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Polio declines in Pakistan

Shamil ShamsJune 5, 2015

A military offensive in Pakistan's northwestern region has caused a major drop in polio cases. It is good news for the Islamic country, but it is certainly not a long-term solution to ending the epidemic, say experts.

A Pakistani health worker gives a polio vaccine to a child in Lahore, Pakistan, Monday, June 4, 2012 (Photo: K.M. Chaudary/AP/dapd)
Image: AP

It is true that Pakistan's ubiquitous military has not been able to eradicate terrorism or crush the Taliban insurgents, but it has at least managed, albeit inadvertently, to bring down the number of polio cases in the country in the first half of the year. Pakistani and international experts say that a military operation, launched last year in the country's northwestern tribal region, allowed polio vaccinators to access areas which were previously under the Taliban's control and led to a decrease in polio cases.

On a number of occasions in the past few years, the Pakistani authorities had to postpone anti-polio drives in parts of the country's restive tribal belt after Islamists banned vaccinations in their strongholds, claiming the campaign was un-Islamic and a cover for espionage. According to Pakistani police, the Taliban militants have killed around two dozen polio vaccinators in the past two years.

On Thursday, June 4, Elias Durry, the World Health Organization's (WHO) senior coordinator for polio eradication in Pakistan, confirmed the drop in polio cases. "Compared to last year, this year polio cases in Pakistan have been 70 percent decreased," Durry told the AFP news agency. "In 2013 and 2014 the program was under pressure, but in 2015 the virus is under pressure."

"The accessibility of children in places that were not being accessed before ... is the number one reason, including proper implementation of the (polio eradication) plan," the WHO official said.

Pakistani troops walk on a hilltop post near Ladha, a town in the Pakistani troubled tribal region of South Waziristan along the Afghan border. The Pakistani army said it has launched a "comprehensive operation" against foreign and local militants in a tribal region near the Afghan border (AP Photo/Anjum Naveed, File)
Military's 'Zarb-e-Azb' operation allowed vaccinators to access areas which were previously under Taliban's controlImage: picture-alliance/AP

Rana Muhammad Safdar, a senior Pakistani health official, confirmed the WHO figures.

Lack of proper access to anti-polio vaccination led to a rise in polio cases in the South Asian nation. The number of polio cases in Pakistan rose from 58 in 2012 to 91 in 2013, out of which 65 were located in the remote tribal region bordering Afghanistan. Last year, the WHO described the capital of Pakistan's northwestern Khyber Pakhtunkhwa province, Peshawar, as "the world's largest pool of polio virus."

Polio is a highly infectious viral disease, mainly affecting children younger than five. It can cause permanent paralysis and death, but can be prevented through immunization. The virus is spread through contaminated food and water.

A major turn-around

Ayesha Raza Farooq, Pakistani Prime Minister Nawaz Sharif's focal person for the polio eradication campaign, says the polio situation in Pakistan has seen a major turn-around in the past few months. "The access regained in the northwestern tribal FATA region to over 260,000 children, who were hitherto denied vaccination, has helped bring down the number of polio cases," she told DW.

Farooq, however, insists that it is the civilian administration's relentless effort which has made the real difference: "We continue to impress upon the provincial governments to engage each and every family that refuses vaccines for any reason and to continue doing so through the persuasive means available," she said.

Ahmed Shaikh, a health rights activist in Karachi, agrees with Farooq: "It is true that the army operation has cleared the areas that were previously under control of the militants, and that has led to an increased number of inoculations against polio, but we must not downplay the achievement of the civilian government."

Shaikh also holds the military responsible for allowing Islamists to enjoy absolute power in the tribal areas of the country. "How did we reach this situation where it became impossible for the government officials to reach certain areas?" said Shaikh. "We would have curbed polio long time ago had we not allowed the armed groups to roam freely all over the country," he added.

The military offensive in the region offers a short-term solution; the epidemic will spread once again if the Pakistan state doesn't formulate a long-term strategy to fight the disease, underlined Shaikh.

Islamists still strong

Militant Islamists retain a strong clout in Pakistan's northwestern areas and their influence has also grown substantially in the central and southern Pakistani cities, including Lahore and Karachi, over the past two or three years.

In July 2012, Pakistani authorities had to postpone an anti-polio campaign in Waziristan after Taliban leaders banned inoculations, claiming the drive was similar to a hepatitis vaccination program run by the imprisoned Pakistani doctor Shakil Afridi. Afridi allegedly helped the CIA find al Qaeda's former leader Osama bin Laden who was eventually killed by the US Special Forces at his Abbottabad hideout in May 2011. Afridi is currently in a Pakistani prison facing treason and murder charges.

The same year, the United Nations suspended its polio eradication campaign in Pakistan after the Taliban killed two of its workers in the northwestern city of Charsadda. The WHO said at that time that the decision to suspend the program was made because of the "very precarious" security situation in the Islamic republic.

Polio Staff is Vaccinating Children at a Polio Center (Photo: Mohmand Agency in Kyber Pakthunkhwa)
The civilian administration's relentless effort to bring down the number of polio cases should be laudedImage: DW/M. Ayub Sumbal

Other factors

According to Sona Bari, a spokeswoman for polio eradication at the WHO in Geneva, a lack of security is not the only reason for Pakistan's inability to stop the spread of polio. The expert says there are also areas without security-related issues that have not achieved a high level of vaccination. This aspect, she says, points to a management and accountability weakness in these areas. "We cannot say that the failure is only due to the militants, although they, and the climate of fear, have definitely played a role."

There are other challenges too. "In parts of Pakistan, the problem is that vaccination activities are not of good quality. Sometimes, this is just because local officials who are in charge of having children in their district vaccinated haven't done their work in a manner that ensures the vaccination is delivered properly," said Bari.

The WHO official believes that international community can assist Pakistan by providing technical support and staff to the country. "It's important to make sure that the high-risk districts in the country are offered all the technical knowledge and human resources they need. Furthermore, it is also necessary to ensure adequate financing and that the country doesn't fail in its efforts just because of a lack of funding."

Bari urges the international community to show solidarity with Pakistan in its campaign against polio. "This is not about Pakistan failing the rest of the world; it is about the rest of the world standing by Pakistan and helping one of the last countries to cross the line. The entire world will benefit when Pakistan eradicates polio."