Travel restrictions and polio dilemma

In a meeting held by the International Health Committee, restrictions have been placed on Pakistani’s traveling abroad without a polio certificate on Saturday. Polio certification would mean that the traveler had received polio drops and is safe to travel around the world. The committee had declared Pakistan to be a nation responsible for spreading the polio virus across the globe. It has been reported that three cases of polio have arisen in Afghanistan, committee blamed Pakistan. In attempts to eradicate polio in six months, the International Health Committee have come down hard on Pakistan and ordered that no Pakistani could travel abroad without a polio certificate. With strict measures being enforced, the committee had said that travelers who were not in possession of the polio certificate would not be allowed to travel under any circumstances and would go through a screening process. Few weeks before International Monitoring Board suggested more hard international travel restrictions on Pakistan. Independent Monitoring Board (IMB) is the board which suggested international travel restrictions on Pakistan and World Health Organisation (WHO) implemented it. Most alarmingly, Pakistani government has failed to implement the recommendations of IMB. In November 2012, IMB recommended that travel restrictions should be imposed on Pakistan and finally those recommendations were implemented on May 5. Over 200 polio cases have been registered in Pakistan in the year 2014 more than previous year, still few months to go to reach 2015. With five lakh children yet to be vaccinated, Pakistan stands at a deplorable position on this year’s World Polio Day where it adds 85 percent of polio cases to the world. Such escalation of the disease creates many doubts about the stat’s measures and their outcome. Pakistan has been the major contributor to confirmed polio cases in 2013 as compared to Nigeria and Afghanistan, the only three remaining endemic countries. The polio eradication campaigns in Pakistan have been suffering from continuous setbacks as 27 polio workers have been assassinated since December 2012 during anti-polio immunization campaigns. Lack of an efficacious regime to tackle this pandemic was not enough, there had to be a conspiratorial element to further depreciate all the efforts. According to the 2013 World Health Organization report, 74 polio cases have been reported in Pakistan. Since this narrative got out, a series of attacks have been carried out targeting polio teams and killings dozens of health workers, mostly in the troubled areas of Khyber Phakhtunkhwa, Federally Administered Tribal Areas and Balochistan. As a result of which the most challenging issue for the government is how to retrieve the lost public trust where people in these areas now refuse to get their children immunised. The Government of Pakistan has highlighted multiple reasons for the growing polio endemic in Pakistan citing primarily militancy and ‘refusal families’. Militancy, especially in the Federally Administered Tribal Authority (FATA) and North Waziristan areas of Pakistan, may have compounded the polio campaign further by putting many children at risk. In spite of multiple supplementary immunization campaigns, the majority of confirmed polio cases identified in Punjab, Sindh and Khyber Pakhtunkhwa provinces in 2013 were from zones considered as low-violence areas. This observation strongly contradicts the perception of militancy alone as an impediment for polio eradication in Pakistan. Lack of accurate polio vaccination coverage estimates and unaccountability of responsible officials are major reason for new polio cases in areas unaffected by violence. In 2012, Egypt health authorities found polio virus strains in two of its sewerage systems. Samples of this polio virus were traced to the environmental samples in Sukkur in Northern Sindh province of Pakistan again a low violence area. In 2013, the same strain from Pakistan found its way both, in the Palestinian and Israeli sewerage system via Egypt. Recently, 17 polio cases detected in four major cities of the war affected country of Syria have also been linked to the wild polio virus strain from Pakistan.

Despite many edicts being issued by different clerics and religious scholars to unequivocally endorse the necessity of these immunisations, no adequate narrative seems to be in place and after having all these alarming facts in front of us, one wonders why the government has not adopted an effective policy on a war footing. Surely, we do not want to isolate ourselves from the rest of the world. It is not only for our own sake but in order to be an active member of today’s dynamic global world that we need to get rid of this affliction as soon as possible. Specific strategies related to anti-polio immunization campaigns in security compromised areas are urgently needed, close monitoring of anti-polio immunization campaigns is essential to ensure accountability. It must be the top most priority of the government to take serious steps to eradicate the menace of polio as new polio cases are emerging on a daily basis with little being done to bring an end to the endemic.

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