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POLIO IN NORTH WAZIRISTAN, PAKISTAN

Thursday, 1st of January 2015

 

"In a country that is going through political turmoil, a lot more effort by all political stakeholders is required to make eradication a possibility."

POLIO IN NORTH WAZIRISTAN, PAKISTAN

The Lancet Global Health, Volume 3, No. 1, e15, January 2015

Syed Osama Ahmad,

Ahmed S Bux,

Fouad Yousuf

Also at  http://dx.doi.org/10.1016/S2214-109X(14)70353-5

Having read the Editorial Polio: is the end in sight? (November, p e616),¹ we felt inclined to share our point of view about the recent increase in polio cases in Pakistan and their link to the military operation being conducted in North Waziristan.

Since 2012, polio vaccination campaigns have not been undertaken in many districts of federally administered tribal areas (FATA), mainly due to the Talibans ban on polio vaccination in the region and the attacks on health-care workers.² Because of this gap, countless residents of FATA were left unvaccinated.³ Consequently, FATA became a major polio reservoir, with the majority of polio cases in 2014 being reported in FATA and the neighboring Khyber Pakhtunkhwa province (KPK).⁴

In June 2014, Pakistans military operation against the Taliban in North Waziristan district of FATA, resulted in the displacement of an estimated 1 million people.⁵ The mass migration of previously unvaccinated people from North Waziristan resulted in an increased transmission of polio within Pakistan, which is quite evident from the fact that as of Nov 29, 2014, 186 cases of polio have been reported since June 2014, taking the total number of cases in 2014 to 268.⁴

Despite the large increase in number of polio cases, the hope that polio can be eradicated in Pakistan is still present. This migration has created an opportunity to vaccinate people who previously were left unvaccinated due to the ban imposed by the Taliban.⁵ Vaccination centres were set up along check points out of North Waziristan, and more than 700 000 people out of the 1 million people displaced were vaccinated.⁵ Furthermore, vaccination campaigns have been undertaken in districts where the migrants have settled. So far in 2014, 11·8 million individuals have been vaccinated throughout Pakistan, compared with 8·5 million in 2013 alone.⁵ Although the 2014 deadline to interrupt wild polio virus transmission is unlikely to be achieved, these developments give us hope for a decline in polio cases in the coming year 2015. In a country that is going through political turmoil, a lot more effort by all political stakeholders is required to make eradication a possibility.

We declare no competing interests.

References

1. The Lancet Global Health. Polio: is the end in sight?. Lancet Glob Health. 2014; 2: e616
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2. The lancet. Global polio eradication: not there yet. Lancet. 2013; 381: 1
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   • | PubMed
   • | Scopus (4)
3. Relief web and Agence France-Presse. Pakistan resumes polio vaccines under tight security. http://reliefweb.int/report/pakistan/pakistan-resumes-polio-vaccines-under-tight-security; Jan 4, 2013. ((accessed Dec 5, 2014).)
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4. WHO. Weekly AFP surveillance update Pakistan week 42. World Health Organization Regional Office, Islamabad, Pakistan; 2014http://www.emro.who.int/images/stories/pakistan/documents/pak_documents/Polio/weekly_bulletins2014/Week_42_Oct_18_2014.pdf?ua=1. ((accessed Dec 5, 2014).)
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5. End polio Pakistan. Pakistan Polio update October. http://www.endpolio.com.pk/images/Polio%20Briefer_%2021%20October%202014.pdf. ((accessed Dec 5, 2014).)
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