There is a case for mandatory polio vaccinations in Pakistan

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All Pakistani media has been awash with the coverage of local political developments and court battles involving political parties and judges for the last many years and the present time is no exception. Debates and arguments in legislatures and courts are all about politics and constitutional matters almost to the exclusion of matters close to ordinary citizens. Legitimacy of the election, allocation of reserved seats to political parties, proposed extension in the terms of judges are discussed endlessly in these institutions but seldom do they have the time to discuss looming emergencies like the fast-spreading polio virus that cripples children for life. 

Since polio is contagious, it can be transmitted across borders through the highly mobile populations of this day and age. This means the emergency doesn’t relate only to Pakistan and has the potential of affecting the entire world. The Global Polio Eradication Initiative (GPEI), an international institution monitoring polio eradication, notes that two years ago a variant strain of the virus had surfaced in London’s wastewater system. While no one was affected, the same variant found in New York state paralyzed a citizen. This easy communicability of the disease provokes discussion on travel restrictions on polio-affected countries whenever polio cases rise. 

At present, Pakistan and Afghanistan are the only two countries in the world which remain affected by wild poliovirus although Gaza, amid war and widespread destruction, has recently seen a case of paralysis through wild polio virus after a gap of 25 years. Afghanistan has reported 23 polio cases since the start of 2024, Pakistan has way surpassed the tally by reporting 45 cases as of November this year. 

A comparison with the region makes Pakistan a depressing case. India became polio-free in 2011. Bangladesh achieved polio-free status in 2000. 

Ahmed Bilal Mehboob

The wild poliovirus cases in Pakistan have rebounded recently. In 2021, Pakistan was at the verge of becoming polio-free when only one child was affected during the year. There have been highs and lows in Pakistan’s journey to become polio-free. Pakistan saw the worst of it in 2014 when 306 cases were reported. Since then, the cases consistently dropped till 2018 but experienced another spike in 2019. After the fall of cases since then, 2024 has become the worst year.

A comparison with the region makes Pakistan a depressing case. India became polio-free in 2011. Bangladesh achieved polio-free status in 2000. Nigeria which was the third country in the world afflicted by wild poliovirus, became polio free in 2017. 

There are two key challenges facing Pakistan in its battle with poliovirus. A sizeable population especially in areas bordering Afghanistan strongly believe that the polio vaccine is a conspiracy to attack the fertility of a future generation. Despite several efforts, which were much hindered by the CIA’s fake vaccination drive to get to Osama Bin Laden in 2011, the government has not been able to counter the disinformation. The result is that as many as 8 percent to 10 percent of parents routinely refuse to get their children vaccinated. These parents not only expose their own children to this crippling menace but expose their communities and societies and the world to the risk. There is, therefore, a strong case for making polio vaccination mandatory by law, but parliament and the provincial assemblies do not have the time to debate and pass the law.

The second grave challenge is violence against the workers who go from door to door to administer polio vaccines to children. A large number of the workers are women and they have been targets for anti-vaccination culprits. The government has tried to provide police security to polio workers but even the officers deployed for security become victims of assaults. Media reports indicate that police in northwestern Khyber Pakhtunkhwa province is reluctant to do security duty for polio workers. It is not clear whether this serious breach of discipline is motivated by ideological leanings or a fear of assault by ruthless anti-vaccination gangs. It is estimated that over 100 polio workers and their security persons lost their lives in violent attacks during the nine years from 2012 to 2021. Some polio workers were also sexually assaulted.

The inability to eradicate polio in Pakistan is a manifestation of the failure of governance and a lack of focus at least until recently, when the Prime Minister appointed an experienced focal person for polio eradication. As long as the country is unable to raise public awareness and change behaviors through effective media campaigns and other means, resistance to polio vaccinations will continue. 

– Ahmed Bilal Mehboob is the president of Pakistan-based think tank, PILDAT.

X: @ABMPildat