LAHORE: The Independent Monitoring Board (IMB), the apex global body — has exposed the Punjab government’s anti-polio eradication programme while declaring Lahore the “epicentre of the polio transmission”.

The IMB provides an assessment of the progress being made by the Global Polio Eradication Initiative (GPEI) in the detection and interruption of polio transmission globally.

“Lahore has become the epicentre of the polio transmission, with continuous detection of positive environmental samples and periodic incidence of polio cases,” reads the report of the IMB recent meeting. (A copy of the report is available with Dawn).

The Board stated that Punjab had remained free of sustained wild poliovirus transmission for more than two years, until mid-2018, unveiling the mispriorties towards polio eradication efforts of the incumbent rulers since they formed government in Punjab.

“In the polio-endemic countries, Pakistan and Afghanistan, there is dual circulation of type 1 wild poliovirus and type 2 vaccine derived poliovirus. They are occurring across multiple districts,” said the IMB.

It stated that the vaccine-derived outbreak started in the northern areas of Pakistan, has spread across the two countries, and now has infected all the core reservoirs.

The priority for Pakistan and Afghanistan is rapidly to knock out the vaccine-derived poliovirus and the ongoing danger that it poses, as well as retaining absolute focus stopping the wild poliovirus.

“The suboptimal quality of campaigns in parts of Lahore, many with migrant Pashtun communities, is largely responsible,” reads the report. “Lahore is at risk of becoming an endemic reservoir like other provincial capitals that reinfect other parts of the country,” the IMB warned in its global report.

While showing its concerns, the IMB stated that “here is ongoing wild poliovirus transmission in southern Punjab as part of the central Pakistan outbreak, with most cases contributed by Punjab during the last six months...

“Well-coordinated and intensive response vaccination campaigns are usually effective in stopping these outbreaks. However, the provincial polio programme needs to give particular attention to sustaining quality in districts with weaker health systems,” the report stated.

According to the IMB, Punjab has found new cases of wild poliovirus in nine divisions in 2020, and vaccine-derived poliovirus in Faisalabad.

After interrupting polio vaccination campaigns because of Covid-19 on March 13, 2020, the Punjab Polio Programme has been able to resume with two campaigns against wild poliovirus and against vaccine-derived poliovirus.

The report stated that Punjab Health Minister Dr Yasmin Rashid assured the IMB that the government was committed to polio eradication in the province and had provided personal protective equipment to all teams so as to ensure polio activities with proper precautions.

The health minister also told the IMB about programmatic improvements. As a result of the continuous detection of wild poliovirus in Lahore and Dera Ghazi Khan, and its intermittent detection in south Punjab, these areas have been targeted to improve the quality of campaigns; micro plans have been strengthened and there is now better intracampaign monitoring.

The health minister put the poor performance down to the large number of vacancies which, she said, were being filled very vigorously, according to the report. She also told the IMB that work was under way to strengthen the provinces’ essential immunisation performance. This involves ensuring a complete record of all children who have received their polio vaccination.

Published in Dawn, February 6th, 2021