The Polio odyssey in Pakistan

Author: Dr Fawad Muhammad

The crippling polio has been vanquished worldwide, except Pakistan and Afghanistan. Back in 2017, it was felt that the last mile journey is just around the corner, but it was a tempting illusion. As a matter of fact, country like Pakistan, once infectious disease entrenches in the local disease pool hard to get rid. Today, polio has 22 years long battling journey in Pakistan and yet the polio eradication is patchy.

It is vague when the first poliovirus case was emerged in Pakistan. However, the polio eradication program was triggered in 1994, and subsequently, 1147 cases of the wild polio were detected. To barricade polio, AFP surveillance was started countrywide, and fully aggrandize back in 2000. After 2014, a declined pattern was observed, and only 54 cases were reported in 2015, 20 cases in 2016, the lowest 8 cases in 2017, and a slight peak of 12 cases in 2018. After a brief hiatus, shockingly resurgence took place, and 147 cases were reported in 2019, and hence new cases are going to rise steeply in the country.The environmental surveillance data showed that 65% environmental samples were positive in 2020 as compared to the ever-lowest 11%, in 2016. The government has decisively chalked a path of National Emergency Action Plan, proposed strategic priorities to afield polio. However, underlying bottlenecks impeding polio eradication.

Polio campaign was folded much time because of the previous incidence when rumors were created that polio vaccine cause abdominal pain, vomiting, and fainting in the children

Committed leadership and sustainablepolicies are vital to eradicate polio. Reminisce, repeatedly changing the leadership and policies had exacted polio mission. The re-emerging virus strain previously eradicated is a looming threat, and should be deal on priority before find a niche in community. Anti-polio controversial materials are rampant on the Internet and social media earnestly to be ponder. Since beginning, health workers and social mobilizers frantically working to tame polio crisis in ordeal situation calling concerted efforts to ensure their safety. For decade’s polio is persistent in Pakistan; however, indigenous vaccine production and quality control laboratory has been never focused and urged that a proactive approach should be adopted to afield polio.

Gain Public trust is another dilemma and need considerable introspection. Disease overstays and doom and gloom response in the past has raised concerns among the local folks. Public has curiosity of why government accentuates polio over other chronic diseases, as infectious diseases like Hepatitis B,C, Dengue, Diabetes and Cancer are more prevalent. Using OPV instead of IPV, overdosing, and repeated supplementary immunization are fueling fears among the public. Besides, there are imputes of concerns among the people about vaccine supply management, vaccine cold chain program, vaccine storage, power outages, and the equipment using in the vaccine campaign. Such a challenging question should be addressed to gain public trust.Previously, put the parents in jail for not vaccinating the children has made parents reluctant to vaccinate their children. However, the recently adopted policy “persuasion is better than force” is a milestone step towards polio eradication.

Conspiracies have significantly harmed the polio mission. These theories are not limited to the specific class or areas of people but widely existed. Myth such as vaccines cause sterility, cause cancer, vaccine formulation contains the components that affect brain development. Polio campaign was folded much time because of the previous incidence when rumors were created that polio vaccine cause abdominal pain, vomiting, and fainting in the children.

The polio vaccine hesitancy due to religious mindset has a long history, especially in Muslim countries. Historically, such rumors were circulated back in 2003 in Nigeria, and got legitimacy, when the famous Nigerian physician, Ibrahim Datti Ahmed stated that the vaccine contains anti-fertility agents, vaccines produced in the cell lines infected with the Human Immunodeficiency Virus (HIV). As a Muslim country such news was quickly flown to Pakistan and the local religious mindset quickly adopted and raised fake concerns. Today, rumors such as polio vaccine contain pig fat, cause early puberty in girls, support family planning, and cause sterility, and vaccine is forbidden in the religion are rife. However, gospel truth is that all Muslim countries eradicated polio by OPV vaccination. In nutshell, a nationwide commitment is needed before get winning against the crippling polio in Pakistan.

The writer is PhD-TWAS & FDDI research fellow. He is an Assistant Professor of Virology & Diagnostics at Peshawar Medical College Peshawar Pakistan

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