Return of the spectre

Poliomyelitis or Polio has been one of the curses of the 20th century, crippling Millions of children for life from all over the world. According to the World Health organization, the tragic disease was endemic in more than 125 countries in 1988, when there were more than 350,000 poliomyelitis infections.

Thanks to one of the world’s most ambitious vaccination campaigns in the history of the world, this horrible disease has declined today by 99.9 per cent in less than a quarter of a century. In 2011, there were only 650 cases and that too only in 3 countries namely Nigeria, Afghanistan and Pakistan. Pakistan unfortunately continues to be one of the only three affected countries in the world even today, where the highly infectious disease, which cripples limbs remains endemic. According to a senior Government official, there were a total of 58 cases in 2012, but in 2013, 73 fresh victims of polio have already been reported. Which means that the dreadful disease is actually on the rise again.

The official reason for this rise is being given as the militancy in the northwest. Vaccination teams are unable to reach the tribal areas because of risks to their lives. Statistics obtained so far supported this. The official figures say that 6 cases were reported in Punjab, 4 in Sindh and 9 in Khyber Pakhtunkhwa, but the bulk of the infections, numbering 43, came from tribal areas along the Afghan border.

Pakistani Taliban banned polio vaccinations in the tribal region of Waziristan last year and claimed that the Polio campaign was actually a cover for espionage. As a result, more than 240,000 children missed vaccination in 2013. Resistance to Polio immunization drive however continues even in other parts of the country also. In other parts of Pakistan, including even port city of Karachi, health workers giving out polio drops were attacked and even killed.

The health authorities in Pakistan were absolutely rattled, when two poliovirus cases were confirmed in the port city of Karachi within 24 hours, in the first week of December 2013. This was something very unusual. Dr Elias Durry, the head of WHO’s polio eradication initiative in Pakistan says: “I must say, the situation in Karachi is very alarming.”

India, which officially became Polio free in 2011, shares a long international border extending over 3000 KM with Pakistan. There is a continuous exchange of people across the border. It is but natural that the return of the spectre of Polio, which has increased by 30 % in an year across the border, is causing much concern in India.

In the beginning of 2013, India decided to give compulsory Polio shots to all children entering or leaving India to Pakistan. The practice then was followed even at Bangladesh borders. The importance of this measure can be only be elucidated from the recent WHO observation that linked an outbreak of polio in Syria, that has paralysed 13 children, to a strain of the virus from Pakistan. The signals are very clear. A lurking danger exists across the borders of India.

India has now decided that all Pakistani visitors would have to take oral polio vaccination (OPV) at least six weeks prior to departure. A communication from the Indian High Commission to Pakistan says: “Travellers from Pakistan to India after January 30, 2014, are required to carry their vaccination record as evidence of polio vaccination and they will only be allowed to enter the country thereafter. ”

The notification also says that the record for administering OPV may be obtained from an authorised medical centre in the format laid out in the World Health Organisation’s International Health Regulations 2005, International Certificate of Vaccination. Once administered, the OPV remains effective for one year, after which the vaccination should be taken again. Official reaction from Pakistan Government says that the Indian government has imposed travel restrictions just to secure their country, which is alright, but it should have been consulted before.

It is possible that other countries are likely follow suit and impose similar restrictions, as no country wants the spectre of Polio ever returning to their lands.

14^th December 2013