ISLAMABAD: The meeting of International Monitoring Board (IMB) on polio, concluded on Friday in London, highly appreciated the progress made by Pakistan during last season. The meeting was especially impressed by programme capacity to preempt risks, identify and address gaps on real time basis. The meeting acknowledged the commitment from the prime minister and the critical role of security forces to provide space for health. The meeting also stressed need to ensure leadership stability in ‘Emergency Operation Centre for Polio Eradication’, health departments and key divisions and districts, said a message received from London. The meeting showed full confidence in strategies outlined in ‘National Emergency Action Plan’ to interrupt virus transmission during the present year. “To make it happen, besides maintaining quality across the country, we need to focus on Karachi, North Sindh, high risk mobile populations especially on Pak Afghan border,” the meeting observed. The IMB also urged donors to fully support the government in outstanding work for children of the world. It emphasised that resource constraints must not be an obstacle to the great work in progress. The board observed that there is no resource gap at the moment but all aggressive approaches outlined in the plan would be supported through additional grant assistance. Minister for National Health Services, Saira Afzal Tarar, said the programme had travelled great distance over the past 18 months to overhaul performance management of the programme and accountability systems including structures as well as personnel. “Our core strategy as elaborated in the National Emergency Action Plan for Polio is to root out the virus in the reservoirs, detect and react aggressively to outbreaks and to maintain population immunity levels elsewhere in the country.” She said, “We are satisfied with the turnaround and rapid progress but recognise that polio interruption and eradication is a zero sum game and we are not yet at zero”. The minister said inaccessible children have been reduced to negligible levels adding that our security forces have contributed to the provision of safe and secure environment within which vaccination teams’ work. “We recognise that success on the doorstep between a vaccinator and caregiver leading to successful, repeated vaccination is the key to sustaining our performance,” she said. An increased proportion of local, female staff and supervisors, improved retention, enhanced training and more timely payment are contributing to a better motivated workforce, the minister said. While speaking on the occasion, Prime Ministers’ Focal Person on Polio Eradication, Senator Ayesha Raza Farooq, said that from July 2015 to June 2016, the programme made further steady progress towards the interruption of poliovirus transmission in Pakistan. The major paradigm-shift from “coverage” to the “missed children” has driven the operations of the programme in all provinces with very encouraging results, she said. She said, “Our programme strengthened and expanded a number of key innovations over the past year.” Most notably, the programme implemented a community-based vaccination initiative that has provided the programme with a real edge when it comes to delivering high quality vaccinations in the core reservoir zones, she added. The senator said that as a complementary strategy, it is now the foundation upon which all programme operations in these zones are built with more than 11,000 staff tracking and vaccinating 2.3 million children. She further said the programme performance has been transformed with no inaccessible children, and the number of missing children steadily reduced through a combination of updated micro-census and extended and persistent catch-up. She said the complementary strategy for vaccinating high risk mobile populations was revitalised with a new focus on vaccinating children in transit during systematic mapping of mobile populations, rationalising the number and positioning of permanent transit points and improving performance at the Afghanistan-Pakistan border. Over three million missed children were vaccinated and the numbers vaccinated have grown by over 25 percent since January between December 2015 and May 2016, she added. The senator said that over 22 million children were vaccinated at permanent transit points during the past year. She said the number of confirmed wild poliovirus cases in Pakistan continued to decline in the present year, environmental surveillance data mirrored a similar story and a deeper analysis of genetic variations of viruses has shown that for the first time ever, poliovirus genetic diversity fell during 2015 adding that the number of clusters identified has reduced to four. While speaking on the occasion, National Health Services Ministry secretary Muhammad Ayub Sheikh said the five strategic objectives of the programme elaborated in the National Emergency Action Plan include the primary targets for each of the three core areas of work that is programme operations, risk assessment and decision support including management oversight and accountability. This management piece crystallises the scale and scope of the direct governmental contribution to ensure the programme stays on track and takes the necessary corrective action.