Islamabad - Top international watchdog of the Global Polio Eradication Initiative in its report released yesterday appreciated the management and governance processes within Pakistan’s polio programme that have improved since the last IMB report, while drawing attention towards immunity gaps in isolated pockets.

The latest report of the Independent Monitoring Board (IMB) of the Global Polio Eradication Initiative — the body that evaluates the implementation of global polio eradication efforts — acknowledged the fact that the number of polio cases so far in 2015 is at its lowest in history. The report titled “Now is the Time for Peak Performance” says that, the world has never been better positioned to eradicate polio and the remaining sanctuaries for poliovirus in Pakistan and Afghanistan are now the key to achieving that goal.

The top body monitoring polio efforts worldwide had met on October 5-6 in London for a detailed review of the performance of countries harbouring the poliovirus including Pakistan. The board comprises world’s top public health specialist. Since the last IMB’s report, Nigeria has been removed from the list of polio endemic countries. Only two now remain: Pakistan and Afghanistan. So far Pakistan has reported 40 cases this year with Khyber Pakhtunkhwa 15 cases, FATA, 13, Balochistan, 6, Sindh, 5 and one case has been reported from Punjab.

The IMB appreciated Pakistan’s polio programme on a number of accounts and went on saying that the management and governance processes within the programme have improved since the last IMB report, a functioning emergency operations centre is now in place, shortcomings in data are being addressed, health camps are operational in different parts of the country, front-line workers are more trained and access has improved substantially reducing the number of children in inaccessible areas from over half a million to 35,000.

Mentioning of fewer wild polio virus cases this year, the IMB particularly noticed Federally Administered Tribal Areas (FATA) where cases are down by over 90 percent.

As a result of the coordinated efforts of all of our society, it is the virus that is now under severe pressure, said Muhammad Ayub Shaikh, the Secretary National Health Services. “We have successfully cornered it in just three remaining sanctuaries – the Khyber-Peshawar corridor, Karachi and the Quetta block where we are continuously challenged by pockets of under-immunised children”. To finally finish this time, the secretary said, “we must sustain our gains and must not allow these sanctuaries to sustain polio transmission across Pakistan by enhancing our programme performance”.

Though encouraged by recent progress in Pakistan, the IMB draws attention towards the need to quickly close the serious immunity gaps in isolated pockets. ‘The challenge for Pakistan’s programme, that is much better coordinated and led than it was a year ago, is to stop the “conveyor belt” of transmission in Peshawar and surrounding large geographical areas’ says the IMB report.

The report points out in some areas supplementary immunisation activity remains substandard – notably in Quetta and Karachi. “Other areas of Pakistan must also receive robust attention. There is an unnerving comparison with Nigeria. A year before Nigeria interrupted transmission there were fewer reservoirs than in Pakistan. On this basis, Pakistan is not yet on the right trajectory for 2016” it says.

It recommends continuous focus on Peshawar and its surrounding territories. “It is the key to success and to failure in Pakistan. If polio can be eliminated in this part of Pakistan during the low season then there is an excellent chance that the country will have interrupted transmission during 2016”

It also calls for massive cuts in the number of missed and persistently missed children in both endemic countries, and all other areas that are vulnerable because of low immunity levels. It stresses major reductions in the number of persistently missed children particularly in the Peshawar and FATA regions as there are still one million under-immunised children in the country.

It also suggest GPEI partners to help the governments of Pakistan and Afghanistan establish a joint executive and planning body to instigate cross-border polio prevention and control that should not only address the border crossings but take account of the need to cover communities at some distance from the border itself. Prime Minister’s Focal Person for Polio Eradication, Senator Ayesha Raza Farooq stated that the Pakistan programme now has all the ingredients required to finish the job in areas pointed out by the monitoring body.