Poliomyelitis in Pakistan

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Pakistan is one of three countries[1] where poliomyelitis (polio) is still categorized as an endemic viral infection.[2] Though a polio immunization campaign started in 1974, its eradication officially started only in 1993. About sixty rounds of vaccination were carried out in the country before 2007, and the infection persists.[3] Polio cases in Pakistan rose by 37 percent in 2011.[1] The World Health Organization reported the presence of the polio virus in Lahore, Rawalpindi and Peshawar, where the virus was found in the sewage systems.[4] According to Heidi Larson, writing in The Guardian, polio eradication efforts were hampered when it was revealed that the US Central Intelligence Agency employed the services of a Pakistani doctor Shakil Afridi and local health officials who used a vaccination campaign to collect DNA samples of Osama Bin Laden before Operation Neptune Spear.[5]


In 1991, due to financial constraints, only 83 percent of Pakistani children had been vaccinated.[6] Intensive eradication campaigns such as door-to-door vaccinations only started after 1999. Recognizing the efforts of Rotary International, who contributed about $12 million to the cause, the government of Pakistan issued a postage stamp on the hundredth anniversary of that organization in December 2000.

In March 2001 about 27 million children were vaccinated across the country, in the hope that Pakistan could be virus-free by the end of that year.[7]

As of 2004, when there were 30 million children in Pakistan under five, about 200,000 health workers were required for a vaccination campaign that was carried out eight times a year.[8] A documentary, Polio True Stories, was aired on several television channels to make people aware of the problems facing people affected by the disease.[9]

Factors affecting eradication[edit]

After the September 11 attacks, a myth arose in Pakistan that the United States was using immunization campaigns to sterilize the local population. Health officials tried to dispel this story, but their efforts, in the opinion of Heidi Larson, writing in The Guardian, were marred by the Central Intelligence Agency (CIA), when it conducted a fake Hepatitis B immunization campaign in Bin Laden's residence in Bilal Town at Abbottabad with the help of Dr. Shakil Afridi.[5] The intention of the campaign was to confirm Osama bin Laden's presence in the city by obtaining DNA samples from children suspected of being his.[10] In a letter written to CIA director Leon Panetta, the InterAction Alliance, a union of about 200 US-based Non-Government Organizations, deplored the actions of the CIA in using a vaccination campaign as a cover.[11] The effect of the fake vaccination campaign in reducing polio program cooperation became evident when the world's highest number of polio cases (198)[12][13] were reported in Pakistan in 2011.[14]

In early 2012, some parents refused to get their children vaccinated in Khyber Pakhtunkhwa and FATA but religious refusals in the rest of the country had "decreased manifold".[12]

Views of the WHO special envoy[edit]

In a 2012 interview with Pakistani newspaper Dawn, Dr. Hussain A. Gezari, WHO’s special envoy on global polio eradication and primary healthcare, gave his views on obstacles to eradication. He said the biggest hurdle in making Pakistan polio-free was holding district health officials properly accountable—in national eradication campaigns officials had hired their own relatives, even young children. "How do you expect a seven-year-old thumb-sucking kid to implement a polio campaign of the government," said Dr Gezari. He added that, in spite of this, "the first national campaign was initiated by your government in 1994 and that year Pakistan reported 25,000 polio cases, and the number was just 198 last year, which clearly shows that the programme is working."[12]


  1. ^ a b Kounteya Sinha (15 May 2012). "WHO to declare polio global health emergency". The Times of India. Retrieved 3 June 2012. 
  2. ^ Centers for Disease Control and Prevention (CDC) (2006). "Update on vaccine-derived polioviruses". MMWR Morb Mortal Wkly Rep 55 (40): 1093–7. PMID 17035927. 
  3. ^ A. Hussain; B. Kolachi; Yasmin Memon; Muhammad A. Kazi; Shankar L. Rathi (2009). "Quality Assessment and Impact of Parent Literacy on National Immunization Days Campaign in District Jamshoro Sindh-Pakistan". Biomedica (Pak Biomedical Research Society) 25 (1): 24–27. Retrieved 25 May 2012. 
  4. ^ "Polio virus found in Lahore, Rawalpindi, Peshawar". Dunya News. 27 May 2012. Retrieved 27 May 2012. 
  5. ^ a b Heidi Larson (27 May 2012). "The CIA's fake vaccination drive has damaged the battle against polio". The Guardian. Retrieved 3 June 2012. 
  6. ^ "Third Plenary Session". 1994 Proceedings: Eighty-Fifth Annual Convention of Rotary International. Taipei: Rotary International. 15 June 1994. p. 38. Retrieved 26 May 2012. 
  7. ^ Silver, Cary, ed. (May 2001). "Pakistani Rotarians help immunize 27 million children in NIDs". The Rotarian (Rotarian International): 54. ISBN: S5LQ-BE8-DD3Q. Retrieved 28 May 2012. 
  8. ^ Svea Closser (16 August 2010). Chasing Polio in Pakistan: Why the World's Largest Public Health Initiative May Fail. Vanderbilt University Press. pp. 40–41. ISBN 978-0826517098. Retrieved 27 May 2012. 
  9. ^ "Polio True Stories". Country Programme Human Interest Stories. UNICEF. Retrieved 27 May 2012. 
  10. ^ "Bin Laden death: 'CIA doctor' accused of treason". BBC News. 6 October 2011. Retrieved 8 October 2011. 
  11. ^ Imran Ali Teepu (2 March 2012). "American NGOs assail CIA over fake polio drive". Dawn. Retrieved 27 May 2012. 
  12. ^ a b c Imran Ali Teepu (26 February 2012). "WHO rejects polio rumours". Dawn. Retrieved 3 June 2012. 
  13. ^ Orla Guerin (24 May 2012). "'Emergency plan' to eradicate polio launched". BBC News. Retrieved 27 May 2012. 
  14. ^ Saeed Shah (2 March 2012). "CIA tactics to trap Bin Laden linked with polio crisis, say aid groups". The Guardian. Retrieved 27 May 2012.