ISLAMABAD - As the country struggles to continue anti-polio campaigns against all odds, around 400,000 children missed the polio drops during the recent immunisation campaign against polio.

Besides, 250,000 children in South and North Waziristan Agencies have been remained unvaccinated since June 2012 due to a ban against polio immunisation imposed by Taliban. The campaign ran from August 19 to September 6 in phases in different districts due to floods, security concerns and by-elections.

According to polio control room data available with The Nation, in the campaign total 34.17 millions children had to be targeted and of them 33.7 millions were vaccinated across the country. Out of total 402,584 unvaccinated children about 15,084 could not be vaccinated in FATA, 345 in Gilgit-Baltistan, 3,222 in Islamabad, 145,259 in Khyber Pakhtunkhwa (KPK), 164,416 in Punjab, 56,675 in Sindh, 17,268 in Balochistan and 351 in Azad Jammu and Kashmir (AJK).

Among the unvaccinated, around 62,078 are refusal cases while 34,506 children were not available when the teams went to administer polio drops.

According to official, a significant reason for this is the insecurity with continuing deaths of polio workers and security personnel assigned to protect them. The insecurity has led to a rise in refusals and has compromised the way vaccinators do their tasks, often hurrying and not making home revisits, which results in a greater number of missed children.

A post campaign monitoring through finger marking showed that 93 per cent children were confirmed as vaccinated.

Proportion of children found finger marked was 97 per cent in Punjab, 93 per cent in Sindh, 91 per cent in KPK, 89 per cent in FATA, 81 per cent in Balochistan, 94 per cent in AJK, 95 per cent in Gilgit-Baltistan and 98 per cent in Islamabad during the surveys.  So far total number of polio cases surfaced this year is 28 compared to 42 during the same time period last year.

Moreover, circulation of poliovirus in sewage in parts of Peshawar, Rawalpindi, Faisalabad, Gaddap and Gulshan-e-Iqbal Town in Karachi, Hyderabad and Quetta risk many more children to the disease.

Improving campaign performance in KPK and access to children in FATA remain the most serious challenges to Pakistan's polio eradication efforts, officials say.  Circulation of wild poliovirus is continually found in Peshawar environmental samples and this is critical because of the heavy influx of migrants and internally displaced persons pass through Peshawar making it both an amplifier and conduit of wild poliovirus to KPK and FATA. 

The continued transmission of poliovirus in Pakistan and the rising numbers of polio cases since 2008 turned into national emergency; risking Pakistan to become the last remaining reservoir of endemic poliovirus transmission in the world, and the only remaining threat to achieving global polio eradication.