The history of human beings being targeted by polio virus dates back to time unknown. It spreads mainly through saliva and stools and causes poliomyelitis in victims. Upon reaching the body the virus attacks nervous system and starts destroying nerve cells which control muscles. During the early 20th century it wreaked havoc in the United States and Europe. In 1952 around 58,000 cases were reported only in the US. Shortly afterwards scientists developed two types of polio vaccines i.e. IPV (Inactivated, given by injection) and OPV (weakened, given orally). Consequently much of the Europe along with the US and Australia managed to eradicate polio from their territories by 1988 with the World Health Assembly resolving to eliminate it from the Earth’s surface by 2000. Sadly, this target couldn’t be achieved even by 2019.

Pakistan and Afghanistan are the last countries in the world which have failed in achieving zero polio transmission. Pakistan has achieved a tremendous success in the last few years by bringing down the number of reported cases from 306 in 2014 to 12 in 2018. But this is not considered satisfactory as health experts are of the view that if spread of the virus isn’t controlled immediately there could be a resurgence and the number of infections each year can rise to as high as 200,000 within a decade. To avert this danger, no effort should be spared in making the world polio-free.

There are many impediments to eradicating polio from our country of which the greatest one is conspiracy theories. In developing of these we have almost a collective expertise. It is an incontrovertible fact that some people believe polio vaccination programs are part of a Western Plan which calls for controlling population growth among Muslims implying the drops cause sterility. Moreover, negligence by polio workers is also part of the problem. Many have been caught up while forging documents and wasting vaccines. It has also been observed that on some occasions Standard Operating Procedures are compromised during storing and transportation of vaccines.

For effective immunization and elimination of the virus, vaccination of 100% of children population at the same time is vitally important, but internal and across the Pak-Afghan border movements along with other factors have made this exercise almost impossible.

Some children already vaccinated with polio vaccines have reportedly been infected allegedly due to ineffective vaccines or their improper administration. This has led some folks into believing, even within educated class, that efficacy and adverse impacts of the vaccines are open to question. The vaccines require refrigeration which is quite difficult and challenging in our mostly hot climate.

Government should come up with a comprehensive strategy which must help in overcoming all hurdles we face in fighting this crippling disease.

First, clerics and the government need to be on the same page. Most of the people who are averse to vaccination have religious reasons and they would do what their prayer leaders may tell them to do. Thus all contemporary ‘Pesh Imams’ should be convinced via a systematic training that polio vaccines carry no harm and then, accordingly, should be directed to give sermons in their respective mosques in support of immunization besides declaring non-immunization of children a cardinal sin. Because such children can become a source of virus transmission and needless to say, putting lives of others at risk is a sinister vice.

Second, polio workers carry out their assignments with outstanding courage as they serve soft targets for extremist elements. Many have sacrificed their lives in the line of duty. Additionally, not only are they paid low, they are also denied timely wages. Therefore, they should be provided with tight security and adequate remuneration for their work.

Third, polio workers should undergo professional training with reference to full coverage of their specific areas and storage and handling of vaccines. Administration of ineffective vaccines in one area can render country wide campaign useless.

Fourth, anti-polio campaigns should be launched simultaneously in Pakistan and Afghanistan with the aim of vaccinating 100% of the target populations in both countries. This is due to the fact of cross border people movements which can lead to carriage of virus from one country into another even if one of them completely eradicates it.

Fifth, there should be a strict monitoring system in place to oversee the performance of polio teams. Prompt action must be taken against those who are found negligent in discharging their responsibilities.

In addition to that, help of mainstream media, social media activists, and civil society should also be sought in combating this potentially fatal virus. This winter we have seen polio workers going through waist-high snow with enormous difficulty to reach out to children in far flung mountainous areas. That speaks volume of the fortitude they endured. People of Pakistan have risen to huge challenges. Eradicating polio pales in comparison. Only strong commitment and decisive action is needed.

Furthermore, if the divide between government and people is bridged and the distrust of the latter in the former is done away with, many riddles would solve automatically.