Hurdles to vaccination: Mismanagement takes a toll on polio spread
WHO official says three to five good campaigns will help eradicate the crippling virus from the country
KARACHI:
Militants have long been the scourge of polio vaccination campaigns, attacking aid workers and the police who protect them as they distribute doses to children.
But experts say there is another reason for the sharp spike in cases of the crippling disease - government mismanagement.
“Pakistan’s polio programme is a disaster. It continues to flounder hopelessly, as its virus flourishes,” the Independent Monitoring Board, which advises agencies fighting polio, will say in a report to be released this week.
The prime minister’s polio cell was disbanded in 2013 elections, the new government delayed reconstituting it, and in
recent months the prime
minister has been consumed with protests in the capital that have only just ended.
“It’s frustrating. Eradicating polio is not rocket science,” said Elias Durry, head of the World Health Organization (WHO) polio campaign in Pakistan.
“If we could have three to five months to have really good campaigns, then we could get rid of this disease,” he said. “We have been doing half-baked campaigns in high risk areas.”
Polio was meant to be a thing of the past. A global campaign came tantalisingly close to wiping out the disease altogether. Now polio, which can kill or paralyse a child in hours, is endemic only in Pakistan, Afghanistan and Nigeria.
So far this year, Pakistan has had 217 polio cases, a 14-year high accounting for 85% of the instances around the world.
Experts say complacency is not an option and the government has called the situation an “emergency”.
Yet as the latest vaccination campaign kicked off this week in Karachi, vaccination workers said they had not received stipends from the provincial government for months. Some have dropped out of the campaign.
As teams prepared to venture out on vaccination missions into some of Karachi’s most dangerous streets, police deployed to protect them showed up late.
Taking responsibility
Prime Minister Nawaz Sharif took six months to appoint an official responsible for polio, and the government approved a funding plan only last month.
That meant provinces did not pay workers their stipends of $2.50 a day on time, said Shahnaz Wazir Ali, Adviser to Sindh CM on polio. “We had a loss of about nine to 10 months, which is a very big setback,” she said.
Ayesha Farooq, the PM’s focal person on polio admitted there were problems, but said that payment arrears were down to provincial, not central government.
Most new cases were in areas where security was poor so children had not been vaccinated, she said, and denied that PM Nawaz was not taking the issue seriously.
The IMB report said the delay “speaks volumes about the inertia of the programme in Pakistan”.
Police protection
For frontline polio workers, late pay is less worrying than lack of protection. Sixty-four people have been killed in attacks on polio teams and their security escorts since 2012, when the Taliban banned vaccinations in areas they controlled.
Police are thinly spread, especially in Karachi where only 26,000 police watch over the huge city. Some are deputed as bodyguards for politicians.
Karachi police spokesman Atiq Shaikh said the force was severely understaffed. “Polio campaigns take 2,000 officials. But we always provide them with security even though we have some constraints,” he said.
A further hurdle is caution among families offered the treatment. Aiding polio’s spread has been this year’s military offensive in the tribal region of North Waziristan, which drove nearly a million people out of the conflict zone.
The mass movement allowed workers to vaccinate children previously unreachable. But families also moved to areas where vaccination coverage was patchy, allowing polio to re-establish itself in cities where it had been eradicated, experts say.
Children may need the oral vaccine up to 10 times for it to be effective. Many children are malnourished or have diarrhoea so the vaccine is not absorbed.
Published in The Express Tribune, October 28th, 2014.
Militants have long been the scourge of polio vaccination campaigns, attacking aid workers and the police who protect them as they distribute doses to children.
But experts say there is another reason for the sharp spike in cases of the crippling disease - government mismanagement.
“Pakistan’s polio programme is a disaster. It continues to flounder hopelessly, as its virus flourishes,” the Independent Monitoring Board, which advises agencies fighting polio, will say in a report to be released this week.
The prime minister’s polio cell was disbanded in 2013 elections, the new government delayed reconstituting it, and in
recent months the prime
minister has been consumed with protests in the capital that have only just ended.
“It’s frustrating. Eradicating polio is not rocket science,” said Elias Durry, head of the World Health Organization (WHO) polio campaign in Pakistan.
“If we could have three to five months to have really good campaigns, then we could get rid of this disease,” he said. “We have been doing half-baked campaigns in high risk areas.”
Polio was meant to be a thing of the past. A global campaign came tantalisingly close to wiping out the disease altogether. Now polio, which can kill or paralyse a child in hours, is endemic only in Pakistan, Afghanistan and Nigeria.
So far this year, Pakistan has had 217 polio cases, a 14-year high accounting for 85% of the instances around the world.
Experts say complacency is not an option and the government has called the situation an “emergency”.
Yet as the latest vaccination campaign kicked off this week in Karachi, vaccination workers said they had not received stipends from the provincial government for months. Some have dropped out of the campaign.
As teams prepared to venture out on vaccination missions into some of Karachi’s most dangerous streets, police deployed to protect them showed up late.
Taking responsibility
Prime Minister Nawaz Sharif took six months to appoint an official responsible for polio, and the government approved a funding plan only last month.
That meant provinces did not pay workers their stipends of $2.50 a day on time, said Shahnaz Wazir Ali, Adviser to Sindh CM on polio. “We had a loss of about nine to 10 months, which is a very big setback,” she said.
Ayesha Farooq, the PM’s focal person on polio admitted there were problems, but said that payment arrears were down to provincial, not central government.
Most new cases were in areas where security was poor so children had not been vaccinated, she said, and denied that PM Nawaz was not taking the issue seriously.
The IMB report said the delay “speaks volumes about the inertia of the programme in Pakistan”.
Police protection
For frontline polio workers, late pay is less worrying than lack of protection. Sixty-four people have been killed in attacks on polio teams and their security escorts since 2012, when the Taliban banned vaccinations in areas they controlled.
Police are thinly spread, especially in Karachi where only 26,000 police watch over the huge city. Some are deputed as bodyguards for politicians.
Karachi police spokesman Atiq Shaikh said the force was severely understaffed. “Polio campaigns take 2,000 officials. But we always provide them with security even though we have some constraints,” he said.
A further hurdle is caution among families offered the treatment. Aiding polio’s spread has been this year’s military offensive in the tribal region of North Waziristan, which drove nearly a million people out of the conflict zone.
The mass movement allowed workers to vaccinate children previously unreachable. But families also moved to areas where vaccination coverage was patchy, allowing polio to re-establish itself in cities where it had been eradicated, experts say.
Children may need the oral vaccine up to 10 times for it to be effective. Many children are malnourished or have diarrhoea so the vaccine is not absorbed.
Published in The Express Tribune, October 28th, 2014.