The global polio eradication effort will miss yet another deadline — that of stopping transmission of all naturally-occurring ‘wild’ polio viruses by the end of this year, a vital first step in completing a task that began in 1988 and was to have been achieved by the year 2000.
The latest report from the Independent Monitoring Board (IMB), which produces periodic assessments of how the global programme is faring, makes for sombre reading. The virus remains out of control in Pakistan. In Africa, Ebola has complicated the task of wiping out the virus.
In the nine months from January to September this year, polio paralysis had increased five-fold in Pakistan compared to the same period last year while in the rest of the world it had been reduced seven-fold.
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Many polio cases in neighbouring Afghanistan were caused by the Pakistan virus. This virus had also gone to Syria and Iraq, and paralysed children there.
“Pakistan’s polio programme is a disaster,” says the IMB in its report. “It continues to flounder hopelessly, as its virus flourishes. Home to 80 per cent of the world’s polio cases in 2014, Pakistan is now the major stumbling block to global polio eradication.”
Instead of the virus being restricted to a dwindling number of pockets, it was present in every province in the country. In key areas, fewer children were being vaccinated than two years back and immunity had plummeted. Less than a quarter of vaccination campaigns carried out over the past year met the required 80 per cent coverage. The fact that the virus has been circulating for six months in a metropolis like Lahore “clearly demonstrates deteriorating accountability and oversight.”
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In May this year, the Board had recommended that Pakistan create an Emergency Operations Centre, as Nigeria had done, to oversee its polio programme. But the country had shown “characteristically little urgency” in doing so, and the plan put forward by it for this purpose was “a pale imitation of its vibrant Nigerian counterpart,” lacking the clear and powerful leadership that characterised the latter.
“There is an answer to Pakistan’s predicament. The National Disaster Management Agency has shown its clear capability in dealing with the country’s natural disasters. The time has come to put it in charge of polio eradication and rescue Pakistan’s vulnerable children,” recommended the IMB in its latest report.
In the latest issue of the Weekly Epidemiological Record , the World Health Organization too has warned that “without significant improvements in Pakistan’s programme and control of WPV [wild polio virus] within its borders, the global efforts to eradicate polio will be undermined.”
The IMB was also concerned about the adverse impact from the Ebola outbreak in West Africa on the polio programme.
“Given the current distribution of Ebola, a substantial part of the African continent is at heightened risk of polio. If Ebola spreads to other countries in the world with low levels of childhood immunisation they too will be the source of potential polio outbreaks,” it noted.