So close and yet so far

That Pakistan has moved closer to the eradication of the polio virus is undeniable. There have been 40 cases reported so far this year — compared to almost 300 in 2014. Attacks on polio workers and their support infrastructure have reduced — but the battle is far from over. There have been fewer reports of the ‘wild’ polio virus and a startling drop in the number of cases reported from Fata, which are down by 90 per cent. It would be all too easy to lower the guard with a victory in sight, a point made by the Independent Monitoring Board (IMB), which is the body that evaluates the implementation of efforts to eradicate polio worldwide. With Nigeria now polio-free, it is down to Afghanistan and Pakistan to finally defeat this killer. Concerns are expressed by the IMB that Pakistan is unable to close what it identifies as “immunity gaps”, but also says that access has improved substantially and that the number of children in the so-called “inaccessible areas” has dropped to 35,000.

Improvements in the overall security environment are undoubtedly in part responsible for this uptick and the innovative Continuous Community Protected Volunteers programme has also made a contribution. Yet polio workers still go unpaid for months despite putting their lives at risk, and there are still yawning gaps in coordination between the various agencies involved in polio eradication. There are over a million children still being missed despite the anti-polio drives and they are the reservoir that harbours the virus, the latency that the rest of the world fears when it comes to international transmission of the virus. The key to eradication is breaking the conveyor belt of transmission in Peshawar and the area around the city, which is still the least-safe area for polio workers in general. Another hurdle in the way of eradication battle is cross-border security with Afghanistan where the virus is also endemic. The challenge remains multi-faceted and predictions of eradication in 2016 are decidedly premature, but 2015 may just be the beginning of the end for polio in Pakistan.

Published in The Express Tribune, November 13^th, 2015.

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