ISLAMABAD: The director general of World Health Organisation (WHO) has submitted a report to the forthcoming World Health Assembly that cases of poliomyelitis in Pakistan are now primarily restricted to the southern Khyber Pakhtunkhwa where challenges remain in reaching children.

In a report, the WHO director general said since January 2021 all reported cases had been from seven polio-endemic districts in the southern area of KP, out of a total of 171 districts nationwide.

There has been one WPV1 case this year reported from Bannu, the WHO data showed. The World Health Assembly is opening in Geneva on May 21, where much of the deliberations will focus on the ongoing and evolving Covid-19 situation whereas the global efforts to eradicate polio will also be discussed by member states.

By submitting the report to the assembly, WHO has sought guidance on measures to adopt to ensure that all remaining zero-dose children in the most consequential geographies are reached with oral polio vaccine.

The WHO stated that wild poliovirus type-1 continued to be detected in parts of Afghanistan and Pakistan, the last two remaining countries where the virus is endemic.

Both countries have continued to make progress since the year 2000, as demonstrated by the declining number of poliomyelitis cases and positive environmental samples, geographically localised transmission and reduction in the number of transmission chains to a single active chain in each country.

The WHO report added that the periodic detection of wild poliovirus type 1 from environmental samples outside of these remaining reservoir areas demonstrated the continued risk of transmission.

According to the report, in Pakistan, 20 cases of poliomyelitis due to wild poliovirus type 1 3 and 41 positive environmental samples for wild poliovirus type 1 4 were reported in 2022. All cases were concentrated in three districts in the southern KP.

An operational plan specifically targeting the southern KP was being implemented. As in Afghanistan, the genetic diversity of wild poliovirus type 1 transmission in Pakistan continues to decline with a single active individual transmission chain at the start of 2023, compared to 11 chains in the year 2020 and four in the year 2021.

In the fourth quarter of 2022, the Technical Advisory Group on poliomyelitis eradication in Pakistan and WHO and Unicef regional directors met to review the progress made to date and underscored the current epidemiological opportunity to eradicate poliomyelitis in Pakistan. The global political will to eradicate poliomyelitis remains strong as demonstrated by the high-level commitments to poliomyelitis eradication made during sessions of the World Health

Assembly, the Rotary International Convention, the G7 leaders meeting, the Commonwealth Heads of Government meeting and the G20 Development and Health Ministers meeting as well as at the global pledging moment held at the World Health Summit in Berlin. At the summit, global leaders pledged $2.6 billion in funding towards the Polio Eradication Strategy 2022-26, an important first step in securing the full $4.8 billion needed to ensure the successful implementation of the strategy.

Additional commitments have been made since then by new and existing partners, including through the European Investment Bank, and, at its December 2022 meeting, the board of Gavi, the Vaccine Alliance, extended the Gavi eligibility and co-financing exemptions for inactivated polio vaccine in support of polio eradication efforts.

Published in Dawn, April 29th, 2023