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ISLAMABAD: The polio eradication campaign in the country posed serious problems with an alarming outbreak of reported cases, which raised doubts about the quality of vaccination reports and prompted officials to review their approach to to stop the disabling disease.
Pakistan is one of three countries in the world where polio is endemic, as well as Afghanistan and Nigeria, although vaccination campaigns have significantly reduced the disease, with only a dozen cases last year against 306 in 2014 and more than 350,000 in 1988, according to the same source. to health officials.
However, there has been a worrying increase this year: 41 cases have been recorded, including 33 in Khyber Pakhtunkhwa, where many people are offending intrusive and coercive vaccination campaigns that often involve repeated visits, officials said.
Just as alarming for health services, environmental sampling has shown the presence of the virus in some parts of the country, a clear sign of gaps in immunization, which must cover the whole of the population to be effective.
The hopes of ending the transmission of the disease this year have been abandoned.
There has been a worrying increase in the number of cases reported this year: 41 cases were recorded, including 33 in the KP.
"We must take the bull by the horns and accept the problems," said Babar Atta, head of Prime Minister Imran Khan for the eradication of polio.
In addition to the difficulty of reaching very isolated areas and keeping track of people pbading through large cities like Karachi, it has also been difficult to collect reliable data, exacerbated by resistance to efforts to force vaccination.
Efforts to eradicate the disease have been undermined for years by the opposition of some clerics, who view vaccination as a foreign ploy to sterilize Muslim children or a blanket for Western spies.
Local officials said that parents suspicious of mbad vaccination campaigns were stealing special markers, which health workers used to put a stain on the little finger of vaccinated children.
"They would mark the fingers of their children, in case of an official visit to control vaccinated children," a senior badociate with an international organization told Reuters.
Officials believe that the so-called falsification of the finger, sometimes in collusion with health workers, hides the real scale of refusal rates and thus gaps in immunization.
In some areas, up to eight percent of families refuse or avoid getting vaccinated, which means the disease is not eradicated.
A senior health official in Khyber Pakhtunkhwa said local health authorities were deliberately worried about hiding the data, fearing responsibility for their failure to provide full coverage. "And the result of the concealment of numbers has led us to face a situation similar to an epidemic today," he said.
Resistance
Poliomyelitis, a sewage-transmitted disease that can cause crippling paralysis, especially in young children, is incurable and remains a threat to human health until it has been eradicated. Vaccination campaigns have been successful in most countries and have moved closer to Pakistan, but problems persist.
International observers have been watching the situation for some time now. In October, the Independent Monitoring Observatory, which oversees polio eradication efforts around the world, wrote in its annual report that there was "something that really was not going to work." not with the program in Pakistan. "
In April, fueled by rumors that children would be poisoned by social media vaccinations, riots rioted in Khyber Pakhtunkhwa and at least three polio workers were killed.
Even without violence, many people view polio as an "American disease". Faced with more immediate threats such as the lack of drinking water, many do not see why their families should be bothered by what they consider to be intrusive campaigns sponsored by strangers.
Health workers, whose proximity to the communities in which they work are essential to building trust, face difficult choices in remote areas where kinship and power structures local authorities can often force them not to report cases of non-compliance.
According to many officials, persistent hostility to campaigns and high rates of avoidance highlight the problems posed by brutal repeat visits by health workers and by the police who Take it from families who refuse vaccination.
"Why are markers in stores? Because parents want to buy them. They are fed up with repeated vaccinations, "said Babar Atta.
Officials are now exploring more targeted approaches in areas where there are problems in overcoming resistance to vaccination involving more persuasion and education.
Oliver Rosenbauer, a spokesman for the World Health Organization, said that resistance to vaccination hampered the eradication effort, though other factors, including movement people in Pakistan and the Afghan border, are potentially more important.
He added that officials were badyzing the range of problems that the program was facing in order to put in place a new approach.
"What is very clear to everyone is that if things continue as they are, we will not be able to eradicate polio in Pakistan," he said.
"We can stay on course, but that's not the goal. The goal is to eradicate it. "
Posted in Dawn, July 16, 2019
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