Fighting polio into the New Year: ‘Refusals and security responsible for 2014 surge’

Focal person suggests NEAP be used to formulate strategies for 2015.

PESHAWAR:

The surge in polio cases across the country, especially Khyber-Pakhtunkhwa (K-P), is a reflection of the uphill task health authorities have faced over the last two and a half years to combat the crippling disease. As yet, the final count for 2014 is still unknown, with the last of the samples being processed in the laboratory.

Looking back

The drive lost momentum when an interim administration took charge after the PPP-led central government completed its five year tenure.

Another major concern remains—security—as more than 60 polio workers, law-enforcement personnel and civilians involved in the eradication campaign were killed in the country – 34 in K-P alone. Nonetheless, campaigns continued across the country in 2014.

Just as security issues plagued campaigns so did coverage; a large number of children were missed in almost every immunisation round.

These challenges faced in the polio eradication campaign and major achievements by health workers were highlighted in the National Emergency Action Plan (NEAP) 2014. With the onset of a new year, the plan could prove a useful tool to form strategies in the coming year.

K-P and Federally Administered Tribal Areas polio focal person Dr Imtiaz Ali Shah said stumbling blocks in this crucial campaign did prompt stakeholders to come up with concrete recommendations.

Extending deadlines

When Pakistan, Afghanistan and Nigeria were unable to eradicate polio by 2004, it was decided that the governments of the remaining countries would declare polio eradication a national emergency and develop their own NEAPs, Shah said.

“The plan spelled out communication and operational strategies for polio eradication and defined the roles and responsibilities of the government,” he said. The official added the prime minister’s focal person leads the programme, while emergency operation centres were to be established for close coordination and uniformity.

Who to blame?

A ban against polio vaccines had been in place in North Waziristan Agency since 2012 and mass migration after the launch of Operation Zarb-e-Azb of unvaccinated children to parts of K-P added to exposure risks.

Before the start of the operation in June, the count for polio victims across the country was 75, yet it also gave unprecedented access to the isolated population.

According to Shah, a majority of the cases were reported from areas inaccessible due to security issues, such as North Waziristan Agency, Khyber Agency, Frontier Region Bannu and parts of South Waziristan Agency. He said people moving in and out of the regions were the main carriers of the virus.

When asked if parents’ refusal was the major hurdle in polio eradication, Shah said it was the sole reason the virus still existed in Pakistan. He pointed out that Punjab hosts more than 50% of the country’s population, yet it only reported three cases in 2014, seven in 2013, two in 2012, and nine in 2011.

The districts and agencies where the administration and health department performed well were DI Khan and Bajaur Agency where not a single case was reported and coverage remained at over 95%.

These areas have remained polio free over the last two years, even though both face security issues.

Published in The Express Tribune, January 7^th, 2014.