Poliomyelitis in Pakistan
Pakistan is one of three countries where poliomyelitis (polio) is still categorized as an endemic viral infection. 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. Polio cases in Pakistan rose by 37 percent in 2011. 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. 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.
In 1991, due to financial constraints, only 83 percent of Pakistani children had been vaccinated. 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.
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. A documentary, Polio True Stories, was aired on several television channels to make people aware of the problems facing people affected by the disease.
Factors affecting eradication
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. 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. 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. The effect of the fake vaccination campaign in reducing polio program cooperation became evident when the world's highest number of polio cases (198) were reported in Pakistan in 2011.
Views of the WHO special envoy
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."
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