Pakistan’s polio pool defies immunisation drives
[LAHORE] Pakistan has emerged as the world’s largest polio pool because of unsettled conditions caused by natural disasters and armed conflict as well as poor quality immunisation, according to a new report.
“Pakistan is now reporting more cases than the combined total cases of the other three endemic countries: Nigeria, India, and Afghanistan,” a team at the bioinformatics laboratory of the Centre for Excellence in Molecular Biology (CEMB), Lahore, noted in the Virology Journal (02 October).
The report came on the heels of the WHO’s Global Alert and Response statement on 20 September that a wild poliovirus genetically linked to a strain circulating in Pakistan has been isolated in China.
“In spite of numerous successes, such as the addition of new vaccines and raising immunisation to over 100 per cent in some areas, EPI (expanded programme on immunisation) is still struggling to reach its polio eradication goals,” the CEMB report said.
“Inadequate service delivery, lack of information about immunisation and limited number of vaccinators were found to be the key reasons for poor performance of immunisation,” the report noted.
Pakistan’s draft National Emergency Action Plan 2011 for polio eradication shows that 10 to 20 per cent of children in the country fail to receive their third dose against the crippling paediatric disease.
The lowest immunisation, as per the report, was observed in the Federally Administered Tribal Areas which border Afghanistan and which remain inaccessible to vaccinators due to the conflict situation there.
“..most of the cases are clustered at its borders with Afghanistan. Pakistan shares common epidemiological block with Afghanistan. So both countries should synchronize their efforts for fight against polio,” the report said.
Groups vulnerable to polio include refugees from disasters such as the 2010 and 2011 floods and Afghans fleeing the ongoing ‘war-on-terror’ in the neighbouring country.
The researchers observed that two of the three polio strains found circulating in endemic countries — vp1 and vp3 — are currently being reported from Pakistan.
Elias Durry, senior coordinator for the WHO's polio eradication effort in Pakistan, told SciDev.Net that what was disturbing was that polio cases were being reported from areas not directly affected by conflict or floods.
“This means there's an urgent need to improve the quality of vaccination services and we are working on that,” Durry said.
“WHO is currently monitoring the whole exercise and fully supporting Pakistan government as a partner along with organisations like UNICEF,” he said.
Link to the full report in the Virology Journal: