ISLAMABAD: A case of poliovirus has been reported from the federal capital after 16 years, taking the tally of cases reported this year to 17, officials have confirmed.
Other than the confirmed wild poliovirus (WPV1) cases — reported from all four provinces — the presence of the virus has been detected in environmental samples collected from 64 districts, indicating the presence of WPV1 in those areas.
The fresh case has been reported from Islamabad’s Union Council Rural 4, located near the Sangjani Toll Plaza, according to the Regional Reference Laboratory for Polio at the National Institute of Health.
The victim, an eight-year-old boy, is the city’s first case since 2008.
A senior lab official said environmental samples from the federal capital and Rawalpindi district have tested positive for the presence of WPV1 since June, underscoring the “persistent threat of polio to children’s well-being”.
Positive sewage samples
The prime minister’s focal person for polio eradication, Ayesha Raza Farooq, called the case “incredibly heartbreaking”.
She said that in view of the virus outbreak, the polio programme has held “in-depth consultative sessions with the provinces and districts” to improve polio eradication efforts.
Muhammad Anwarul Haq, the coordinator of the National Emergency Operations Centre for Polio Eradication, said the government is “ramping up efforts” to reach every child with polio vaccines, including in Islamabad.
The government has now planned another large-scale vaccination campaign in 115 districts from Sept 9 to 13.
According to Ms Farooq, the teams will go house-to-house in 115 districts to vaccinate more than 33 million children under five.
The campaign will also cover all 36 districts of Balochistan, which has reported 12 polio cases since February.
During a meeting on September 6, the province’s chief secretary, Shakeel Qadir Khan, said foolproof security would be provided to the teams participating in the vaccination campaign.
He warned the officials that no negligence would be tolerated and strict action would be taken against those who tried to interrupt the drive.
Meanwhile, sewage samples collected from 13 districts have tested positive for WPV1.
According to the Regional Reference Laboratory for Polio Eradication at the NIH, environmental samples collected from Attock, South Waziristan Lower, Tank, Peshawar, Abbottabad, Qambar, Karachi West, Karachi South, Malir, Keamari, Karachi East, Korangi and Dukki contained the virus.
‘Serious blunders’
An expert who is part of the decision-making process regarding the polio programme said a number of mistakes on the part of Pakistan’s partners had pushed the country to a position “where it has to start again from zero”.
“Following successful and synchronised high-quality campaigns,” the expert said, Pakistan was nearing victory in its fight against the virus in 2021.
After only one case in January that year, none was reported for almost 15 months. The core virus reservoirs — Karachi, Quetta, Peshawar, and Khyber — were cleaned of the virus, and its traces weren’t found in the environmental samples either.
“The virus was struggling to survive in its last hideouts confined to small pockets in south KP,” said the expert while requesting anonymity.
According to the expert, the decision at that point to “replace the government-accountable leadership by partner paid staff” was the turning point.
The frontline workers were left “unsupervised without required facilitation and support” and the communication strategy also “failed to perceive and address people’s misconceptions” regarding the virus.
As a result, more and more people started refusing vaccines because of misconceptions and linked inoculation to social and civic demands, the expert added.
He said due to the lack of supervision, many frontline workers started reporting “fake vaccination coverage” data.
“The Expanded Programme of Immunisation could also not quickly improve its vaccination coverage at the required pace,” the expert claimed, adding these issues created a significant gap in immunity across the country.
Soon, the virus was reintroduced from across the border in 2023, initially showing up in sewage samples and then paralysing the children.
The Technical Advisory Group for polio eradication has also concluded that the programme was “grossly off track” and needed “complete resetting and restoration of the one-team approach”.
As a result of realisation, the accountable leadership has been restored, and in consultation with provinces, a thorough analysis of failures has been undertaken, the expert said,
Now, a consensus roadmap has been prepared, which includes “resetting all programme components” to eradication level in two months, including the posting of the most capable workforce in challenging areas.
During the next four months (September to December), the programme plans to deliver three large-scale campaigns aimed at reaching all vulnerable districts and children by the end of the year, the expert added.
“The above approach will help the programme to reverse the current virological trends and push the virus back to small pockets of circulation.”
The plan, according to the expert, is “ambitious” and requires a collective approach to achieve its goals.
Published in Dawn, September 7th, 2024
