KARACHI: A communiqué from Islamabad sent to the provincial governments wants more rigorous polio vaccination coverage in parts of Sindh, Balochistan and Khyber Pakhtunkhwa to help the country improve its image abroad and send better signals to the global health-care institutions persuading them to relax the travel sanctions, which have been in place for a month and will remain so for the next five months until the World Health Organisation reviews it, it emerged on Wednesday.

Sources in the provincial health department said the federal government was not satisfied with the polio immunisation campaigns, which it considered low in parts of the three provinces and wanted to see it more proficient and result-oriented.

In Sindh, Karachi is the main area of concern where all the seven polio cases of Sindh have been confirmed so far this year.

Know more: Karachi records seven polio cases

Still, the sources said, the federal government was terribly concerned over the condition of most parts of Karachi West district, particularly Gadap and Baldia towns. Besides, the middle-class neighbourhood of Gulshan-i-Iqbal was also in focus from where polio strains had been found in its sewage.

Although Balochistan has been a polio-free province since October 2012, officials and experts gather positive environmental samplings from its various parts, which makes it as risky as any other part of Pakistan.

Sources said the officials in Islamabad reckoned Balochistan’s Quetta, Pishin and Killah Abdullah districts as highly sensitive and asked the provincial government to work on a war footings to keep those areas safe from the crippling disease.

“After the internally-displaced persons from North Waziristan arrived in hordes to Balochistan, the province has been in the eye of storm,” said an official of the Prime Minister’s Polio Cell wishing not to be named as he was not authorised to speak to the media.

Similarly, parts of Khyber Pakhtunkhwa and Federally Administered Tribal Areas (FATA) are hugely dangerous for the viral disease because of ‘highly mobile populations’.

“These areas have been consistently infected with poliovirus, which has turned them into reservoirs where the virus breeds freely and spreads all over the country,” said an official document sent to the Sindh health department from Islamabad.

“Such areas are high-risk and almost all polio cases in Pakistan are attributed to them. Defeating polio there means ending polio almost all over the country.”

Similarly, sources said there were 10 ‘high-risk’ districts in Sindh, including Karachi, vis-à-vis the consistent presence of wild poliovirus.

Most of the districts termed high-risk areas by the health department authorities belong to northern Sindh. They are Khairpur, Sukkur, Ghotki, Kashmore, Shikarpur, Jacobabad, Kambar and Larkana.

The other two districts are Hyderabad and Karachi. In Karachi, Baldia, Gadap and Gulshan-i-Iqbal towns have been bracketed as high-risk zones.

Poliovirus sanctuary

Gadap Town’s volatile UC-4, where anti-polio campaigns have been frequently interrupted by attacks on officials and vaccination teams, has been dubbed as a poliovirus sanctuary — a site of consistent presence of wild poliovirus. Three of the seven cases in Sindh this year have been found there.

The environmental samples, taken during the last seven months, show the presence of the virus and is in the Priority 1 areas.

In the Priority 2 areas, which have reported at least one case in the last four years, are: Ghotki, Jacobabad, Kambar, Kashmore, Khairpur, Larkana, Mirpurkhas, Naushahro Feroze, Shikarpur, Sukkur and Gulberg, Liaquatabad and SITE areas of Karachi.

Official figures show that at least 329 polio cases have been reported in Sindh since 2000, including the seven this year.

The annual incidence of polio in Pakistan, which was estimated to be more than 20,000 cases a year in early 1990s, had decreased to 28 cases in 2005. Officials said it was hard to believe at present but only a few years ago Pakistan was about to achieve the polio eradication goal.

“It seemed that we had almost made it…but the number of cases increased to a 15-year record high of 198 in 2011, which came down to 58 in 2012 before shooting up to 93 last year and 88 already this year. We are depressingly short of our objective to get rid of this menace,” said an Islamabad-based official overseeing the polio campaign.

Published in Dawn, July 3rd , 2014