Polio is an acute paralytic disease that primarily affects children under five years of age. It is caused by a single-stranded RNA virus known as poliovirus (PV), classified into three serotypes. Since 1988, the World Health Organization’s Global Polio Eradication Program has reduced polio cases worldwide by 99.9%. Over 33 years, this effort has vaccinated nearly three billion children.
Polio eradication in Pakistan has been a huge challenge throughout due to various factors.
Challenges to Polio Eradication in Pakistan
Pakistan is one of three countries still endemic in the world, along with Afghanistan and Nigeria. However, since the start of the Polio Eradication Program in Pakistan in 1994, the number of polio cases in Pakistan has declined dramatically, from around 20,000 per year in the early 1990s to just eight cases in 2018.
Pakistan has faced several obstacles in its campaign against polio. Lack of good governance, geopolitical instability, insecurity, extremism, limited access to rural areas, and most importantly, widespread public misinformation about the polio vaccine are just some of the reasons why Pakistan has failed to eradicate polio. Some misconceptions about vaccination have become quite widespread in Pakistan.For example, there was formerly a widespread idea that this immunization would sterilize children and cause them to lose their fertility. Furthermore, beliefs such as Western countries implanting microchips in the guise of polio immunization remain prevalent. Many polio workers have been killed as a result of people’s misconceptions about the polio vaccine. A recent attack on a polio vaccination team in northeastern Pakistan killed one health worker and two police officers. Therefore, it is necessary for Pakistan’s health services to take proper measures not just to safeguard the safety of polio workers, but also to raise public awareness about the necessity of immunization.
As long as the virus circulates in Pakistan, no child is entirely safe from the virus. This is the reason why it is everyone’s responsibility in Pakistan to ensure that all vulnerable children under the age of five are immunized against this fatal disease during each door-to-door campaign.
Measures for Polio Eradication in Pakistan
Pakistan has made significant progress in controlling poliovirus transmission. The number of cases has significantly decreased and differences in immunity among children continue to narrow. To help Pakistan achieve its goal of zero polio cases, a variety of tactics and tools are being used. These tactics and strategies are defined in the Pakistan Polio Eradication Program’s National Emergency Action Plan (NEAP), which sets out specific goals, targets, milestones, and indicators to help the program achieve its goal of zero polio cases.
As outlined in the NEAP 2018/19, the program will implement a rigorous vaccination schedule to ensure optimal vaccination coverage for children at risk. According to this plan, five nationwide vaccination campaigns are planned in September, November, and December 2018 and in January and April 2019. In addition, smaller subnational vaccination campaigns will take place in selected districts in July, August, and November 2018 and in March and June 2019.
Highlights of the Critical Efforts to Ensure that Every Child is Vaccinated against Polio
- Highest level of government commitment, with the program’s lead officer reporting directly to the Prime Minister
- High-quality immunization campaigns reaching the most vulnerable children in all parts of the country and increasing population immunity
- Dedicated and highly dedicated frontline staff consistently vaccinating children across the country
- Improved program surveillance, detection, and response capabilities
- Efficient handling of operations under government control and the ‘one team under one roof’ operational approach as per the establishment of Emergency Operations Centers at the provincial and federal levels
- Improved coordination with Afghan counterparts to synchronize program operations and management
In parallel, the Pakistan Polio Eradication Program continues to vaccinate children who travel or move through 500 Permanent Transit Stations (PTPs) located at all major national transit points. These PTPs are installed along the country’s borders and districts, as well as in major transit areas such as railway stations, bus stops, and roads. In 2018, PTPs vaccinated 1.7 million children. The use of PTPs throughout Pakistan is essential to ensure that every child is vaccinated against polio.
Given the frequent population movements between common borders and the common epidemiological blocks of Afghanistan, the program also works to synchronize and fully coordinate its actions with the Afghan Polio program. This includes the synchronization of immunization programs, the implementation of in-depthanalyses and the sharing of data in large population movements, the implementation of strategies developed in cooperation, and the extent of cross-communication activities.
The NEAP also contains communication with the extermination strategy, which focuses on the contextualization of program communication initiatives to meet the requirements of communities. This strategy also includes the strategic use of media, social media, and methods of representing interest to create the confidence and acceptance of the communities necessary to eliminate the polio communities. The program continues to relate to a network of community vaccines (CBV), local influencers, religious managers, health service providers, and ordinary elders to strengthen the confidence and acceptance of the program and, at the same time, Answer joint concerns and misunderstandings questions.
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