LAHORE: A Unicef report disclosed that inaccessibility to some 290,000 (0.29 million) children to immunise them against poliovirus has turned to be a major challenge due to insecurity in Gadap Town of Karachi, North and South Waziristan, FR Bannu and Khyber Agency in Fata, being major reservoirs of the virus all over the world.

The country-wide missed-out children are being taken as a major threat to the recent programme of controlling poliovirus in Pakistan.

“Almost all polio cases reported from North & South Waziristan agencies in 2014 did not receive any dose of oral polio vaccine (OPV),” the report says. It merits mentioning that no polio campaign has been conducted in North and South Waziristan agencies since June 2012, leading to an ongoing polio outbreak in the region, the report says.

It further reveals that globally polio has been all but restricted to just two areas: a region along the Pakistan-Afghanistan border and several states in northern Nigeria. Until poliovirus transmission is interrupted in these three countries, all countries remain at risk of importation of polio. This should serve as a stark reminder that polio anywhere is a threat to children everywhere.

The Unicef report which carried latest updates of poliovirus status in Pakistan was released on July 9.

It says the polio programme activities in Pakistan are challenged by inaccessibility and insecurity. More significantly the increased attacks on polio workers since late 2012 and continuing into 2014 have brought a new dimension to some of the remaining infected areas, and highlighted the critical need for adaptive methods to increase access to children for vaccination in areas of high threat, and closer monitoring of the risks that could severely impact the success of the global initiative.

According to the latest statistics compiled by Unicef in its report, the total number of polio cases so far in 2014 stands at 90 compared to 22 in the same time in 2013. These cases come from 12 infected districts/towns/tribal agencies/areas in the country compared to 11 in the same time in 2013. About 94 per cent (83) of polio cases this year have been reported from Khyber Pakhtunkhwa and Fata together; of which 67pc (60) from North & South Waziristan agencies.

Persistent wild poliovirus transmission in Pakistan has been restricted to three polio reservoir areas including, Karachi (specifically UC-4 Gadap), the Quetta Block (Quetta, Pishin and Killa Abdullah), Khyber Pakhtunkhwa and Fata. These areas remain reservoirs of polio virus and are considered high priority if Pakistan is to eradicate polio.

So long as polio exists in enclaves like North and South Waziristan, where vaccinators have not been able to reach children for more than 20 months and where cases are on the rise, the world will always be at risk of outbreaks.

The report also highlights another aspect stating that despite multiple and complex challenges in the field, Pakistan has made a significant progress towards polio eradication over the past years. Like, it says no isolation of Wild Polio Virus type 3 (WPV3) has been reported in Pakistan since April 2012.

This progress is the result of concerted effort of the government at all levels, civil society and all national and international partners to implement a national polio emergency action plan, aimed at overcoming long-standing challenges during polio activities.

More children are being reached than ever before, in particular in the traditional reservoir areas of Peshawar, Karachi and Quetta Block.

Pakistan is the only polio-endemic country in the world where polio cases rose from 2012 to 2014.

Published in Dawn, July 10th, 2014