ISLAMABAD: With one more case of polio reported in the country, Pakistan on Tuesday informed the Independent Monitoring Board (IMB) for Polio that the Covid-19 pandemic had also been a reason for a surge in polio cases in the country as it had hampered routine immunisation and campaigns against the crippling disease.

The top world polio body, headed by Sir Liam Donaldson, was informed that though the government had been considering initiating anti-polio activities, due to a high-risk perception of Covid-19 it would require immense hard work to gain the willingness of communities to open their doors to vaccinators. It was apprised that an upsurge of vaccine-preventable diseases was expected as the country had already started witnessing measles cases in some districts.

The IMB works on behalf of international donor agencies and issues reports on the performance of countries after every six months. In November 2012, the IMB recommended that travel restrictions should be imposed on Pakistan. The recommendations were implemented on May 5, 2014 due to which it is mandatory for everyone travelling abroad to get vaccinated.

Another polio case reported in KP, taking national tally to 56

Giving Pakistan’s viewpoint, Special Assistant to the Prime Minister (SAPM) on Health Dr Zafar Mirza told the IMB during a video conference that 2019 proved to be an extremely challenging year for the anti-polio programme.

“The October 2019 IMB meeting raised as many as four issues — dysfunctional team, politicisation of the programme, community mistrust and programme performance. We redefined our priorities and assembled ourselves defining 2020 as the year of transformation and 2021 as the year to stop transmission,” he added.

The SAPM said the national team had been reorganised, rebuilding the one team approach at the federal and provincial levels.

“We started with bringing the coordinator back into the programme who understood the programme and rules of engagement as well as the benefits of a unified team. I am pleased to state today that we now have a strong one team that interacts effectively with a sense of collective responsibility. There is encouraging response from our political leadership. We all have witnessed the level of engagement across all parties starting from December 2019,” he said.

“We are now feeding findings of anthropological assessments directly into the development of community engagement strategies in difficult areas. Frank discussions with community members are providing valuable information. The listening exercise is leading to more strategic and meaningful engagement with communities. The programme now has a sub-union council level challenge mapping process. This is helping us identify street-level issues in cities like Peshawar and Karachi and taking our Pashtun-focused engagement to the local mosque and hujra,” he explained.

Dr Mirza said nationwide campaigns in December 2019 and February 2020 gave an opportunity to regroup and recover from the deep dysfunction. The programme further benefited from an unprecedented security support enabling frontline workers to reach every doorstep all across, he added.

“Our old enemy, the wild poliovirus, continued to spread and today the virus is everywhere in Pakistan. The large resurgence observed starting from late 2018 highlighted the fragility of the gains observed in the preceding three years in the absence of optimal essential immunisation coverage. The high number of cases in south KP and interior Sindh, which were transiently polio-free areas, suggests that our response to changing epidemiological environment was suboptimal,” he said.

“We have learnt lessons from our failures and worked with all stakeholders to acquire the discipline and right capacities. Our aggressive response plan, however, has been interrupted by bigger global challenges. We are learning useful lessons from our Covid-19 response too, especially in terms of working with broader partners in further closeness to communities. As we plan to resume our polio work, we will be in a much better shape to direct energy and resources towards polio eradication,” he said.

The SAPM said polio campaigns were suspended in March as Covid-19 cases started rising, adding that like in most countries, health workers had been adversely affected i.e. 0.3 per cent by Covid-19 of the infected persons in Pakistan this point were healthcare workers — half of them had fortunately recovered.

While giving a hint that Pakistan is considering resuming the anti-polio campaigns, he claimed that the polio team had full support of the top offices of the country, including the prime minister and chief ministers, as well as the army chief.

Dr Mirza claimed that the health team was determined to control the vaccine-derived poliovirus and wild poliovirus type 1 by the end of this year and that was why the polio campaigns would be held in consultation and coordination with Afghanistan.

National coordinator for polio programme Dr Rana Safdar, while talking to Dawn, said: “We have told the IMB that we will take all possible steps for the eradication of poliovirus and nothing will be hidden from the top body.”

He said the IMB acknowledged the programme’s enormous challenges ahead, but simultaneously appreciated the clarity of direction and strategic approach to achieve the defined objectives.

“We as a team are greatly encouraged and stay committed to collectively work together for protecting our children against all vaccine-preventable diseases, including polio,” he said.

The IMB will hold meetings with Afghanistan and Nigeria in the coming days. It will issue its report in a few months.

One more polio case

Another polio case has been reported in Khyber Pakhtunkhwa, taking the national tally for the current year to 56.

According to an official of the National Institute of Health, a 42-month-old male child, resident of Union Council Sangtoi, tehsil Shakai, South Waziristan district, has become the latest victim of the crippling disease. He said all four limbs of the child, who did not receive even a single dose of the vaccine, had been paralysed.

Published in Dawn, July 1st, 2020