PAKISTAN: Country moves toward polio-free status before year's end

[ This report does not necessarily reflect the views of the United Nations]

ISLAMABAD, 28 Apr 2005 (IRIN) - Following more than a decade of aggressive campaigning and house-to-house immunisation rounds, health experts in Pakistan remain confident that the South Asian nation will be polio-free before the end of 2005.

"In 2003, we had around 103 reported cases of polio, which dropped by almost 50 percent in 2004 with a total of 53 cases registered. Now, so far in 2005, a total of only five polio cases have been reported," Jeffery Bates, polio communications officer at the United Nations Children's Fund (UNICEF) told IRIN on Thursday, the concluding day of the national polio immunisation campaign.

"But more importantly having zero cases in the month of February for the first time in the history of Pakistan since the campaign started is the most significant achievement so far this year," he said.

Pakistan, a country of over 140 million, has more than 31 million children under the age of five, including Afghan refugees, of whom 90 percent have been immunised, according to the country’s health authorities.

About 75,000 teams with two health workers in each were employed for the second in a series of six national polio vaccination campaigns planned for 2005, Dr Rehan Hafeez, the national programme manager for the Enhanced Programme of Immunisation (EPI) at the Pakistani National Institute of Health (NIH), told IRIN.

According to a regional update by the Islamabad-based National Institute of Health (NIH), no polio cases have been reported in Afghanistan so far this year, while India has reported 14 cases against Pakistan's five cases reported.

The UNICEF official noted that the country had never looked better in terms of eradicating the disease completely. "It's very likely that the next couple of months will see the last polio case,” Bates claimed.

Local health departments, working with UN agencies, have run an aggressive media campaign for every household in the country to have their children under the age of five immunised.

"The campaign has been extensively advertised and the message has been aired through television and radio in the national language of Urdu and almost all regional languages as well, including Pashto, Saraiki, Sindhi and Punjabi, to encourage the people to have heir children vaccinated,” Bates said.

"The impact of the message when relayed in local languages is much more far-reaching, as the people feel closer to it and think that they should go for it,” he maintained.

But despite the success, as many as 12 districts across the country in upper and central Sindh, southern Punjab and a few in North West Frontier Province (NWFP) and Balochistan province, remain considered as high-risk areas for the disease.

“Even though these districts do not have polio, they are still at high risk for several reasons and we monitor them closely to ensure the proper vaccination of every child under the age of five," the UN official said.

Pakistan’s struggle against polio has been prolonged given a variety of factors including cultural obstacles, frequent transfers of district health officers, along with the system of immunisation and supervision, health officials maintain.

"Until last year, the immunisation level was very low. This has improved only since 2004 when we saw an almost 50 percent drop in the number of reported cases. We hope that in 2005, we’ll see the final cases and this will be the final year of polio in Pakistan," the UNICEF official said.

According to the World Health Organization (WHO), poliomyelitis (polio) is a highly infectious disease caused by a virus. Invading the nervous system, polio can lead to total paralysis in a matter of hours. The virus enters the body through the mouth and multiplies in the intestine. Initial symptoms are fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs. One in 200 infections leads to irreversible paralysis (usually in the legs). Among the paralysed patients, 5 to 10 percent die when their breathing muscles become immobilised.

There is no cure for polio, making prevention a key tool. Polio vaccine, given multiple times, can protect a child for life, the world health body maintains.

Since 1988, the number of polio cases worldwide has decreased by over 99 percent, from an estimated more than 350,000 cases to 1,919 reported cases in 2002 (as of 16 April 2003). The reduction is the result of the global effort to eradicate the disease.

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