Since January 13, 2011, India has not recorded a single case of polio — an achievement the World Health Organisation officially acknowledged, stating that India had stopped indigenous transmission of wild poliovirus. India’s success should serve as a beacon of hope for some nations still struggling to control polio. As one of three nations (Afghanistan and Nigeria being the other two) recording indigenous transmission of wild poliovirus, Pakistan could imbibe invaluable lessons from its neighbour about eradicating polio. This is especially important because Pakistan had experienced the world’s largest nationwide outbreak of polio in 2011 with 198 reported cases.
As of June 8, 2012, Pakistan had reported 21 cases of wild poliovirus, compared to 52 cases during the same period in 2011. The saving grace — transmission has been curtailed to known transmission zones. In regions where the virus is rampant, there are two main reasons, each a cause for concern. Firstly, insurgency and security-related dangers mean Pakistan’s national polio programme cannot consistently reach children in certain areas of FATA. Secondly, sub-optimal management of the programme at the sub-district level in KP, Sindh and Balochistan have seen inconsistent polio campaigns, with many children being missed during immunisation drives.
Adopting best practices
Against this disconcerting backdrop, Rotary International has undertaken vigorous efforts in promoting the Polio Eradication Campaign in Pakistan, just as it did in India. Along with its partners, Unicef and WHO, Rotary’s PolioPlus Committee in Pakistan has been overseeing eradication efforts. Toward this end, Pakistan has emulated India by roping in celebrity ambassadors to advance the cause of polio eradication. Accordingly, Pakistan’s erstwhile cricket captain Shahid Afridi is part of the Polio Eradication Campaign.
Pakistan has also adopted best-practice modules from India — such as the identification of high-risk blocks, roping in religious leaders from different sects in door-to-door campaigns, conducting health camps to augment abysmal healthcare services, and producing social mobilisation materials for Information, Education and Communication on Polio. During NIDs (National Immunisation Days) and SNIDs (Sub-National Immunisation Days), Rotary Clubs in Pakistan work alongside government health workers during immunisation drives and also collaborate with multinational companies to boost awareness levels.
In the Sindh region, Rotary clubs join hands with local community-based organisations (CBOs) who facilitate in accessing communities at the grassroots level, to create awareness and facilitate in surveillance and monitoring during and after campaigns. With multiple misconceptions bedevilling polio vaccine drives across many regions of Pakistan, Rotary has been reaching out to Ulema conventions and religious scholars to dispel misplaced notions.
All-out efforts required
Efforts are also underway to ensure participation at polio booths in Attari and Wagah on the border, where India has instituted preventive measures to guard against polio import. It’s essential to convince various stakeholders in Pakistan about the importance of polio eradication. With widespread poverty and security concerns in many regions, immunisation against polio is not a pressing concern for Pakistanis — and understandably so. But if polio is to be successfully stamped off the earth, special attention should be paid to Pakistan because it could likely be the “last polio reservoir worldwide” that may hamper not just the hopes of Pakistan’s vulnerable children but the global polio eradication goal.
Rotary Clubs in Pakistan have been more proactive and persist with polio camps, walks and workshops that drive awareness and eradication efforts; distributing polio social mobilisation materials in schools and communities; local Rotary members volunteer time to take up training by the WHO representative to improve monitoring and surveillance; Polio Awareness Guidelines, PolioPlus newsletters and updates are also disseminated regularly, for Rotary members to better understand polio eradication efforts .
Pakistan PolioPlus Committee has installed billboards in high-risk districts for national campaigns, with some billboards being permanent. As per the government’s request, an additional 45,000 vaccine carriers have been made to ensure quality of activities don’t suffer.
Cross-border cooperation
Appreciating the importance of polio eradication, Pakistani authorities are firmly committed to implementing eradication efforts to ensure polio spikes within its borders are curbed. To facilitate the success of its anti-polio initiatives, Pakistan has sought India’s support in this drive. In end-May, a team of eight delegates from Pakistan comprising federal and provincial government representatives, led by Begum Shahnaz Wazir Ali, the Prime Minister’s special assistant for the social sector and National Polio Focal Point, and Dr. Azra Pechuho, member of the PM’s National Polio Task Force and MLA from Sindh province, left for India.
Apart from the exchange of delegations between the two nations, Pakistan’s serious intent is also evident from the fact that Pakistan President Asif Ali Zardari is personally involved in the campaign against polio.
There’s little doubt that it will take concerted, sustained efforts on the part of all stakeholders — public and private entities, partnerships and the public — for polio to be finally eradicated from Pakistan. But failure to do so will leave open the perennial threat of wild poliovirus making a surreptitious comeback in other geographies too; that is something Pakistan, and the world, can ill afford at this crucial juncture.
(Aziz Memon is chairman, Rotary Pakistan PolioPlus Committee.)
