Dropped chances
WE have been approaching polio wrong all along. It is not just a public health, water, and sanitation problem. Above all else, it is a political economy and geostrategic challenge.
Poliomyelitis is a viral infection transmitted via the oral-faecal route that targets the motor nervous system, leading to paralysis. It is sometimes fatal. Pakistan and Afghanistan are the last holdouts of polio. The fate of the rest of the world depends on these two countries separated by the Durand Line. Those who have been helping Pakistan eradicate polio face a choice; how would they choose if the choice came down to a polio-free world and the status quo in the region?
The custodians of Pakistan’s national security must decide if any strategic depth is worth inflicting on the country’s future generations this crippling disease and, in the process, being singled out as the nation that took down the entire globe with it because it sought to treat a neighbouring country as its backyard.
The hospitable people in the borderlands regularly take to the streets in the thousands to participate in peace rallies; it is the security apparatus that should realise that we suffered enough by embroiling ourselves in other people’s wars and espousing proxies. If we had informed certain ‘guests’ that they were not welcome on our soil, those hunting them would not have stooped so low as to go sniffing in the guise of vaccinators. The backlash continues to haunt us.
Polio eradication is more of a communication challenge.
The political economy of procuring the polio vaccine drops and utilising the Bill and Melinda Gates Foundation IDA buyback programme by successive governments in fits and starts warrants an in-depth investigation. We have a history of under-the-table deals on anything and everything, from wheat imports to sugar exports. What makes us believe some will not salivate when procuring polio drops?
No country in the world has lost as many polio vaccination workers, including health and police personnel, in terrorist attacks as we have. According to reports, more than 200 members of vaccination teams have been killed. The shambolic handling of security strategy in campaigns is among the prime reasons.
Polio eradication is more of a communication challenge than anything else. Mullah Fazlullah was running over 100 illegal FM channels, spewing venom against the vaccine and vaccinators. Pakistan and its development partners were solely focused on vaccine drops, the cold chain, and some attention to inter-provincial movement. No effort was made to counter the negative propaganda in the guise of religion. One cannot think of a single public or community radio channel countering the militant vitriol. A lack of political will is usually disguised as a lack of capacity. We would have had different results if even five per cent of the polio eradication budget had been earmarked for strategic communication and the right expertise had been tapped.
Photo-ops for prominent personalities administering polio drops are fine but insufficient. An in-depth and nuanced communication strategy is required, with the right messages and messengers reaching every neighbourhood and street. India and Nigeria did it despite poverty, illiteracy, and myriad insurgency movements to match ours, so why can’t we?
The poorest corners of Africa have won the battle against this disease; whenever a freak case reappears anywhere, we brace ourselves lest it be traced back to us. The last case Malawi recorded two years ago was traced to a Pakistani strain. We are not too popular around the globe for myriad acts of omission and commission. The world is seeing a tilt towards right-wing, authorita-rian leaders vowing to build iron walls to keep out immigrants. Even supposedly friendly countries go about announcing that Pakistani labour is not welcome. Before the world decides to put polio-related travel curbs on us, we need to put all the genies of extremism, militancy, and regression back in the bottle.
All entities trying to help Pakistan need to change tack. They should use all the leverage; any stakeholder who does not cooperate in polio eradication should forget about transit trade, continued facilitation to refugees, defence courses, spare parts for the stockpiled junk, and access to technology.
At times, one feels pity for Bill Gates. He tries his best to help us rid ourselves of polio. One wonders if the amused look on his face during his last meeting with the Pakistani leadership was because he had heard ‘resolves to fight polio’ before or if he was merely bemused by the matching socks and neckties in the room. Fourteen new polio cases have already surfaced in Pakistan. We must turn the search for the latest polio case into a hunt for the last one.
The writer is a poet. His latest publication is a collection of satire essays titled Rindana.
Published in Dawn, August 23rd, 2024