Ashfaq Yusufzai
PESHAWAR, Jan 26 2011 (IPS) – Pakistan became the world s top polio-endemic country in 2010 and is now the biggest source of the polio virus to countries declared polio-free many years ago. Due to the unrestricted movement of children along the long and porous Afghanistan-Pakistan border, both countries have begun to put in place a joint strategy to stem the tide of the ailment.
About 200,000 children cross the border every year, said Rasheed Juma, director-general of health in Pakistan. Thousands of these children are not administered oral polio vaccine (OPV).
Ministers of health from Pakistan and Afghanistan have established a cross- border coordination committee to consider the operational challenges in tackling the transmission of polio in high-transit areas and to devise a strategy to cope with vaccination along the border.
Under the strategy, one dozen vaccination points are being set up to ensure that all children below the age of five years get vaccinated.
In addition, the governments are partnering with the Taliban to help with vaccination in the border regions, Juma said. We have planned to hold talks with Taliban in the border areas and win their support, he said. Cooperation of Taliban in some provinces of Afghanistan had paid off, he added.
Pakistan has long been blaming its border with Afghanistan for the continuing rise in polio cases.
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According to the Polio Eradication Initiative of the World Health Organisation (WHO), Pakistan recorded 140 cases of polio in 2010, followed by India with 41, Afghanistan 24 and Nigeria 18 cases. In 2009, India topped polio- endemic countries with 694 cases, followed by Nigeria with 388 cases, Pakistan 86, and Afghanistan 31 cases.
The global health agency blames these four countries for transportation of polio to other countries long declared polio-free.
Of the total 140 confirmed polio cases in Pakistan, 72 are from the Federally Administered Tribal Area (FATA) bordering Afghanistan where administration of OPV to children is a herculean task, Mujahid Hussain, a polio officer in FATA and adjacent Khyber Pakhtunkhwa, told IPS.
Unrestricted mass movements across the 2,400-kilometre Pak-Afghan border is a major reason due to which thousands of children remained un- immunised, Hussain said.
The problem is the transportation of P3 virus, which is found in Afghanistan. This year, 33 children have got P3 virus in Pakistan which is due to the Afghan children, Hussain explained. Twelve of the 33 children who tested positive for P3 in 2009 were Afghan refugees, he said.
Years of conflict in Afghanistan has meant that it remains among four endemic countries that have failed to eradicate the acute viral disease that attacks the nerve cells of the brain stem and spinal cord.
In 2007, a Pakistani student of the Melbourne University visited the border area of the Khyber Agency and was tested positive when he returned to Australia.
Later, genetic sequencing of the virus showed that it had originated in Afghanistan. Now the people visiting Saudi Arabia for Hajj are required to get vaccine for polio, according to WHO s Abdul Jabbar.
Jabbar said that without a joint strategy, children in Afghanistan and Pakistan would continue to be haunted by polio.
Mashal Shah, who represented Afghanistan in talks with Pakistan, told IPS that his country was committed to wipe out the crippling ailment. For this purpose, we are going to strengthen vaccination points in border areas close to Pakistan, Shah said.
Shah said that Afghanistan has already made headway it has brought down number of cases from 31 in 2009 to 24 in 2010.
The strategy also seeks to start immunisation campaigns in both the countries simultaneously that would ensure that Afghan children leaving Pakistan would get OPV in their own country. While the children coming from Afghanistan would receive polio drops in Pakistan. At a later stage, Shah said, the plan is to involve other Central Asian States in the strategy.
Talks with Taliban are also on agenda, Shah stressed.
On Dec. 21, a joint meeting of Pakistani and Afghan religious leaders issued a decree which stated that all Muslims should vaccinate their children against polio.
We would prevail upon Taliban to allow vaccination, Maulvi Ghulam Rasool of Jalalabad, told IPS. It is the religious responsibility of parents to administer OPV to their children and fulfil their Islamic duty, he said.
Donor agencies, including U.N. agencies, have been spending an estimated 1.5 billion dollars on polio eradication efforts every year but the campaign has failed produce the desired results due in part to Taliban propaganda that OPV is a U.S. ploy to make recipients infertile.
