KARACHI, June 17: Alarmed by the recent reports of laboratory-confirmed polio-virus cases in Sindh, some highly designated international experts on polio eradication are rushing to Karachi to review the long prevailing supplementary immunisation activities and find out the loopholes.

A source privy to the immunization initiatives in the province said that an emergency meeting of the Technical Advisory Group on Polio Eradication for Pakistan had been convened on June 24 and 25 at Karachi to review progress on “interrupting wild polio transmission”.

The group, including a couple of globally active experts on polio eradication, may visit the polio- affected districts and make recommendations for improving the technical and management aspects of the polio eradication initiatives launched in the province as in other parts of the country in 1994, the source added.

The TAG in routine was to meet in July, but the sustained outbreak of wild poliovirus in Sindh had compelled that the meeting be held on an emergent basis. Besides a presentation by the Sindh director-general for health, NWFP health high-ups are likely to make presentations about the polio situation in their respective jurisdictions.

Authorities concerned with polio preventive efforts, both national and international, were highly upset as the province was close to equal the number of the reported polio cases of 2007 only in a span of six months. Authorities now want to ensure a zero reporting from July onwards that included the peak virus transmission as well, the source said.

However, a layman’s review of the affair suggests that there was poor implementation of the polio eradication initiatives at the district level, and ghost vaccinators, inaccessible areas, insincere supervisors, an inadequate accountability system and a loose command over the related field staffs were to blame for the problem.

The detection of 18 cases during the last 12 months has brought about a bad name to Sindh, which was close to getting a polio-free province status in 2005. In all, Pakistan has reported 12 cases since January 2008, of which 88.33 per cent cases have been detected in Sindh.

In addition to TAG members, the June 24 meeting may be attended by the federal health secretary, the federal director-general of health and representatives of WHO and Unicef in Pakistan.

The group may also call on the new chief minister of the province as efforts to generate necessary commitment for the accelerated implementation of the TAG’s polio eradication management strategy. The group will tell the CM about the deliberations of the two-day meetings and its recommendations, the source added.

Seeking anonymity, a couple of polio initiative undertakers said that the provincial administrative high-ups as well as partners and supporters from the federal government and international agencies were needed to renew their efforts to identify the pitfalls.

The field staffers further said that the TAG meeting should consider the fatigue in government and partner agencies staffs and the community as a whole, otherwise the quality of eradication activities might decrease further.

There is also a need to maintain an adequate number of high-quality partnership staffs in critical areas or districts. There is also a need to evaluate the activities carried out under the communication and social mobilization plans for polio eradication and expanded programme on immunization in the province to know where the money was being spent and how.

Administrative and technical bosses should be discouraged from undertaking foreign trips frequently, and attending meetings as it mostly proved joyrides having nothing to do with local field activities and practical circumstances prevailing in the province.

The number of polio-affected districts has reached nine against the six of 2007, which also necessitates the evaluation of the state of immunity against preventable diseases that came as a result of routine immunization, said an official, adding that almost half of the polio cases reported this year had no history of effective routine immunization.

Routine immunization plans be revisited and efforts made to reach some new and innovative designs to get the true impact of routine and supplementary immunization activities in the province, the staffers said.

According to an analysis of polio vaccination-related data of 2007 in the province, there were 115 union councils which fell in the high-risk category areas for various reasons, including low routine immunization, a highly mobile population, seasonal migrants, a low socio-economic status, a low literacy rate, environmental issues and poor sanitary conditions, managerial issues and unwilling workers, including vaccinators and women health workers, at the district and UC levels.