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Polio eradication: Trying to win a vicious war

Die-hard struggle: A number of polio vaccinators and health workers vaccinate a child for polio in a conflict-ridden area of Pakistan

Rita Widiadana and Malik Ayub Sumbal (The Jakarta Post)
Hanoi/Islamabad
Wed, October 28, 2015

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Polio eradication: Trying to win a vicious war

Die-hard struggle: A number of polio vaccinators and health workers vaccinate a child for polio in a conflict-ridden area of Pakistan.

After polio was declared no longer endemic in Nigeria, there are now only two countries in the world '€” Pakistan and Afghanistan '€” that still have poliovirus, posing a serious threat to the rest of the world.

Pakistan is also all set to win the tough battle against polio after years of struggle, countless immunization campaigns and international pressure.

In 2015, there have been 34 cases reported as compared to 2014 with an alarming 306 polio victims, the highest reported number in the world.

The Pakistani government along with other stakeholders is working hard to make Pakistan a polio-free country. In 2015, more than 35 million children have been immunized with the polio vaccine, which is a milestone toward achieving a polio-free Pakistan.

However, Pakistan still has a long way to go toward polio eradication. There have been constant attacks on polio workers in the country and in 2014 there was a series of attacks on polio teams nationwide. Dozens of polio workers were killed by militants during the polio eradication campaign.

North and South Waziristan are the major parts of Pakistan with the highest reported polio cases because the areas are under the tight control of the Taliban, leaving no access at all for polio workers.

After military operations in these areas, there was a mass exodus of internally displaced peoples (IDPs), who were immunized at the various transit points set up in these areas.

Aziz Memon, chairman of the Pakistan PolioPlus Committee, said: '€œRotarians have been the catalyst of change worldwide including in Pakistan. Let us continue with our efforts to support all polio campaigns in Pakistan so that we may safeguard our children and the generation to come from a disease that is incurable but preventable.'€

Rotary International has spent US$1.4 billion worldwide and $107 million in Pakistan alone on polio eradication efforts. In 2015, it gave additional support of about $12.2 million.

Global investment in polio eradication is badly needed. Polio eradication by 2018 would help prevent more than eight million cases of life-long paralysis, with net economic benefits of up to $50 billion, according to a Global Polio Eradication Initiative (GPEI) report.

Oral vaccination: A baby receives an Oral Polio Vaccination (OPV) to protect her from the dangerous poliovirus, which can cause life-long paralysis and, at worst, death.
Oral vaccination: A baby receives an Oral Polio Vaccination (OPV) to protect her from the dangerous poliovirus, which can cause life-long paralysis and, at worst, death.

While Pakistan and Afghanistan are still struggling to eradicate polio from their soil, Indonesia along with 10 countries in Asia '€”Bangladesh, India, Bhutan, Korea, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor Leste '€” were declared polio-free in 2014.

The accomplishments of these 10 Asian countries, home to 1.8 billion people, in polio eradication efforts have been a historic milestone in the worldwide efforts and a vital step to achieve the goal of the global polio end game by 2018.

Health Minister Nila Moeloek said at the Global Health Assembly in Geneva that despite the fact the country was certified as polio free in 2014, '€œThe war is far from over'€.

When the wild poliovirus type 1 attacked a 20-month-old baby boy in Indonesia in April 2005, the government with technical and financial support from the World Health Organization (WHO), UNICEF, Rotary International and other parties mobilized a nationwide immunization program named National Immunization Week (PIN).

The initiative targeted more than 25 million children under five with funding of more than $39 million. In 2006, there were 305 cases found in 10 provinces, making Indonesia the 16th country to have a high rate of polio cases.

The battle against poliovirus has not been easy in any part of the world. The Indonesian archipelago, stretching across 5,000 kilometers with 17,000 islands, is home to 240 million people, the world'€™s fourth largest population. Implementing polio eradication in this vast geographical area was a logistically and technically challenging task.

Strong government commitment, international support and community engagement were the perfect ingredients to make polio eradication a success story in Indonesia.

'€œChildren in Indonesia received only Oral Trivalent OPV polio vaccine and we have committed to replace it with more potent bivalent OPV and Injective Polio Vaccines [IPV], which are the key to eradicating polio,'€ added Nila.

The current achievement is still at risk of change unless polio is removed from Pakistan and Afghanistan. Until polio is wiped out in these two countries, the world must still be on high alert of the risks of transmission and the return of the wilder and vaccine-derived poliovirus.

The writers are working collaboratively to report on polio eradication in Indonesia and Pakistan.

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