Pakistan is one of the three countries where polio is still endemic, the other two being Afghanistan and Nigeria. Due to an a alarming increase in the number of polio cases in Pakistan (the number of polio cases reported this year stand at 61 whereas last year a total of 91 cases were reported), the WHO has recommended that the vaccination be made mandatory and all travelers from the country should carry a polio vaccination certificate.
Polio eradications efforts in Pakistan have faced a lot of opposition on religious grounds. Clerics have issued sharp censure calling the drops haraam and part of a larger American conspiracy to sterilize the Muslim population. Things have become more complicated since the OBL episode where the drive was used for espionage purposes and thus resulted in a ban from the Taliban. Not too long ago, India was the country with the worst polio problem but it too has not reported a single case of polio in the last 3 years. The scenario in countries like Pakistan and Nigeria which are plagued by extremist insurgency is different: the Pakistani Taliban and the Boko-Haram stand in the way of polio eradication efforts. It is very likely, according to Bill Gates, that the goal of complete eradication of polio might be missed by a year or two given the extent of violence and its repercussions for the immunization drive.
Hopefully, the dangerous trends in the country will serve as a wake-up call while the government is working on budgetary proposals for the next fiscal year. During FY2013-14, the government allocated Rs 35.6 billion for the health sector which is insufficient considering how far it lags behind. However, some steps are being taken to increase the momentum of the polio immunization process. As of now, polio drops are being administered to children under the protection of the army in areas of the KPK where the locals are also being receptive as well as supportive. The government has also decided to make it compulsory for travelers from the FATA region to be administered polio drops and has decided to involve the army to ensure security and keep a check on the ingress of people to other areas of Pakistan. This is very similar to the process through which India got rid of the disease and will help Pakistan’s case. The Ministry of Health has also requested the Prime Minister for a supplementary grant of Rs. 800 million to ensure provision of vaccines to passengers.
The WHO has expressed its optimism by stating that Pakistan’s polio crisis can be overcome within one year if the government ensures security of polio workers and facilitates access to the high risk areas in Fata, Karachi and Peshawar where polio workers are often attacked and threatened. There have been more than 100 attacks on polio teams and at least 50 casualties and no arrests in association with the violence against polio workers thus far. The WHO has also acknowledged that it is an equal stakeholder and has emphasized its resolve to help facilitate the eradication of Polio.
The government should also look to take tribal leaders on board and involve them in the campaign. This will help reduce security concerns and push locals to trust the vaccination drive. Through advertisements and effective PR, the government can effectively trash all misconceptions about the vaccine and communicate the benefits and the trade-offs. The support of the government and the international community through funding and effective policy setting will help provide momentum. Taking the input of all concerned stakeholders and entities that can exert influence and facilitate the journey towards a polio-free Pakistan is the first step towards the achievement of the goal.