As Pakistan continues its struggle to eradicate polio, and remove itself from the list of the two countries in the world where the disease is still endemic, the WHO representative in Pakistan has conceded that agencies working with the government were in part accountable for the failure to make the country polio-free. The WHO representative has said that warning letters had been issued to WHO and Unicef staff members regarding their performance, notably in Peshawar which remains a centre from where the polio virus spreads out to other areas.
Essentially, the WHO representative has noted that blame was being shifted to issues such as lack of access. He, however, stated that managerial and operational problems were the chief culprit and that a joint effort was needed by the government and organisations working with it to remove these. While there are 26,000 polio workers engaged in the country and the UN has recently hired 3000 more female community health workers, it appears that the systems in place are not sufficient. In the past too there have been reports of households being repeatedly missed, even in major cities and of administrative issues which hold back the delivery of drops. Such problems have surfaced in all provinces over the years and been inadequately addressed.
All partners involved in the anti-polio drive need to assess the current situation and openly accept the problems which exist. Only when these gaps are filled will it become possible to drive the potentially crippling polio virus out of the country. Till now, there has been a reluctance to admit to managerial problems both at the level of government and agencies working with it. The motivation of the workers in the field may also need to be assessed and measures taken to engage them fully in the process; they also need to be incentivised far more than they are – given that they are at times doing the impossible in such terrible circumstances. We need transparency and a willingness to admit that mistakes have been made and problems exist. The WHO as now pointed this out in clear cut terms. The next step would be to put in place strategies to remedy the situation and ensure polio coverage for all the children of Pakistan.