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National

January 14, 2015

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Pakistan equals its own 16-year-old polio record

ISLAMABAD: Pakistan surpassed the embarrassing figure of 300 polio cases in a single calendar year with six new cases being confirmed from last year here Tuesday. The country has, as such, equaled its own 16 year-old record of 1998 by crossing the 300 mark.
The global embarrassment that Pakistan has earned with 303 polio cases now listed in 2014 alone, is akin to the shame that a student experiences when sharing a poor progress report with parents.
The only difference is that when a student flunks in a subject, the marks that he may have obtained cease to have any value. On the contrary, every new case that adds to Pakistan’s polio scorecard makes a world of difference, not only to the country itself, which is reeling under the effects of travel restrictions, but also to the international community, which is simply not prepared to allow one odd country to reverse the global gains which have so painstakingly being achieved.
Of the six new cases in Pakistan, two each are from Khyber Pakhtunkhwa and Fata, and one each from Sindh and Punjab. The year 2014 is being described as the darkest year in the history of polio eradication in Pakistan. The reasons behind this failure have been adequately highlighted in the media; independent international entities have also minced no words in highlighting the deficiencies that plague Pakistan’s polio programme. They have even proposed strategies that can lead to success. The problem is: we know our job so well that any piece of advice from global partners ends up being dismissed as “undue interference in our internal affairs.”
This is precisely the kind of treatment that was meted out to the 9th report of the Independent Monitoring Board (IMB). The report had termed the PM’s Polio Cell as an entity that “only allows shadow-boxing against the polio virus,” and had recommended the establishment of an Emergency Operation Centre (EOC) as “a strong national body with the power, resources and capacity

to drive transformative action.” The IMB had recommended the inclusion of top-level civil servants, senior representatives of national, regional and local governments, religious leaders as well as military leaders in the process leading to the establishment of the EOC.
None of the above criticism, or recommendations, was taken seriously. Acting in haste to cover up its embarrassment, the polio leadership instead announced strengthening of the Polio Emergency Control Room functioning in the Prime Minister’s Polio Monitoring Cell. It was only in the face of rising global pressure that an EOC was belatedly established at the federal level by end-2014, again much against the spirit of the IMB guidelines. Rather than having one powerful national entity, several EOCs ended up being set up; one at the federal level and one each in the provinces, defeating the very objective of a powerful entity that could drive transformative action. The reputation of the federal EOC can be gauged from the fact that two key international agencies working in partnership with the government to eradicate polio, have expressed serious reservations about the appointment of an official who currently heads one of the three arms of the EOC, and are not willing to engage with him under any circumstances!
While there is little logic left now in reiterating mistakes of the past, the tragedy is Pakistan even made a bad start to 2015 by canceling the first campaign of the year. According to evidence, the polio leadership called off the Short Internal Activity Days (SIADs) scheduled from January 5-7, 2015, due to “non-availability of proper security arrangements for polio teams.” Why were adequate security arrangements not in place for the first campaign of 2015, particularly when 2014 had been such a bleak year? Is cancellation of campaigns any answer to Pakistan’s polio predicament?
Not a single province of Pakistan is free of polio. Of the 303 cases confirmed in 2014, Fata tops the list with 177 cases, followed by KP with 69 cases, Balochistan with 23 and Punjab with 4. At a time when every case is seen by the international community as “a case too many,” the polio leadership really must pull up its socks and show progress rather than hiding behind excuses which the world is ill-prepared to accept.
Meanwhile, in a press release issued on the momentous occasion of 303 polio cases being confirmed in a single year, the EOC believes “we need to dissect the numbers and focus on what the numbers say in terms of the challenges we continue to face.”
Polio cases, the press note highlights, are mostly clustered in Fata. “In fact, 93% cases in 2014 have come from Fata and KP. A study of cases from 2014 indicates that an absolute majority came from areas that were inaccessible for polio vaccination due to ban imposed by militants in North and South Waziristan. It is evident that the region had an outbreak of polio as the teams were denied access for over two and a half years,” it states.
The EOC moves on to describe 2014 as “a year of both challenges, and conversion of those into opportunities.” It also refers to some of the major breakthroughs achieved such as using exodus of IDPs to immunise children, resumption of polio drive in South Waziristan, special campaign for transit population, improved security for polio teams through coordination with the Ministry of Interior, functionalisation of EOCs at the federal and provincial levels, and introduction of injectable polio vaccine.” If improved security for polio teams was available, and if such enviable coordination really existed with the Ministry of Interior, why was the very first campaign of 2015 called off, one may question.
According to the EOC, 17 national, sub-national and short interval campaigns were conducted during 2014; these campaigns targeted over 34.6 million children below five years of age. “The enhanced effort will start showing results soon though we see a spike in the case count for 2014 at the moment,” the EOC says in conclusion.
The polio leadership is perpetually ignoring the fact that the world does not care about the number of campaigns that Pakistan conducts in a year. It also does not care about the number of children that are targeted through these interventions. What kind of strategies the country adopted to rise above its peculiar set of challenges also means little to the global community. What matters to the world is that 303 children in Pakistan have fallen prey to polio during a single calendar year, and each of these children poses a risk to every single child residing in any part of the world. The goal of global eradication remains an elusive dream, unfortunately because of the way the polio programme in Pakistan has been and continues to be run. So by the time the polio leadership dissects numbers to see what the numbers say in terms of challenges, new data on polio cases during 2015 will start speaking for itself.

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