International Committee Warns Pakistan About Polio Gaps

(CTN News) – The International Health Regulations Emergency Committee has raised concerns about the progress of polio eradication efforts in Pakistan and Afghanistan.

The committee evaluating global poliovirus spread highlighted gaps in these countries’ attempts to eliminate polio during a session convened by the World Health Organization (WHO) director general on August 16, 2023.

Persistent Risk of Polio Outbreak in Pakistan

Despite efforts, the committee underscored the persistent risk of a polio outbreak in Pakistan. Favorable environmental samples from major cities like Peshawar and Karachi have raised concerns, emphasizing the urgent need for more effective eradication strategies.

Emergence of New Polio Cases in Pakistan

The committee noted that a recent Wild Poliovirus Type 1 (WPV1) case emerged in Pakistan, bringing the total for 2023 to two cases. Both cases originated from the Bannu district of Khyber Pakhtunkhwa (KP) province. Throughout the year, at least 15 environmental surveillance-positive samples were identified, indicating the presence of the virus in the environment.

Challenges in Polio Eradication

Addressing the challenges faced in polio eradication, the committee acknowledged the difficulties in the context of Pakistan. These include political instability, insecurity in certain areas where front-line workers require police escorts for protection, and vaccination boycotts driven by communities’ demands for other services in exchange for polio vaccination.

Pakistan’s Response and Strategies

Pakistan’s caretaker health minister, Dr. Nadeem Jan, expressed that enhancing routine immunization and reaching zero-dose children through outreach campaigns are vital for successful polio eradication. He announced initiating a targeted, integrated campaign to achieve the endogenous circulation of WPV1 by December 2023.

Afghanistan’s Polio Situation

In Afghanistan, five new WPV1 cases have been reported since the last committee meeting, all originating from Nangarhar province. These cases were spread across five different districts between April and May 2023. The committee emphasized the potential risks to Pakistan’s program due to high population movement between the two countries.

Genetic Clusters and Surveillance Gaps

Although there has been a reduction in the number of genetic clusters of WPV1 identified in 2023, the committee noted multiple chains of transmission within the two remaining clusters. These chains were primarily detected in the endemic zones of Eastern Afghanistan and South KP of Pakistan. This situation indicates gaps in surveillance efforts.

Ongoing Risk and Re-introduction Warning

The committee issued a warning regarding the ongoing transmission of the virus in eastern Afghanistan, which poses a risk of cross-border spread into Pakistan.

A significant pool of unvaccinated zero-dose children in southern Afghanistan further increases the risk of WPV1 re-introduction in the region.

In conclusion, the challenges and progress in polio eradication efforts in Pakistan and Afghanistan remain complex. The commitment to overcoming these challenges through targeted campaigns, routine immunization, and improved surveillance is essential to achieve the goal of a polio-free world.