Polio was once a disease that threatened children across the world, its outbreak was a constant cause of worry among communities in every country. However, thanks to successful worldwide immunization, more than 2.5 billion children have received a polio vaccination since the late 1980s and polio is largely a disease of the past. However, children still face the threat of polio in Pakistan, Afghanistan and Nigeria, where the disease remains endemic.

Polio is an extremely infectious viral disease, largely affecting young children under five. Symptoms can range widely from flu-like illness to paralysis or even death, with paralysis victims often permanently losing use of their legs or arms. This life-altering virus spreads via fecal-oral transmission or occasionally through contaminated food or water and can spread rapidly through communities if not managed carefully.

Eradicating Polio in Pakistan

In an effort to tackle the persisting threat of the virus, Pakistan launched its Polio Eradication Programme in 1994 and has since seen a significant decline in polio cases, with cases dropping from 20,000 annually in the 1990s to only eight cases in 2018.

The country’s eradication strategy prioritizes:

• Quick and early detection, containment and elimination of outbreaks
• Efficient and widespread vaccination
• Dedicated and properly trained frontline workers
• Continued government attention and support
• Coordinating their efforts with neighboring Afghanistan, where polio is also a pressing health issue.

Vaccine Home Delivery

In 2000, the year Pakistan launched home delivery of the oral polio vaccine (OPV), there were a reported 119 cases of polio in Pakistan. Although figures were initially on the decline, with only 32 cases reported less than a decade later, these figures have been steadily increasing since 2008. In 2019, there were 146 cases of polio in Pakistan reported.

Many parents and carers are beginning to refuse the vaccine for their children, proving to be a critical factor in polio’s resurgence. In polio-endemic countries such as Pakistan, children require multiple doses of the vaccine in order to build up sufficient immunity from the disease.

Tracking Reasons for OPV Rejection

In an attempt to address the rising rejection of OPV, the World Health Organisation (WHO) developed a tally sheet for frontline workers to make a record of the various reasons for vaccine refusal.

Here are some of the notable reasons for rejection:

• Religious beliefs
• Children unavailable to receive OPV (such as being unwell or sleeping)
• Demand of compensation
• “Campaign fatigue”, whereby parents had lost patience with repeated OPV campaigns

However, despite this regression in the 2010s, polio in Pakistan has been back on the decline in recent years. Cases dropped by 36% from 2019 to 2020, with numbers continuing to drop in 2021. This is reassuring progress for Pakistan and all the more impressive when considering the additional challenges the Coronavirus pandemic posed to the safety and efficiency of successful OPV rollout.

Polio in Pakistan: The Future

In 2023, there were six reported cases of polio in Pakistan. As the country continues to press on with its fight against this life-altering virus, there seems reason for optimism for the future. Consistent and thorough vaccination campaigns continue to be carried out across Pakistan, but it seems that successfully and thoroughly eradicating polio relies upon both the continued efforts from the government and health care workers in hand with consistent cooperation from parents.

– Rose Williams
Photo: Flickr