Tuesday, February 7, 2023

Challenges Of Eradicating Polio In Pakistan: Insecurity, Terror And Misconception

Washington, DC – Armed assailants attacked a polio vaccination team during a door-to-door inoculation campaign in North Waziristan, a district in the Khyber Pakhtunkhwa province. The heinous incident occurred on June 28, when two policemen and a health worker were mercilessly killed. Local administrator Shahid Ali Khan said that the victims were participating in a United Nations-funded campaign in regions at high risk for outbreaks. The campaign aims to inoculate more than 12.6 million children. Many polio workers and security officials guarding them have lost their lives in such attacks since 2012

The year 2012 marked the commencement of a series of violent attacks against polio workers across Pakistan, beginning in July 2012 and continuing until today. The victims of these attacks include frontline workers, international consultants, program staff, and even police officers providing security. Polio transmission is highly active in certain core districts of Pakistan, including Karachi (Sindh), Peshawar (Khyber Pakhtunkhwa), and the Quetta block in Balochistan. Polio cases have also been identified in northern Sindh and Southern Punjab. A large proportion of cases are among Pashto-speaking populations.

Earlier on May 17, Dr. Zeeshan was kidnapped from the Haiderkhel area of North Waziristan. He belongs to the Swat district and went there with a 17-member team to raise awareness among the masses about polio and drum up support for the polio campaign.

On March 2, armed assailants on the outskirts of Peshawar, Pakistan, shot and killed a female polio worker when she was returning home after taking part in the country’s latest anti-polio campaign, police confirmed.

On February 22, at least five police officials got injured in a remote control blast near a police van deployed for polio duty at Ibrahim bridge on Maddi road Gara in Tehsil Kulachi, in Dera Ismail Khan.

According to media reports, as many as 70 polio workers have been killed in terrorist attacks since 2012, mainly in the province of Khyber Pakhtunkhwa.

Established in 1994, Pakistan’s polio program demonstrated early accomplishment. From 2000, the eradication program was extended, counting an increase in personnel and the number of rounds and the adoption of a door-to-door strategy. The national polio eradication effort made significant strides in reaching out to children with immunization in all parts of the country as polio cases plummeted as low as 28 in 2005. Still, the country has witnessed an alarming increase in the number of polio cases since 2009.

Pakistan’s polio eradication program has come under international inquiry due to its position as the primary driver of global wild poliovirus spread in recent years. The problem is rooted in financial and organizational deficits, as well as active conflict and insecurity, which has caused the persistent failure of effective immunization campaigns in the country.

Nevertheless, despite over 120 supplementary immunization activities in the last decade, polio eradication efforts in Pakistan have failed to attain their objective of halting polio transmission. Variable governance, unpredictable leadership, and lack of accountability are directly responsible for unnecessary delays in achieving a desirable result for the polio program and the quality of the campaigns. Insecurity and an environment of terror have also interrupted polio activities, and community fears and misbeliefs about polio vaccinations persist.

Many polio workers and security personnel have lost their lives in the past years during polio vaccination campaigns, and such incidents have been one of the major reasons that polio is still endemic in Pakistan. Pakistan and Afghanistan have faced significant security challenges along the border, including targeted attacks on polio workers and security guards and an absolute ban on polio immunization in certain areas. Diffidence in the region is often listed as a significant hindrance to polio eradication. 

As the attacks on polio workers, doctors, and security forces intensify, Pakistan is falling into the cruel grip of the polio virus. Pakistan officials reported an eighth wild poliovirus case of 2022 on June 3. This most recent case is a 20-month-old boy paralyzed by wild polio. “Following the first two cases in April, the polio programme took immediate steps to ring-fence this area and prevent the virus from spreading further, particularly in the historic reservoirs of Karachi, Peshawar, and Quetta. “Pakistan has made tremendous success against polio over the past few years, and we are taking all steps to protect the gains made by the programme,” claimed Federal Health Minister Abdul Qadir Patel. Unfortunately, all eight cases are registered in the restive province of Khyber Pakhtunkhwa.

The last case in the country was detected in January 2021. Earlier this year, Pakistani authorities celebrated going 12 months without a single case – the first time since eradication efforts began. Pakistan is one of two countries, together with neighboring Afghanistan, where polio is still endemic, though case numbers have dropped drastically in recent years. However, Nigeria, the third country on the list, officially eradicated wild polio in 2020.

Pakistani Taliban have long been the country’s most prominent resistance to the polio vaccination drive. The reasons for their opposition are bizarre. Some say it aims to sterilize Muslims. The Taliban have repeatedly threatened health workers involved in the campaign. Some said they received calls telling them to stop working with “infidels” just before the attacks. Moreover, in reply to the misconception about vaccines being incompatible with the Islamic Shariah Law, the Islamic Advisory Group (IAG) adopted a new anti-polio action plan incorporating advocacy and communication activities in 2015. In light of continuing attacks against polio workers, the security plan for polio workers was revised in 2015 and included the program’s utilization of civil armed forces for heightened security protection.

The most significant cause of mistrust of the local population in the tribal area is due to the false polio immunization campaign of the CIA launched to trace Osama bin Laden. With the help of Pakistani physician Dr. Shakeel Afridi, the CIA carried out a fake Polio vaccination campaign to facilitate the search for the mastermind behind the September 11, 2001 attacks in the US, the Al-Qaeda leader, Osama bin Laden. The campaign confirmed the presence of bin Laden in Abbottabad city of Pakistan by obtaining DNA samples of his family members and subsequently killed by US Navy SEALs, the US Naval Special Warfare Development in Pakistan in 2011.

Interestingly, in many cases, the family members show reluctance towards vaccination. Most parents refuse to administer polio drops to their children due to misapprehension about the vaccine. They believe that it will harm or sterilize their children. Such discernments are prevalent in certain areas of the tribal regions of Khyber Pakhtunkhwa. Parents mainly refuse to immunize their children due to a lack of awareness, doubts regarding vaccine quality, misunderstandings related to vaccination, and low confidence in vaccinators. 

Pakistan’s failure to eliminate polio reflects the acute lack of commitment and obligation on the part of the government and society toward saving children from the menace of this devastating disease. Despite receiving substantial foreign funding and carrying out several campaigns for countering polio over the years, there have been some serious lapses in the state’s efforts to address this pernicious health problem. Despite numerous supplementary immunization campaigns, the failures in Pakistan’s polio eradication campaigns are now obscuring the global scenario for a polio-free world.


Author profile
Pia Sherman

Pia Sherman is a freelance writer. Views expressed are solely of the author.

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