Pakistan’s polio eradication efforts hit a snag with 21 cases reported in 2024

Poliomyelitis, more commonly known as Polio is a viral disease that causes acute paralysis, muscle weakness and autonomic dysfunction. Its primary targets are children under the age of 5. It is basically transmitted via the fecal-oral route, through contaminated water. Since the year 2022, Pakistan has become one of the only two countries where polio is still endemic, the other being Afghanistan. 2024 marks 30 years since the launch of Pakistan’s Polio Eradication Program in 1994. From approximately twenty thousand polio cases surfacing every year in the early 1990s to only eight cases in 2018, there has been a massive decline in this number. As of September 20th 2024, Pakistan reported its twenty first case of polio this year. Prime Minister’s Focal Person for polio eradication, Ayesha Raza Farooq appealed to every parent and caregiver across the country to vaccinate their children against polio, a disease that is threatening to disable future generations. She also reiterated the government’s resolve to speed up the Polio Eradication Efforts. The government has issued urgent appeal to parents and caregivers across the country to help protect children from Polio disability through vaccination. 

The government has updated its National Polio Eradication Emergency Operations Plan to get to zero cases. Priority focus is to address the critical gaps in campaign quality, including access, migrant mobile populations, vaccine acceptance, and service delivery for the upcoming campaigns in 2024. Numerous myths and misconceptions regarding the polio vaccine, lack of awareness and proper governance, terrorism and difficult access to remote areas due to poor infrastructure, are just some of the reasons why polio remains endemic in Pakistan to this day. The government will need to take measures to ensure the safety and well-being of healthcare workers, as well as spread awareness regarding the importance of polio vaccines while addressing the myths and misconceptions about the vaccine.

In 1988, the Global Polio Eradication Initiative was launched, since then the global incidence of Poliomyelitis has fallen by nearly 99%. From a situation where wild type Poliovirus was endemic in 125 countries across 5 continents, transmission is now limited to regions of just two countries. In the past too, a sharp increase in Pakistan’s polio cases in 2014 prompted the International Health Regulations Emergency Committee to declare the situation a public health emergency of international concern. Global Polio Eradication Initiative (GPEI) hinges on Pakistan’s ability to address the religious, political and socioeconomic barriers to immunization; including discrepancies in vaccine coverage, a poor health infrastructure and conflict in Polio-endemic regions of the country, this analysis provides an overview of the GPEI focusing on the historical and contemporary challenges faced by Pakistan’s Polio Eradication Program and the impact of conflict and insecurity and sheds light on strategies to combat vaccine hesitancy, engage local communities and build on recent progress towards Polio eradication in Pakistan.

In 115 districts in Pakistan, more than 30 million children have been administered Polio vaccine drops in a campaign that began on the 9th of September and lasted till 15th September 2024. In the current year, one case each from Dera Bugti, Quilla Abdullah, Quetta, Jhal Magsi, Zhob, Quilla Saifullah and Kharan from Balochistan plus twelve other cases have been reported. Zero Polio cases were reported from Balochistan in the last two years. But these positive cases within the first 8 months of this year have alarmingly increased the chances of its spread.

Positive cases were reported from many cities across Punjab, including Lahore. The samples taken from Lahore’s Gulshan Ravi, Multan Road, Outfall Road and Mehmood Booti all came out positive. Out of two samples taken from DG Khan one came out positive, the same from Bahawalpur and Bahawalnagar. One sample was positive from Raheemyar Khan while one out of two samples from Faisalabad also came out positive. Four from Rawalpindi, one from Sahiwal came positive. However, samples collected from Gujranwala, Gujrat, Sialkot, Mianwali and Okara were all negative.

Due to these circumstances, people traveling abroad from Pakistan need to carry their polio certificate and in some cases the polio drops have also been administered to them on the spot.

Although the government claims that these samples actually originate from Afghanistan and get mixed in the sewerage, getting reported as positive samples in Pakistan, they have failed to determine the exact root cause of the spread of this virus which remains a question mark on the competitiveness of the concerned authorities.