Poliomyelitis was responsible for paralyzing and killing half a million people each year before the development of the poliovirus vaccine in 1955. By 2000, through mass vaccination campaigns using oral polio vaccines, the world had virtually eradicated polio except in a few areas.
However, the global fight against polio has suffered a significant setback, as cases of the disease have begun to rise again in Pakistan. Despite being on the verge of eradication in 2023, with only six cases of the wild form of the virus, the number of cases is expected to rise to 73 in 2024. This alarming trend has prompted concerns among health experts, pointing to an ongoing conflict. Contributes to the spread of the disease as a major factor in Afghanistan.
Per WHO data, infectious diseases such as pneumonia, dengue fever and measles have also been on the rise in Afghanistan for the past six months.
Zulfikar Bhutta, a renowned expert on child vaccination strategies in conflict zones, said the genetic strains of wild poliovirus in Pakistan are all from Afghanistan, according to a report on Deutsche Welle.
Bhuta, who has worked extensively in the field, attributed the resurgence of polio cases in Pakistan to the spillover of the virus from Afghanistan. “It has spread to all the districts of Pakistan. We have snatched defeat from the jaws of victory,” Bhuta said.
“This is a virus that doesn’t want to be eradicated, so give it an inch and it’ll take a yard,” Bhuta said.
The challenges facing polio eradication efforts in the region are multifaceted. Bhuta cited Taliban restrictions on female health professionals, poor sanitary conditions and regional insecurity as significant obstacles. The lack of reliable data on poliovirus cases in Afghanistan further complicates efforts to combat the disease.
Pakistan has invested heavily in poliovirus vaccination programs, with an estimated $10 billion since 2011. Despite these efforts, the country’s progress in eradicating the disease is uneven, with provinces having varying vaccination rates. In Punjab, 85% of children are vaccinated, while in Balochistan the rate is as low as 30%. Bhuta said it is not possible to eradicate it unless coverage reaches 85-90% in all provinces. He also emphasizes the need for a comprehensive review of vaccination strategies, highlighting the importance of strengthening routine immunization programs for all infectious diseases, not just polio.
Bhutta’s expertise in working with the Taliban in Afghanistan provides valuable insight into the complexities of delivering health services in conflict zones. He said the Taliban are not the enemy and they share the same health concerns as everyone else. Bhutta’s experience in working with the Taliban to deliver smallpox vaccines during the period of negotiations underscores the potential for cooperation to address health needs.
The resurgence of polio cases in Pakistan serves as a stark reminder of the need for continued efforts in combating infectious diseases. Bhuta’s call for a comprehensive review of vaccination strategies and his emphasis on addressing the broader health needs in the region are the way forward in the fight against polio. Ultimately, eradicating poliovirus in the region will require a concerted effort from international and local health authorities, as well as cooperation with the Taliban government in Afghanistan.
