Washington Report on Middle East Affairs, August 2014, Pages 54-55
Human Rights
Pakistan’s Fight Against Polio
The funding is there, the vaccines are there and the scientific expertise is there. So why is Pakistan still losing the battle against polio? The Atlantic Council’s South Asia Center held a discussion June 5 at its Washington, DC headquarters to assess this dilemma.
While its neighbor, India, celebrates three years of being polio-free, Pakistan remains one of only three polio-endemic countries left on the planet. According to the Global Polio Eradication Initiative (GPEI), 71 polio cases have been recorded in Pakistan in 2014 alone. Furthermore, the World Health Organization (WHO) has issued a travel ban preventing long-term residents of Pakistan from traveling abroad without presenting evidence of vaccination.
Ambassador John E. Lange, senior fellow for Global Health Diplomacy at the United Nations, traced the story of polio back to the 1970s. “It’s a terrible disease… More than 350,000 cases of life-long paralysis were recorded each year. The world felt determined to eradicate the disease, especially after succeeding in eradicating smallpox,” Lange explained. But the path toward eradicating polio has been much more precarious than was that of eradicating smallpox.
“It’s not just sad, it’s dangerous,” said Dr. Samia Altaf, a physician and public health specialist. Not only does the virus have the ability to mutate, she explained, but it is now re-surfacing in some areas where it was eradicated more than a decade ago. Lange pointed out that in addition to being the only country in the world with a rising number of polio cases, Pakistan is now exporting the virus to the Middle East—namely, to Syria. “The vaccinations are not available because of the civil war, making the population very vulnerable,” she noted.
The deteriorating state of affairs in Pakistan is occurring even though a wealth of international efforts and funds have been allocated to eradication programs. Altaf, who has worked on the ground consulting for international aid agencies and authored So Much Aid, So Little Development: Stories from Pakistan, posed and answered the million-dollar question: “Why can’t we do something as simple as getting those two drops [of vaccine] to a child’s mouth? Because something is missing, the eradication program designed is flawed, it is out of context.”
Eradication programs in Pakistan have not endeared themselves to local populations, Altaf argued. “Polio is a disease that happens within contexts, not in a void,” she added. “We developed these programs without paying attention [to the fact] that these communities have internal dynamics, values, desires.”
Among the striking statistics Altaf shared was a 2012 UNICEF survey which showed that about 50 percent of the respondents did not know that there is a protective mechanism against polio. “They demand knowledge, information, and understanding,” Altaf said. One barrier to knowledge is the fact that the eradication program has relied on brochures and pamphlets in high-risk areas where literacy rates are among the lowest in the country, she noted.
Another problem is an acute deficiency in human resources that could effectively carry out these projects, Altaf contended. On paper everything is there, she said, “but if you look at the plan, one crucial part is missing: who is going to do it?”
“It’s hard-hitting, but there is still hope,” Lange concluded, reminding the audience that the number of worldwide polio cases recorded per year dropped from 350,000 in 1988 to a few hundred last year. “It is really hard to finish the job,” he acknowledged, “but it is imperative to finish the job.”
—Dina Salah ElDin
