High hopes for polio eradication efforts

The World Health Organization (WHO) believes this year’s campaign to eradicate polio in Pakistan, one of four countries in the world where the virus remains endemic, will prove successful.

“I am very hopeful,” Dr Nima Abid, head of WHO’s eradication activities for the country, said from Pakistan’s southern Sindh province. He added that a recent technical advisory group meeting by national and international health experts in the capital, Islamabad, concluded that the virus had now been cornered in just four zones of the country.

Included in those zones are northern Sindh and the adjacent areas of Balochistan and southern Punjab province; the city of Quetta and areas west of it to the Afghan border; parts of Pakistan’s North West Frontier Province (NWFP) and parts of tribal areas bordering Afghanistan.

“If planned activities are implemented accordingly, we can interrupt the virus’s transmission by the end of this year or the beginning of next year,” Abid said.

His comments coincided on Tuesday with the launch of Pakistan’s second of four national immunisation rounds this year in which as many as 33 million children under the age of five will be immunised against the debilitating disease.

The three-day campaign will involve more than 180,000 volunteers and health workers who will go house-to-house administering anti-polio drops to eligible children in a joint effort now being managed by the government of Pakistan, WHO and the United Nations Children’s Fund (UNICEF).

But despite the optimism, the road ahead for polio’s full eradication is not without hurdles.

The most persistent habitats of the virus remain in districts along Pakistan’s 2,430 km-long porous border areas with Afghanistan, where a number of key challenges continue to hamper polio eradication, such as insecurity and cultural barriers.

“In addition to insecurity in certain areas of the tribal belt [bordering Afghanistan], the fact that we cannot easily employ women to work as vaccinators in the area makes it particularly difficult for us to reach children under six months of age,” Abid said, noting that unless the vaccinator was female, it was quite unlikely that they would be allowed to enter the home.

Another challenge is the high degree of cross-border migration taking place between Pakistan and Afghanistan, particularly in the latter’s south where polio remains endemic and continues to prove problematic for the overall eradication effort in both countries.

Health experts consider the two countries as one epidemiological block and it is estimated that more than 1.7 million children below the age of five cross the border annually.

According to WHO, the world’s success in eradicating polio depends on four countries where the virus remains endemic – India, Nigeria, Afghanistan and Pakistan.

In 2006, there were 40 confirmed cases of polio in Pakistan and 31 in Afghanistan. This year, there have been no reported cases of polio in Afghanistan but seven in Pakistan. Of these, three were in the country’s southwestern Sindh province, two were in NWFP and two in Balochistan.

ds/at/ed

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