Daily Times

LAHORE: International health partners have raised questions over political commitment towards elimination of polio from Pakistan, fearing it will affect the country’s efforts for eradicating the crippling disease by the end of this year.

The Independent Monitoring Board (IMB) of the Global Polio Eradication Initiative (GPEI) has expressed concern over the Sindh polio programme. “The low degree of political engagement in province is a major barrier to eliminating polio from that part of Pakistan and declared the polio programme in many parts of Karachi has been chronically under performing,” it said.

The IMB consists of global experts from a variety of fields relevant to the work of the GPEI, and working for the World Health Organisation (WHO), Rotary International, the US Centres for Disease Control and Prevention (CDC) and UNICEF.

Citing four core reserves in Pakistan – KP, FATA, Sindh and Balochistan – it said the country had not yet been able to reduce the number of reservoirs.

According to the latest report of board available with Daily Times, political leadership in the northern areas of Sindh is not fully engaged and aligned with the urgency of the situation; resultantly, many observers believe that this could be the last place in the world where the poliovirus exists.

“The polio programme in the city and districts of Karachi is continuing to let the poliovirus slip out of its grasp; it made a slow start to the low season and there is a core group of families persistently refusing the vaccine,” it said, adding that the polio programme in Karachi needs to embrace the practices of programmatic excellence that have eliminated the poliovirus elsewhere.

The board also expressed concerns over changes in the leadership of the polio programme and said abrupt changes to crucial senior personnel had imposed unnecessary difficulties, leaving a vacuum in vital leadership roles and making an inexplicably friendly gesture to the poliovirus.

The IMB also highlighted grim situation of polio campaigns in Karachi and pointed out worst performing areas in the Sindh metropolis. It stated that six out of 12 polio campaigns in Saddar area, two out of four in Shah Faisal area, seven out of 15 campaigns in north Nazimabad, 10 out of 22 in north Karachi Town, three out of 7 in Jamshed Town, 10 out of 24 in Gulshan-e-Iqbal, six out of 15 in Gulberg, seven out of 20 in Malir, 6 out of 19 in Bin Qasim and 5 out of 16 campaigns had been declared fail in Liaquatabad.

The report also mentioned three polio cases reported from Bannu, KP this year; one with date of onset of paralysis in March 2016 and two in April 2016. The first polio case was genetically linked to wild poliovirus circulation in Gadap Town Karachi and the two later cases were linked to viral transmission in Nangarhar. In its recommendations, the IMB suggested that GPEI leadership should make an intervention to urgently engage with the political leadership in Northern Sindh to establish a clear commitment and ownership of the goals of the polio programme. “This should be done in consultation with the government of Pakistan and the polio programme leadership in this part.” It further recommended that the GPEI should introduce a system of financial incentives for reporting acute flaccid paralysis (AFP) cases in Pakistan. To this end, any healthcare worker who reports a case should be paid, with a higher payment being given for confirmed cases. “Safeguards should be built in for independent validation to prevent unfair manipulation of the system. The scheme should be piloted in Karachi where awareness of frontline healthcare staff is very low,” the report added.