PAKISTAN: Polio Vaccination: One Hurdle Down, One More to Go

PESHAWAR, Pakistan, Nov 3, 2009 (IPS) - Until the Taliban were forced to flee by the military, the militant group’s deadly opposition to vaccination had been severely hampering efforts to make Pakistan a polio-free country in the foreseeable future.

"My son has been crippled due to the Taliban. We didn’t have vaccination teams here over the past two years," said Mohammad Hakim, father of two- year-old Mohammad Ibrahim, who was diagnosed with polio at the National Institute of Health Islamabad on Oct. 25.

Ibrahim, who lives with his family in Koza Banda, a small village in Swat, was among the 15 children in the district who would not have been stricken with polio had they been immunised against the debilitating disease.

Taliban, which held sway over Swat from January 2007 to May this year, when they were decimated in full-scale military operations, had argued that the oral polio vaccine (OPV) rendered its recipients impotent and sterile.

With the easing of the security situation in the district, 63 percent of the population was able to receive the vaccination in September and 99.3 percent in October, up from zero in July when the polio campaign got into full swing.

But while the Taliban may no longer be a threat to the administration of polio vaccine, hard-line clerics are still vigorously campaigning in restive northwest Pakistan against polio vaccination, claiming it is a tool of the United States to render people incapable of producing children. The same clerics had been carrying out the campaign even during the Taliban’s reign— reportedly on instructions of the radical Islamist group.

"It’s a U.S. programme to cut the Muslim population. We won’t allow this because permitting the polio campaign amounts to displeasing God Almighty," said prayer leader Umar Hadi in Mattani locality near Peshawar. A number of decrees have been issued since 1995 by Muslim clerics seeking to prevent parents from allowing their children to get vaccinated against polio.

It seems not religious leaders agree. "It is the responsibility and religious duty of the parents to get their children vaccinated against any disease. Those refusing the vaccination are causing harm to their own children," said Maulana Akhtar Shah, a South Waziristan-based cleric, in a decree issued in August last year.

"Polio drops are safe, and no anti-fertility agent, including estrogen and progesterone, are added to it at any stage of its manufacturing nor any such agent is present in the final product," said Dr Khalif Mahmud Bile, World Health Organization (WHO) representative in Pakistan.

Dr Bile added that the OPV procured by the United Nations Children’s Fund met the specifications set by the International Expert Committee on Biological Standardization, which is responsible for setting standards for vaccines to be supplied to the U.N. members countries.

"These specifications make it impossible for OPV to contain any other undeclared biological active substances such as viruses, hormones or other materials," he said.

According to him, the OPV used in Pakistan was of the same high quality as was being administered globally. He added that during the last 20 years more than 10 billion doses of polio vaccines had been provided to more than one billion children globally. "No side effects have been reported in this period," he remarked.

"Since 1994, about a dozen international organisations, spearheaded by the World Health Organization, have spent more than one billion dollar per year to wipe out the crippling ailment from Pakistan, but the situation has not been showing any signs of improvement," immunisation expert Dr Jawad Ali told IPS. Both the Taliban and the clerics have been blamed for this situation.

Last year, Pakistan registered a total of 117 polio cases, including 52 from the NWFP, mostly from the Taliban-controlled areas where the children had not been administered the vaccine.

"Of the total 72 confirmed polio cases this year in 28 of the country’s [polio- ]infected districts, 29 belonged to Swat and Bajaur [with 18 and nine, respectively], where vaccination has not taken place over the past 20 months [since Feb 2008] due to Taliban’s opposition," Dr Abdul Jabbar, team leader of the WHO’s Polio Eradication Initiative in North West Frontier Province (NWFP) and the Federally Administered Tribal Area (FATA), told IPS.

Taliban’s opposition to the polio immunisation resulted in the outbreak of poliomyelitis in Swat district in August, which has reported a total 18 cases this year, the highest number so far in any district within the country.

Pakistan is among the four polio endemic countries that, according to WHO, has been the source of the poliovirus that has spread to countries long declared polio-free. For instance, Zaheer Ahmed, 22, was found positive for polio in May 2007 while studying in Australia. Later genetic sequencing of the virus showed that it came from Pakistan. The case was the first in Australia since 1986.

Of the 1,169 cases of polio recorded worldwide so far this year, three countries accounted for 77 percent, or 901 of the total, according to WHO, namely, Afghanistan (23), Pakistan (65), Nigeria (382) and India (431).

Top polio officer Dr Mujahid Hussain concedes that the Taliban were a major hindrance to the smooth-sailing implementation of anti-polio efforts, but insists the situation is improving.

"The problem of inaccessibility to Taliban-controlled areas has been overcome a great deal. In the Oct. 12 campaign in NWFP and FATA, 473,158 compared to approximately one million children in July had been missed of the targeted six million children below the age of five," he told IPS.

The federal health authorities had to suspend the OPV campaign in Bajaur Agency in August last year after armed men beat up the vaccinators in the Charmang area. On May 25, 2007, FATA’s chief surgeon, Abdul Ghani Khan, was killed in a roadside blast on his way from a polio-related meeting in Bajaur Agency, a Taliban stronghold.

Among those who did not receive the Taliban-intercepted vaccines for Bajaur Agency FATA was 20-month-old Wahidullah, who is now counted among the 30 children suffering from poliomyelitis.

Nawab Ali told IPS over telephone from Swat that he had decided to volunteer his services for the polio campaign to help save other children from the disabling disease.

"Polio has affected my sweet daughter. I want to save other kids," said the father of Yasmeen, 2, who, unable to get the vaccine, has been afflicted with the crippling disease. (END)

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