Polio, population and progress

“In the early twenty-first century the train of progress is again pulling out of the station – and this will probably be the last train ever to leave the station called Homo sapiens.

"Those who miss this train will never get a second chance. In order to get a seat on it, you need to understand twenty-first-century technology, and in particular the powers of biotechnology and computer algorithms. The main products of the twenty-first century will be bodies, brains and minds, and the gap between those who know how to engineer bodies and brains and those who do not will be far bigger than the gap between Sapiens and Neanderthals". – Yual Noah Harari

Could Pakistan be well on its way to miss the last train. Sadly there is little realisation as to why this may happen and what must be done to catch up with the rest of the world. Countries that made dramatic economic breakthroughs in the last thirty years had one thing in common. They all managed to drastically reduce the average number of children that would be born to a woman over her lifetime. Iran did a spectacular job of reducing its fertility rate from 6.53 to 1.96 in a span of 30 years. Bangladesh brought its fertility rate down from 6.92 to 2.1 since its independence, while Korea (1.21), China (1.65), Hong Kong (1.23) and Taiwan (1.1) made similar impressive reductions.

Pakistan has no realisation, plans or solutions to reduce its unsustainable female fertility rate of 3.7. Nor is it willing to follow the Iranian, Bangladesh or any other model to ensure that every girl does receive schooling till the age of sixteen. There is no way a nation with 22.5 million out- of-school children and 44 percent malnourished and stunted children can even dream of becoming a progressive modern state. The burgeoning population makes this challenge even bigger and more unattainable with each passing day.

Nigeria has not seen any cases of the wild polio virus for the last 3 years. That leaves Afghanistan and Pakistan as the only two countries in the world that are still stuck with polio. Pakistan’s polio cases appear to imitate its uncontrollable population. From 8 cases in 2017 to 12 in 2018, we have already identified 72 cases of wild polio virus in 2019. It is becoming increasingly obvious that Pakistan may well be the last country on the globe that would still be breeding polio in its backyard.

Neither healthcare professionals nor the pharma industry is willing to talk about the real causes of polio. While polio drops are much needed, there is no way a country can be polio-free if its people do not have clean drinking water or a half-decent sanitation system. Sadly Pakistan’s bureaucracy and politicians have utterly failed to address this problem. Their own lives being well protected by plastic mineral water bottles, they are least concerned about dispatching almost 100 percent untreated raw sewage to open ‘nullahs’ or the nearest water sources. The state has felt no need to break the fecal-oral linkage, which is critical for polio elimination and ought to have been its first priority.

Pakistan needs urgent reforms and actions to introduce massive multi-pronged population control programs. The existing sleepy population welfare ministries ought to be disbanded to give way to a dynamic new structure to tackle this task. It is the responsibility of the state to provide clean drinking water and not that of the groundwater depleting multinationals. Likewise it is the task of the state to treat sewage, collect garbage and eliminate plastic bags.

While polio events may only be the symptoms of a larger disease, Pakistan should begin to appreciate the inextricable link between population, polio and every development target that it wishes to achieve. Failing to do so would be a mistakes that could cost Pakistan a seat in the last train leaving the station.

The writer is a management systems consultant and a freelance writer on social issues.

Email: naeemsadiq@gmail.com