Pakistan in front line of polio resurgence

When I was a child in the United Kingdom my mother told me about “the poor lady” in the house at the corner of our street who had “infantile paralysis”. I had not the faintest idea what that meant, but I did occasionally see her moving painfully about her garden using two sticks.

I don’t think she ever got beyond that overgrown piece of dirt, a breeding ground for slugs and snails that meant we had to be constantly on the watch for the migrating pests among our own neat rows of cabbages and beans. 

Outbreaks of infantile paralysis, or polio as I later learnt to call it, were a feature of my youth. An England international footballer, Jeff Hall, was stuck down by the disease, dying within a month of playing his last game. I remember having to miss several sessions of Saturday morning kids’ films because cinemas and dance halls closed in an effort to stem the spread of the highly infectious disease. 

In more recent times we thought we had polio beaten. With vaccinations now easily available, country after country was able to declare itself free of the disease, including, earlier this year, in India where thousands once died or were crippled by it. But now it is making a comeback and in a move that seems to belong to another era, the World Health Organisation (WHO) has declared the disease a public health emergency.

The problem is purely political. In countries such as Syria, Somalia and South Sudan, vaccination programs are disrupted by degraded infrastructure and warfare, but the epicentre is in Pakistan, where insurgent groups, most notably the Pakistani Taliban, are vehemently opposed to vaccinations and regularly attack and murder health teams trying the carry them out.

Religious extremists among these groups say that vaccinations are un-Islamic as they interfere with the will of God. There are also rumours, happily spread by the insurgents, that the vaccinations are really a Western plot to sterilise Moslem children.

Some Islamic clerics have even proclaimed polio sufferers “martyrs” for refusing the Western drug. Other claims are the vaccinations contain traces of pig fat and alcohol, both abhorrent to pious Muslims.

These falsehoods gain credence though allegations the United States Central Intelligence Agency gained access to Al Qaeda chief Osama bin Laden’s family under cover of a bogus hepatitis vaccination program; the DNA thus obtained confirming his presence in Pakistan and laying the groundwork for the operation to kill him.

As a result, polio cases are on the increase in the country – 91 in 2013 from 58 in 2012 – with the majority in the country’s northwest where insurgency is at its greatest. The porous border in this region means Afghanistan is at risk with the potential for infections to spread further into the Middle East and beyond.   

In reaction to WHO demands on restrictions on Pakistani travellers, the Government in Islamabad has announced mandatory immunisation for anyone leaving the country, with counters being set up at airports, seaports and border crossings.

The campaign carries few details – even whether it applies to everyone or just those who have not received vaccinations in the past – while the greatest danger lies in the virtually uncontrolled borders in the northeast.

Even so, it is a step in the right direction, and one that must be taken if this deadly scourge is ever to join smallpox in the history books.