Pakistan is on the verge of polio eradication

For the first time in more than 26 years since Pakistan launched a massive campaign to stop the spread of poliovirus, it has recorded only one case of the debilitating disease.   

Pakistan and Afghanistan are the only countries where polio remains endemic. 

“The closest we have come to eradicating polio was in 2017 when we had 8 cases in a year,” said Dr Shahzad Baig, the head of the country's polio programme. 

“We have never been this close,” he told TRT World. 

Nigeria is the last country to be declared polio-free. Abuja reported its last wild poliovirus, which can cause life-long paralysis, in 2016. 

Pakistan saw a resurgence in the number of cases after they dropped in 2017 - then jumped to 147 in 2019 and 84 in 2020. 

This year’s single case surfaced on January 27 in restive Balochistan province where an ongoing insurgency and absence of a proper road network make vaccination drive particularly difficult. 

While officials feel relieved with a significant reduction in polio cases, Islamabad still has to wait three years and ensure that no child falls victim to the illness before declaring the country polio-free. 

Pakistan’s polio campaign has been challenging due to frequent militant attacks. A policeman was shot dead in August while accompanying vaccinators in Khyber Pakhtunkhwa province, which borders Afghanistan. 

“In some parts of the country people don’t want women to work,” said Baig. “Our female staff often hide vaccine carriers under their dupatta to conceal what they are doing.” 

Making them open the door 

Pakistan’s anti-polio programme involves more than 280,000 frontline workers, doctors and other staff, almost two thirds of them women. 

Having female vaccinators has helped the campaign as they are better suited to convince mothers to let their kids have the oral polio vaccine drops in door-to-door drives. 

Vaccine hesitancy has been a big problem, especially as some families mistrust its efficacy or true purpose, seeing it as part of a 'foreign agenda' to 'destabilise' the country. 

There was a surge in refusals to allow polio vaccination after it emerged that US spy agency CIA had used a Pakistani doctor, Shakil Afridi, to run a fake vaccination campaign to track Osama Bin Laden in Abbottabad city. 

The reasons people cite to refuse polio vaccines vary. Some raise concerns about it being halal; and others doubt whether the medicine has expired. And after the outbreak of Covid-19, many people refused to come in close contact with vaccination staff.

“One of the biggest reasons for vaccine refusal is that people think it will make their kids impotent,” said Rabia Abdullah, a communications specialist with the polio programme in Karachi, the metropolis long considered a high-risk place for the spread of virus. 

“Or they believe that the quality of the vaccine is not very well maintained and they can get a better one at private hospitals,” she told TRT World.  

Pakistan’s polio programme, which is backed by UNICEF, WHO and other multilateral organisations, has traversed a host of political and social issues to reach this point. 

Abdullah said vaccinators are trained to look for local solutions to overcome vaccine hesitancy. “For instance, we have recorded messages of religious leaders of every sect that support the vaccination drive. We also have a printed book of fatwas (religious decrees).” 

Covid-19 pandemic, which delayed the vaccine drive for a few months last year, also made parents wary of opening doors for polio vaccinators, she said. 

It goes to the credit of Pakistan’s polio programme workers that they have completed the target of vaccinating millions of children despite many challenges. 

Last year, when heavy rains flooded Sindh province’s rural parts, female staff walked miles, waded through mud and knee-deep water with vaccine coolers to reach far-flung villages. 

Once there, locals who had lost their homes and cattle to the deluge, rebuffed them, saying they needed shelter and money more than polio drops. It was not until some local influentials and village elders intervened and helped the vaccination drive go ahead. 

“We try different ways to make them open the door,” said Abdullah.