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October 24, 2020

Toward a polio-free Pakistan

Islamabad

October 24, 2020

Pakistan along with the rest of the world is observing the World Polio Day today (October 24). The polio immunization campaign in the country started in 1974 but the efforts for eradication officially started in 1994. Pakistan now is one of only 2 remaining countries in the world with ongoing wild poliovirus transmission, along with Afghanistan. After the launch of the Pakistan’s Polio Eradication Programme in 1994, there has been a massive decline in polio cases from approximately 20,000 every year in the early 1990s to only twelve cases in 2018. However, in 2019 the programme witnessed a significant spread of the virus and reported 144 polio cases across all provinces. So far in 2020, 79 cases have been reported from various provinces. In its resolve to eradicate polio, the government has made key interventions including deployment of highly committed and dedicated frontline workers in various areas, enhancing surveillance, detection and response capacity of the programme besides adopting “one team under one roof “ operational approach as per the creation of Emergency Operations Centres (EOCs) at provincial and federal levels. The UNICEF on its official website has acknowledged Pakistan’s progress towards eradicating poliovirus transmission in the country. “Case numbers are the lowest they have ever been, while immunity gaps among children continue to decline. An array of approaches and tools are implemented to help Pakistan reach the finish line of zero polio cases. These approaches and tools are outlined in the National Emergency Action Plan of the Pakistan Polio Eradication Programme (NEAP) with specific objectives, targets, milestones and indicators that guide the programme to its goal of zero-polio.” Five Nationwide Immunization Campaigns were planned for the months of September, November and December of 2018 as well as in January and April of 2019. Smaller Sub-National Immunization Campaigns in selected districts were conducted in July,

August and November, 2018, and later in March and June of 2019. The Pakistan polio programme faced a setback with 1 million refusals as a result of a massive antivaccine propaganda in the first quarter of the year 2019. In order to build community trust, the program realized successful national immunization drives in December 2019 and February 2020. The first COVID-19 case was reported in Pakistan on February 26, 2020, immediately after the February NID was completed. The COV ID- 1 9 pandemic has had a significant negative impact on EPI immunization activities. In mid-March a special immunization drive planned in limited districts of Khyber Pakhtunkhwa had to be called off due to the pandemic and the NID in April was also suspended. On June 11-15, 2020 the Technical Advisory Group (TAG) comprising international experts warned of an ‘explosive’ outbreak of the polio virus resulting in hundreds of cases if polio campaigns did not resume. While considering the need for resumption of essential health services including immunization, the government re-adjusted the immunization and polio campaigns to the restrictions, limitations and risks caused by COVID-19 pandemic, while also not losing on the need to take into consideration the risks of polio workers contracting the disease and the possible increased transmission of COVID-19 to communities by frontline workers (FLWs). An operational plan for resumption of the polio campaign was validated during a meeting of the National Command and Operation Centre (NCOC) under the Prime Minister of Pakistan and endorsed by all provinces on July 4, 2020. With limited scale polio campaigns conducted in July & August, in September a countrywide polio campaign was carried out successfully with strict COVID-19 prevention measures for FLWs and communities. Mass media campaigns Given the polio program’s pivot to support the COVID-19 response, a mass media program has also been chalked out by the government of Pakistan to elevate stories about how the polio programme delivers broad health benefits to the communities it works in. The World Polio Day media content will focus primarily on the three narratives - the positive milestone of Africa being wild polio-free, the programme’s ability to adapt in the face of challenges, and the ways in which the eradication effort supports other health initiatives. In the said media plan, the government seeks to recognize the role of major media houses to use their influence and networks to help establish a polio-free Pakistan as a national cause, and to rally the people of Pakistan around polio eradication as a matter of national pride. The media is also entrusted with the responsibility to use their platforms and influence to promote facts about polio vaccines as effective, safe to counter the harmful misinformation. In order to unify the above mentioned priority messages, the mass media will push focus on daily sub-themes anchored by Rotary’s overarching World Polio Day theme - A win against polio is a win for global health. The media houses have been asked to produce creative organic content and post on social media according to these themes and intensify content starting on Thursday, 22 October through Saturday, 24 October. Mir Khalil-ur-Rahman Foundation (MKRF) which has been working for the eradication of polio as part of its advocacy program--- has been in the forefront of these initiatives. Jang, The News and Geo as media partners have planned special programs under the banner of MKRF towards this national cause. In this connection on-air discussions with health experts and concerned people, awareness programs for parents and caregivers to inform them that if their child has missed vaccination during COVID-19 lockdown, she/he can still be vaccinated, information messages for the families that the out-of-sync children, as well as the newly born children, can receive their vaccination free of charge, at a government health facility or an outreach vaccination camp, advocating to the people who are watching /listening to the discussion on childhood vaccination to pass on this information to those who have young children but may not hear this message (e.g., servants, street vendors, or relatives living in rural areas), initiating a “chain of information” by asking people (audience) to inform at least one person about the importance of childhood immunization, and its availability at health centers as well as outreach sites. The main objective of the World Polio Day media campaigns is to reach the public with messages that promote confidence in the eradication effort. All the polio campaigns will also appreciate the efforts of frontline workers, who risk their lives even in calamities like COVID-19 but fulfill their responsibilities towards a national cause. MKRF is all geared to fulfil its objectives towards making Pakistan a polio free country.