Pakistan polio cases: a reflection of poor health policy

By Dr. Tayaba Naim Khan

A recent travel restriction on polio campaign since the 5th of May has increased the number of polio vaccination attempts at airports, hospitals and railways stations across the country. Travellers are now advised to take their polio vaccine at least 4 weeks prior to their departure. Complicating the matters is the recent ban in financial support by WHO, stating that it is not in its mandate to provide financial assistance for polio vaccination. It however will continue to provide any technical support needed to achieve the MDG and polio eradication goals. Along with Pakistan, Ethiopia, Israel, Cameroon and Afghanistan have also been banned from international travel without polio vaccination.

The effort has suddenly sprung to action the dormant and slow health ministry, which announced an interprovincial conference to address the alarming situation. Sindh Minister of Health Dr. Sagheer Ahmed claims that the country and Department of Health are capable of handling the current crisis of measles and polio afflicting the children of the country. The strategies include attempts to make Polio Certificate hospitals, and making polio vaccinations effective and assured at airports.

Meanwhile, polio cases continue to rise in the country with each passing day. Newly reported cases come from Kandh Kot, Gaddap Town Karachi, 4 cases in Peshawar and 2 cases from Manghopir.

The current total of 61 cases sadly is higher than 58 cases of last year which was considered to be the final indicator of any improvement since last year. Saira Afzal Tarar, Minister of Health of the State however, is advocating the efforts of the country internationally, citing that the number of cases is consistently going down, compared to the number of cases reported two decades ago.

Karachi also continues to put efforts in trying to alleviate polio from the city with its Karachi Anti-Polio Vaccination Campaign. The target populations were 24 highest risk areas where polio cases were suspected. Serious measures were undertaken to help the campaign run smoothly, which recently ended its sixth stage of completion. Avoidance of media coverage, restriction on motor cycles and additional security is being provided to polio teams which have in the past been struck down for this noble cause.

The campaign has targeted 23 lac children with numerous teams and vehicles dedicated particularly for this cause. So far, Karachi has been successful in completing the campaign in the areas of Gaddap, Gulshan-e-Iqbal, Baldia Town, Orangi Town, S.I.T.E, Bin Qasim, Landhi, Saddar and Gulberg.

The rise in cases has attracted international attention with Imam-e-Kaaba issuing and promoting anti-polio campaign for the country to banish religious misconceptions. It is hoped that this step will finally convince the population to allow polio vaccinations to take place in the country.

Challenges include maintaining cold storage, ensuring quality polio vaccine supply, reaching inaccessible areas, identifying and reporting cases immediately diagnosed with polio.

On the administrative side, the inability of the government to provide remuneration to the paramedical staff and lady health workers shows the problems post devolution of the centralized healthcare governance.  The actual role of lady health workers and their future will depend on the promise extended by the Governor of Sindh, Dr. Ishrat-ul-Ibad, who has recently awarded permanent status to 23000 lady health workers in Sindh.

These problems are largely to the inability of the government to appoint a federal figurehead to spearhead national polio campaigns, which have been pointed out to the Prime Minister at his recent visit to WHO. Without strong strategic plan, the quest for polio drive will remain elusive.