come from FATA and K-P combined.
“However, 7 per cent have come from Karachi,” she said.
Within Fata, she said more than 90 per cent of the cases come from North and South Waziristan while the rest from FR Bannu and Khyber Agency. “More than 80 per cent polio cases this year did not receive a single dose of polio vaccine; another 9 per cent received less than four doses. It is important to note that nearly 90 per cent of wild poliovirus cases this year are among children less than two years of age,” she said.
Farooq said that the barrier to vaccination in North and South Waziristan as well as Khyber Agency due to the ‘ban’ by militants and military operation is the major hurdle to a polio-free Pakistan. “Shaken confidence of the vaccinators due to direct threats and killing is another significant barrier,” she said. The official further quoted her as saying that in Khyber Agency polio programme officials have set a target to vaccinate 75,927 children under the age of five and efforts are under way to achieve this set target.
She said that the highest percentage of parents’ refusal due to religious concerns was recorded in Balochistan at 52 per cent, followed by K-P and Sindh with 35 per cent each. The refusal rate in Fata is 30 per cent
A security official, who requested anonymity, said that after April 17, army personnel providing security to polio vaccinators are going door to door to vaccinate children in K-P and Fata. “Even children in militancy-hit areas are getting vaccinated, which is a positive sign,” said the official.
Published in The Express Tribune, May 16th, 2014.