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The 31-year global campaign to eliminate polio, which cost more than $ 16 billion, has been held back by a resurgence of new cases in Pakistan and Afghanistan.
As of July 10, there were a total of 42 cases of polio paralysis in both countries. They understand a single big epidemicbecause most of the cases are in the tribal areas along the border, where people cross easily.
Pakistan has registered 32 cases, compared to only three at the same time last year, and the situation should worsen as the summer heat favors the virus. There were only 12 cases in the country in 2018 and eight in 2017.
According to the World Health Organization, every paralyzed victim – usually a child under five – is infected and gets rid of the virus.
Around 20,000 children are born every day in Pakistan. In cities with open sewers, and where other pathogens can attach to the same intestinal receptors as the vaccine, it can take several doses to fully immunize a child.
Earlier this year, Pakistan announced that it would streamline its national immunization campaign in June to make the campaigns faster and less intrusive. The teams will try a more user-friendly approach and collect less data on the families they have visited, said the Prime Minister's Office.
False rumors spread on social media, saying the vaccine had fainting triggered – or even that he has killed dozens of children – and many families have locked their doors to vaccinators or hid their children.
The question divided the families; The London Times recently described a Pakistani man who was returning from work and divorce his wife on the spot after finding the fingers of their children marked with the indelible ink used by the polio vaccinators. Islamic law allows a man to end a marriage by simply saying "I divorce" three times; he threw his wife and children out of the house.
As in other countries, like Italy, vaccines have become politicized, with opposition parties spreading anti-vaccine rumors.
Babar bin Atta, the prime minister's special assistant for polio eradication, said in a letter to the Dawn newspaper that population movements and the growing number of refusals were hampering the effort.
The country, he added, will attempt to address persistent problems related to routine immunization, clean water and sanitation, as well as the high incidence of malnutrition.
The eradication of polio in Pakistan "could take longer than expected," he said.
The virus threatens to spread to other countries. In May, a sample of wastewater in a border province in Iran was tested positive for the strain of virus circulating in Pakistan; Iran had its last case of polio paralysis in 2001.
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Another threat to the eradication campaign is that some countries – mainly in Africa – have not been able to eliminate some mutant strains of polio viruses used in live vaccines. These strains returned to forms likely to cause paralysis.
In the past two years, there have been epidemics of "vaccine-origin polio" in Angola, Democratic Republic of Congo, Ethiopia, Indonesia, Mozambique, Niger, Nigeria, Papua New Guinea and Somalia.
Last week, a sample of wastewater in western China positive test for a polio strain of vaccine origin, which means that the virus must circulate there although no case of paralysis caused by it has yet been detected.
Xinjiang, the province where it was found, is bordering Pakistan and Afghanistan.
Historically, these outbreaks have always been eliminated through the use of killed injectable vaccines, which can not mutate, and live vaccines protecting against mutated strains. But epidemics in some countries have lasted for several months.
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