Poliomyelitis, better known as polio has existed throughout history. There are Egyptian stone carvings dating back to 1403-1365 BC which show a man with a walking stick and deformities that very much resemble polio. However, the virus was brought to the limelight when it became a major public health issue in late Victorian times. This disease results in spinal and respiratory paralysis, can cause death and does not have a cure. Vaccines, though, have helped almost eradicate the disease today in most of the world.
In 1789, Michael Underwood, an English doctor, gave a proper description of the disease: he called it the debility of lower extremities. Since then, it has been given many names: the Heine-Medin disease, infantile paralysis and then polio.
The spread of the virus occurred during the phase of industrialisation and migration in the 1900’s and reached large proportions in the first half of the 20th century. In the year 1928, Philip Drinker and Louie Shaw invented the iron lung, a machine that provided oxygen to those paralysed by polio and unable to breathe. Most patients would spend two weeks inside the device. By 1939, 1,000 were in use in the US and people used to cue up to avail the service. The iron lung has now been replaced by vaccinations and ventilators.
In 1952, the United States suffered badly with 58,000 cases of polio. In 1961, Johanas Stalk was followed Albert Sabin, who concocted the easily administered oral polio vaccine. The number of polio cases in the US started decreasing, from 45,000 in 1953, to 910 in 1962. We must be eternally grateful to these two men as they have saved millions of children from polio throughout the world.
According to the World Health Organisation, since the year 2000, more than 10 billion doses of the oral polio vaccine have been administered to nearly three billion children worldwide. More than 10 million cases of polio have been prevented, and the disease has been reduced by more than 99 per cent.
So why is polio so important and why is there so much concern? Well it is the only virus in the world after small pox that is on the verge of eradication. In 1988, the 41st World Health Assembly adopted a resolution for the worldwide eradication of polio and launched the Global Polio Eradication Initiative (GPEI) which was spearheaded by national governments, WHO, Rotary International, US Centers for Disease Control and Prevention (CDC), Unicef and were supported by key partners. After small pox that was eradicated in 1980, polio will be the second virus to be eradicated in history.
Intensive eradication campaigns such as door-to-door vaccinations only started after 1999 in Pakistan. Before that the vaccine was available but parents had to take their children to the clinics to get it administered. In March 2001, about 27 million children were vaccinated across the country, in the hope that Pakistan could be virus-free by the end of that year, but that was not to be. Since then, we have come close to eradicating polio on a number of occasions, but have faced a number of challenges and have suffered setbacks. We had one such opportunity towards the end of the PPP-led government in 2012 which surrounded by numerous challenges, managed to bring numbers down. The enhanced functioning of the Prime Minister’s Polio Monitoring and Coordination Cell made the accomplishing of the goal of polio eradication look ‘possible’ in 2012. A 71 per cent reduction in the number of polio cases was witnessed in 2012 as compared with 2011. Karachi reported zero cases, Sindh only two and a total of 58 cropped up in that year. These efforts, unfortunately, were undone by the interim government led by interim Prime Minister Mir Hazar Khan Khoso, who took a criminal step by abolishing the Prime Minister’s Polio Cell. The Nawaz Sharif government restored the working of this cell towards the end of June 2013. However, it was not fully operational and took months before the positions there were filled.
Meanwhile, the challenges to polio eradication increased with vaccination bans, military operations and displaced/migrating populations. The virus spread across the country, which brings us to where we are today with more than 245 cases of polio. The future though will be better and very soon we will start seeing a decline in cases. The Emergency Operation Centre for polio in Sindh is applying new strategies and has identified super high risk 11 UCs which are being targeted with special polio drives. The cell is now using female members from the community, not only to raise awareness but also for vaccination. This will soon start paying dividends and we will be on our way towards eradicating polio from Pakistan. No child should suffer from a virus that is easily preventable, but for this to happen the federal and provincial governments, communities, parents, care givers, the media along with all other stakeholders must work together to make the country polio free.
Published in The Express Tribune, November 21st, 2014.