Pakistan advised to hand over eradication task to NDMA

Independent Monitoring Board’s report terms country’s efforts to eradicate the disease ‘a disaster’.

PESHAWAR:

Terming Pakistan’s polio eradication efforts ‘a disaster’, the Independent Monitoring Board (IMB) has recommended that the charge of wiping out the crippling virus be immediately handed over to the National Disaster Management Authority (NDMA).

In a report released on Saturday, the IMB – which independently assesses the progress of the Global Polio Eradication Initiative – put aside the Pakistan government’s claims of undertaking ‘all-out efforts’ to eradicate polio and noted that fewer children were being vaccinated in key areas of the country compared to two years ago.

The IMB was established at the request of the Executive Board and the World Health Assembly. Reports from its quarterly meetings go directly to the heads of the partner agencies - the WHO, Rotary International, the US Centres for Disease Control and Prevention and Unicef - and the Bill and Melinda Gates Foundation and are public shortly afterwards.

“Less than a quarter of vaccination campaigns assessed in the last 12 months have met the required standard of 80% coverage,” stated the report compiled following a meeting in London last month. “With 330,000 children from North Waziristan now out of an area where the Taliban had banned polio vaccination, there is no reason the [Pakistan] government should not be able to reach them,” it added.



According to the IMB, the poliovirus has been ‘striking at will’ in all provinces of Pakistan. “The virus has been circulating in Lahore for six months,” the report said. It added that in Peshawar, the success of a one-day vaccination drive had not been followed up or properly scaled up throughout the province.

“In Balochistan, more than half the environmental samples tested since May 2014 showed up positive for polio,” the report noted. “Quetta is home to the world’s longest missed chain of polio transmission, highlighting terrible surveillance.”

Karachi, according to the report, was the oldest polio reservoir while the virus has been moving about in Hyderabad since April. The Federally Administered Tribal Areas (Fata), meanwhile, reported “four times more cases than any country in the world other than Pakistan.”

According to the IMB, while security concerns surrounding polio vaccination campaigns in Pakistan are ‘serious’, the eradication programme needs to be restructured with ‘innovative techniques and committed leadership’. “If Pakistan had matched India’s performance, only 35 people would have been paralysed by polio in the world this year,” it said. The report added that if current trends continue, “Pakistan could be the last home of the poliovirus on Earth.”

Recommendations

The IMB report advised the government of Pakistan to order the NDMA to take over polio eradication efforts ‘with immediate effect’ and called for strengthening the Emergency Operations Centre (EOC) so that it could provide intelligence and coordinate functions in support of disaster management authority.

“If there is delay in adopting the NDMA recommendation, the EOC should be strengthened to have the capacity and power needed to run a programme truly set on eradication.”

The report also called on the International Health Regulations Committee (IHRC) to advise all countries to ‘turn away’ travellers from polio-infected states unless they produce a valid vaccination certificate. “This should be implemented urgently,” it said.

It should be noted that the travel restrictions Pakistan currently faces were imposed by IHRC this year on the recommendation of IMB in 2012.

The report also proposed convening a special meeting of the IMB with “those who will lead the eradication of polio from Pakistan,” in early 2015. It hoped that United Arab Emirates will play an important role the proposed meeting.


Published in The Express Tribune, October 26^th, 2014.