WORLD POLIO DAY 2014

Saira Afzal Tarar Mamnoon Hussain, Muhammad Nawaz Sharif Minister of State, President, Prime Minister, National Health Services Islamic Republic of Islamic Republic of Pakistan Regulation & Coordination

he observance of World Polio Day on 24th October has a special significance for olio is a global scourge with the potential to debilitate flower of nations. rotecting the children of Pakistan from the crippling disease of polio Pakistan as we are one of those few countries which are still fighting this crippling It is a humanitarian issue requiring coordinated supranational remains the top most priority of the Ministry of National Health disease. This the day therefore is an occasion to reiterate our commitment to make preventive and remedial action. Gravely aware that the number of Services Regulation & Coordination. The ministry continues to support Teven greater efforts for securing the future of our children from the perils and disabilities Pchildren paralyzed by wild polio virus this year was the highest in a decade, Pthe provinces in implementing the initiative through ensuring uninterrupted caused by Polio. my government devised a National Emergency Action Plan 2014 aimed supply of vaccine, logistics to operate the program activities smoothly. To this at eradicating Polio from Pakistan that was duly approved by Executive Polio eradication is the highest priority of the Government of Pakistan. We are taking end the ministry was able to secure necessary resources so there is no delay in Committee of National Economic Council and fully funded till 2018. all possible measures to check this endemic disease. .Besides political commitment at holding polio campaigns anywhere in the country. the highest level, the mobilization of civil society, religious and local communities and The National Polio Eradication Plan is diligently supervised by a dedicated This crippling disease has become a matter of concern for us and we are the media is a testimony of our sincere efforts to eradicate this menace from our soil. focal person based in office of the Prime Minister who consistently monitors making every effort to restrict the circulation within the country and It is indeed a matter of great concern for us that despite hectic efforts, poliovirus is still activity and performance of responsible personnel operating at federal, being reported in some parts of the country and continues to threaten the future of our provincial, district, tehsil and union council levels. Emergency Operations also prevent its exportation. We realise the concern of the international children. But let us not be oblivious of the fact that polio cases are being reported mostly Cells have been established in two provinces and will soon be expanded to community over increasing number of polio cases in Pakistan and our efforts in those areas which are undergoing peculiar security situation. The ongoing fight against cover all provinces. are strongly reflected in our approaches. Polio vaccination counters at land, air terrorism, militant activities and law and order situation are some major reasons that have and sea ports for travellers are operational and proactive response to inoculate Our anti-Polio efforts are based upon a country specific, contextually impeded our efforts to reach out all the children especially in tribal areas, far-flung areas children among the internally displaced people from Federally Administered designed implementation strategy. Well designed anti-Polio drives are of Balochistan and some other pockets. But despite these challenges, the Government Tribal Area is also in place. The presence of wild polio virus anywhere is a periodically conducted countrywide during which anti-Polio vaccines are and the people of Pakistan remain committed to pursue their fight against polio and to threat to children everywhere and we cannot allow this to happen. The orally administered along with creating awareness about the hazards of the ensure complete eradication of polio virus from the country. Prime Minister has provided leadership any patronage to the initiative and disease as well as methods of preventing it. is personally monitoring the progress of the program. This represents the I take this opportunity to call upon international community to be fair and objective in its My government has specifically solicited the support for conducting strongest commitment at the highest level. The government Pakistan will live analysis of the existing situation in the country. Being a shared concern, the international widespread anti-Polio vaccination from prominent religious authorities up to the commitment of the people of Pakistan and will succeed in eradicating community needs to assist us and complement our effort s in dealing with this daunting through obtaining sharia based legal pronouncements (Fatawa). In addition challenge. polio at every cost. the assistance of media and civil society is also obtained and channelized to Let me reiterate once again that the Government will continue making every possible strengthen this vital national exercise. Our religion calls upon the faithful to protect the vulnerable and perform effort towards eradication of Polio and will continue to pursue zero-tolerance policy duties towards ones family. It also enjoins the believers to save a life for saving I can assure that we are undertaking suitable measures to curb the current towards polio eradication campaign. While appreciating our international partners, one life is indeed saving the entire humanity. It is thus inconceivable that any trend and I am confident that we possess adequate capacity to reverse it and foreign governments and international NGOs for their valuable assistance towards individual would oppose protecting an innocent child from crippling disease soon make Pakistan polio free. We owe this to our people, our children and fight against Polio, I also commend the efforts being made locally by all those who are the world community. through vaccination. I urge all scholars, intellectuals, opinion leaders and committed towards safe and secure future of our younger generations. On this day, I also influentials to join the hundreds of Islamic scholars in Pakistan, Saudi Arabia call upon civil society, religious leaders, media and people from all walks of live to paly I call this opportunity to exhort all parents and caregivers to play their part and world over in voicing the strongest support to the cause for the sake of even greater role towards creating awareness against polio, complementing government by helping the government in reaching every child for oral polio vaccination humanity. efforts and facilitating polio teams to reach out to each and every child in every nook and so that our future generations grow physically healthy and free of polio. corner of the country. We have the will and insha Allah we will success in our mission.

Ayesha Raza Farooq, Prime Minister’s Focal Person on Polio Eradication

orld Polio Day is a stark reminder that the threat of polio looms and all of us wherever we are in leadership is unfaltering and the realization among the parents for protection against polio is strong. With Wthe country must play our role to ensure that our families, communities and the entire country all segments of the society in support of polio eradication, the increasing numbers are rightly a cause for is protected from this disease that can cripple a child for life. We started the journey in 1994 and our concern. This view most of the polio cases are linked to virus circulation in FATA where polio vaccinators struggle continues. No matter how difficult the task, it cannot weaken our resolve to protect our children had limited or no access since July 2012. The operation Zarb-e-Azb is an opportunity for us as it gives a against this crippling disease. We have a responsibility to hand over a healthy and polio free country to chance to reach the cohort of children that were missed for more than two years. We have through perma- our future generations. Let me assure you that the Government of Pakistan takes polio eradication a pri- nent transit points successfully vaccinated children amongst the IDPs from North Waziristan. ority and has declared it as a health emergency. The situation is changing fast and we are reaching more children in the campaign than ever before. These The Government of Pakistan is availing every opportunity to win this battle. There is high level of political efforts need to continue and a stronger commitment is being exhibited at every level from the leadership commitment for the cause in Pakistan. Recently the Prime Minister constituted a focus group on polio to the frontline health workers. There is only one direction for us to move forward towards a Pakistan free and all top level leadership is working on war footing to achieve the goal. The support of the religious from the scourge of polio.

Khawaja Salman Rafique Shahram Khan Tarakai Rahmat Saleh Baloch Advisor to CM on Health, Minister for Health and ST&IT Minister for Health, Punjab Balochistan

n the World Polio Day, I would like to assure all that Punjab government orld Polio Day, being observed around the world today, is a stark reminder orld Polio Day provides us an opportunity to join the polio eradication Owill not leave any stone unturned in eradicating polio from the province. Wof the danger posed by polio to the health of our children and provides us Wcommunity to renew our promise of a polio-free world. During last three Despite multiple challenges, Punjab has made notable progress on its journey to- an opportunity to gear up our efforts to fight this scourge with unwavering deter- years Balochistan performed well to rid of the local virus circulation and re- ward stopping polio virus transmission and eradication over the past years. No mination and firm resolve. mained polio free for almost two years. There is an opportunity for us to solidify isolation of Wild Polio Virus type 3 (WPV3) has been reported since April 2012. gains of our efforts that were hard earned. We stands committed to the cause of polio eradication and renew our commit- This progress is the result of concerted effort of the government at all levels, civil ment on World Polio Day to stop polio transmission in the region and to ensure While tremendous progress has been made since 2011, pockets of low vaccination society and all national and international partners to implement a National Polio healthy and bright future to our children. coverage remain. This calls for intensification of efforts on the part of the govern- Emergency Action Plan, aimed at overcoming long-standing challenges during ment to bridge the gaps in coverage and ensure that the most vulnerable children It is regrettable that Khyber Pakhtunkhwa is contributing heavy chunk of polio polio activities. Provision of best health services to the children is the vision of are reached and protected. It also calls for the public to continue its support and cases. We cannot and will not allow this disease to play havoc with our children. Chief Minister Shahbaz Sharif. He has started CM Roadmap Initiative to prior- cooperation to ensure that every child is vaccinated with oral polio vaccination. Polio eradication is a huge challenge for the government of Khyber Pakhtunkhwa itise vaccination and safe delivery to reduce the IMR and MMR to achieve the given the particular security situation and frequent population movements in the Polio eradication is a priority for the government of Balochistan and we on track Millennium Development Goals 4 and 5. province. We haven taken steps in consultation with technical partners to tackle to eradicate polio by the end of 2015. We are closer to polio eradication than ever The government will ensure that every child has a bright and healthy future. On this challenge. However, sustained efforts on war footing and robust monitoring before and it is critical that we maintain the momentum. It is moral and religious the other hand, I would like to appeal to all parents that always make sure that your mechanism is needed to reach out to every child in the province and to material- obligation on parents and community that all the children up to 5 years of age children are immunised against nine vaccine preventable diseases. Government ize the dream of polio free Khyber Pakhtunkhwa. receive polio drops every time these are offered. The polio virus is in the environ- has deputed health teams at border crossings, bus stops and railway stations. It ment and the risk to our children from this disabling disease is high. It is equally I take this opportunity to pay tribute to our ‘polio heroes’, the people who have has constituted mobile teams to vaccinate your children at your doorsteps. Please important that children under 2 years of age are protected against nine vaccine embraced shahadat for the noble cause of polio eradication. I would also like to cooperate with them whenever they pay a visit to you to vaccinate your children. preventable diseases for which services are available free of cost at public health appreciate our global partners including UNICEF, WHO, Rotary International centres. You may also take your children to nearest health centre for free of cost vacci- and acknowledge their strong support in combating polio. nation. I would like to reiterate the commitment of the government of Balochistan to On this occasion of World Polio Day, I want to hold an appeal to the parents in polio eradication and our resolve to contribute effectively in the global efforts to particular and to the people in general to play their individual roles in strengthen- free the world from polio. ing the polio vaccination efforts. 2 Community Influencers Dispel Myths About Polio Drops in Punjab By Wasif Mahmood

ahore, Punjab – Just over two to vaccinate their children and show paigns in their countries to eradicate years ago in November 2011, no carelessness in this regard every polio”, he explains. health authorities in Lahore time polio drops are offered”, Maula- “Most Pashtun communities are Lwere puzzled over inability to reach a na reiterates. guided by strong traditional values. large number of population who had Maulana, is a smart man in his mid- Dominant social norms and conser- migrated to Lahore from the polio 40s. He hails from Chaveri, a remote vative religious orientation requires virus high risk areas, including the village in Buner, special, contextually acceptable Federally Administered Tribal Areas communication approaches. (FATA) and Khyber Pakhtunkhwa Khyber Pakhtunkhwa. He shifted to (KPK). Lahore eight years back and is one of “Sessions with Pakhtun elders and at least one million Pakhtuns living religious leaders are held in madras- “More than 1,000 families were re- in the city after migrating from their sahs and mosques to educate the ported averse to polio drops in the native towns in FATA or Khyber Pa- children on the debilitating impacts high risk union councils (UCs) of khtunkhwa. of polio, to increase acceptance for the city the same year”, says Omer polio vaccination and encourage Feroze, District Health and Commu- Referring to the statement of Aqsa students to maintain good hygiene nication Support Officer of Commu- Mosque Imam which Maulana reads to help protect them”, explains the nication Network (COMNet). out in Friday sermons, he says: “con- COMNet Officer. cept of preventive health is clearly “Language barriers, continuous enshrined in Shariah. Polio drops, Environment in the union council is movement to and from the polio being part of preventive health, are so amicable now that Pakhtun fami- high risk areas, inadequate knowl- not forbidden in Islam. We should be lies even exchange gifts with us when edge about the customs and tradi- vigilant about spread of polio virus”. we go to their homes for vaccination tions of the migrant population have their children”, says Nadia, polio been major reasons behind the spike Union Council (UC) 84 is one of 29 team member working in the UC. in opposition and apprehensions to- UCs that have been declared high wards polio vaccine”, adds Feroze. risk for polio in Lahore. High risk Although nearly all parents accept districts are identified due to the polio vaccine if workers are able to The situation in 2014 has changed presence of wild polio virus, very low deliver it, findings of the Knowledge, after hundreds of community in- routine immunization poor sanita- Awareness and Practice (KAP) sur- fluencers including Pakhtun elders tion, scarcity of clean drinking water vey conducted recently among par- joined the fight against polio. and public health facilities for a pop- ents and other caregivers of children Latest Polio Control Room data sug- ulation of more than 30,000. under age five in select parts of Paki- gests that now only 23 families re- stan that are at greatest risk for polio A substantial number of people in main opposed to polio vaccination; transmission suggest there are some the community is Pashtu-speaking, an increase of almost 100 percent misperceptions about polio and oral which is a priority population for po- in the coverage of pockets of refusal polio vaccine. These misconceptions lio eradication since all children par- communities. could erode demand in the future, if alysed by polio in 2014 so far have parents do not see this terrible dis- Maulana Wasim is one of the tireless Pashtu speaking backgrounds. ease as a real threat to their children’s activists against misconceptions. He Pakistan is one of the last three re- health, or if they are not convinced is the Imam (prayer leader) in Hazrat maining strongholds of polio virus of the multiple dosing required for Siddiqul Farooq mosque in UC-84. in the world. The number of polio full protection. In the run up for every vaccination cases has reached 88 so far this year. A sizable share of parents in Pakistan round he makes announcements Almost all polio cases reported from (30%) believe that the paralysis from from mosque to inform community North and South Waziristan agen- polio would be curable if their child about polio drives asking them to cies in 2014 did not receive any dose got sick. As another example, fifth cooperate with the visiting vaccina- of oral polio vaccine (OPV). The of parents were not aware that OPV tors and health teams. Sometimes he only polio cases reported outside must be taken every time it is offered also joins health teams vaccinating FATA/KP in 2014 are from the great- in order to maximize protection for children in the community on his er Karachi area. their children against the disease bicycle. “Vaccine used in Pakistan is the same (37% in FATA, 19% in lower-conflict “Let’s not read into suspicions and used in Saudi Arabia and all other areas of Pakistan. misconceptions attached to Oral Islamic countries to wipe out polio “Do you know how difficult it is for Polio Vaccine (OPV). After consul- and we should double efforts to do a paralyzed child to live shoulder to tation from doctors it has been ver- so”, says Maulana during the sermon shoulder with his age fellows who are ified that OPV is not harmful”, Mau- of the Friday prayers. leading normal life? Nobody can un- lana Wasim says as he knocks a door “Islam lays stress on hygiene and derstand the pain of these children along with health team in UC 84-A therefore it is rightly said that clean- except their parents and the child during a recent campaign launched liness is half of religion. Organisa- himself”, maintains Maulana Wasim. after Lahore’s polio environmental tion of Islamic Cooperation (OIC) sample tested positive. in a declaration has urged all Muslim “It is the responsibility of all parents states to conduct effective polio cam-

Farah Deba Ghazala Mushtaq Abdul Sattar Edhi Mohammad Arshad Lady Health Worker in Peshawar, Social Mobilizer in Peshawar, Social Worker and Philanthropist in Railway Scout, Cantonment Station Khyber Pakhtunkhwa Khyber Pakhtunkhwa Karachi, Sindh in Karachi, Sindh

“I have been going door to door to administer polio “My work is to sensitize communities about polio “I am 85 years old now and I have dedicated my “I have been working for polio eradication for 12 drops to children under the age of five for 16 years virus so that they agree to administer the vaccine whole life to philanthropic activities which range years. I have been threatened on more than one oc- now. I have received threats on numerous occasions to their children during every immunization cam- from running orphanages to providing free ambu- casion and even my family tells me to stop working while my husband too has been warned of serious paign. I am a messenger and I inform people about lance services. Pakistani people recognize me for for polio programme because of the consequences, consequences and as a result my family wants me to the disadvantages of refusing the vaccine as well the work that I have done and by the grace of God yet I believe it is my moral responsibility to keep stop working for polio eradication. However, I am as the larger impact that it can have on Pakistan as they have trust in me. I try to counter pervasive ru- striving for polio eradication. and will remain committed to this cause. well as the rest of the world. mors about the polio vaccine. I give messages on At the moment I am in charge of the teams that ad- the media and other forums that the polio vaccine I feel that my role is very important in polio pro- We are very close to eradicating polio. In 2011 there minister polio drops at Cantonment Railway Sta- is safe. I have also offered my fleet of 1,800 ambu- gramme because if field workers do not go door to were 198 cases and in 2012 that figure came down tion in Karachi. I take it upon myself to ensure vac- lances to serve as mobile vaccination units during door to vaccinate children the disease wouldn’t be to 58. I always tell people we are the only one of cinators’ performance is always up to high standard all polio campaigns. My over 300 philanthropic eradicated from Pakistan. Somebody needs to get three countries that are still polio endemic. Apart and not a single child should be missed.” health centers administer polio drops to children the job done and I enjoy doing it. Polio cripples from the fact that refusing the vaccine endangers throughout Pakistan. Inshallah polio will be erad- children and I am proud to say that because of my the future of our children, I also remind people that icated from Pakistan, but for that we need to keep continuous hard work in the field there has been no Pakistan may have to face travel restrictions if we working with dedication and honesty.” polio case in my area for a number of years now.” do not get rid of the virus.” 3

Islam and Child’s Health Maulana Sami-ul-Haq

s Islam orders children ence of Hadhrat Abu Saeed and Hadhrat Abbas, he [PBUH] milk also cast deep impacts on the heart and spirit, emo- Ato obey, follow and serve said: who has the birth of a child with him, he should name tions and feelings, and morality and character. The moth- their parents, so it directs him well; teach him etiquettes; when he will get matured, he er not only provides her child with only a healthy food by parents also to treat the well should arrange his wedlock. If he gets matured and is not feeding her milk, but she also transfers her pure thoughts, and pay attention to their ed- being married, then if he commits any sin it will go to his pure tendencies, paramount emotions and favorite morali- ucation and training. Parents generally complain that their father. The father has been held responsible for these three ties into his body and soul; and the child naturally absorb all children do not comply with their directions; and do not things, for he is the real answerable person and a caretaker, these things along with the mother’s milk. give their rights. Is the reason behind it only the betrayal as the father is answerable for whatever action i.e., repug- of children or is there any lack of training on the part of nant to Shariah is committed in the household. It is an im- Unfortunately, every year 750000 children up to five years parents also? Parents should not complain but they should portant responsibility of parents to teach etiquettes to their old fall prey to death in Pakistan by suffering various diseas- examine whether they have fully fulfilled the rights of their children in addition to teaching them the way to live their es; several other children get disabled due to these diseases. children. They should study the rights of children which the life in accordance with the Shariah so that they could be According to the estimate of an international organization, Koran and hadith have stated; should understand them and seen as a best person of the society as they grow. about 700000 children in Pakistan fall prey to pneumo- treat their children in the same manner. nia every year and 27000 children out of them land in the Mother’s First Gift for a Child: clutches of death. The reason behind 5.7 percent mortality The children’s health should be taken care of from the very rate among children less than five years old is pneumonia, beginning, for children are the future of a nation. The more The breast milk of a mother is a complete diet. It contains while Pakistan is facing travel bans due to polio. healthy children are, the better the nation’s future will be. everything that an infant needs. Undoubtedly, the milk of a Where Islam has issued general directions for health, there mother contains all those essential ingredients which can- Today the World Polio Day is being observed. The polio vi- it has ordered to particularly take care of children’s health not be substituted for any artificial milk. The mother’s milk rus has assumed an epidemic only in Pakistan in the whole and their better alimentation. is the best diet for every infant and it is a first gift of a moth- world, but the writer has expressed his views at different fo- er to the newly born child. rums that the matter of health should not be put at stake The Holy Prophet [peace be upon him -- PBUH] used to for politics, nor should it be made a tool for the west. Apart immensely love children and take care of them. He [PBUH] According to experts, an infant should be fed mother’s milk from this, not only polio but all other fatal diseases need says: Whoever do not extend mercy to our children are within one hour after birth. The infant should have mother’s a lot to be paid attention. Particularly, the vaccination sys- not among us. [Bukhari] He [PBUH] guided us about bet- milk merely within half hour after birth. The mother’s milk tem needs to be made more effective. As we are still failed ter health and treatment of children. On one occasion, he is easily digested; it keeps the stomach clear, and creates to eliminate them, so the basic reason behind it is the lack [PBUH] saw children being treated in a painful way, he immunity against various diseases. The milks other than of of acting upon Islamic teachings, lack of Halal foods usage, [PBUH] said: “Do not give pain to children this way.” a mother is unable to do this. The child whom his mother eating or drinking western foods in markets as well as igno- takes in her lap and feeds her milk, besides the diet he also rance and delinquency in cleanliness, treatment and vacci- Best Gift: gains a priceless sense of security which rests with him for nation. the whole life and psychologically makes him a good human God has inculcated the love for children in the hearts of par- being. The relationship of milking establishes an unbreak- If the teachings of Holy Prophet [PBUH] are acted upon ents. Parents want to see their children prosperous and hap- able relationship of love between a mother and her child. even today and arrangements are made for cleanliness and py in all terms. They try to provide them with every worldly hygiene, dozens of diseases like pneumonia, measles, po- blessing in their life and they desire that their children ought Also physically, the body of a mother after the birth of a child lio, hepatitis, cancer, tuberculosis, convulsion, diphtheria, to live a best life. The biggest responsibility of parents is to rapidly comes back to its original shape only if she feeds her chin cough, and meningitis etc, which are spreading in our bring up children and train them well -- not only through milk to the child and fulfills the natural requirements. The regain regularly. They can be easily overcome. Besides, the wealth, but also by giving time to them and working hard. feeble bodies of twins and prematurely born children also lack of facilities at small medical centers and hospitals is get energy from the mother’s milk. Three Rights of Children: also a reason. The mother’s milk is a natural diet for a child, which gives The Holy Prophet [PBUH] has specially mentioned three him a complete health and energy. It is not only a physical rights of children obligatory to parents. According to a refer- diet, but it is also a spiritual and moral food. The mother’s 4

If we cannot stop the polio virus now we might never be able to stop it and children will be infected and crippled. Children are our future. No one wants a future that is crippled.

Ms. Assefa Bhutto Zardari

“We need to be polio-free in Pakistan but a lot of children still suffer from this disease. The players want to publicly appreciate the vaccination teams for their Why can’t we fail in courage and the way they continue to work to finish this disease in Pakistan.” Pakistan Captain Misbah ul-Haq (Pakistan Captain seen in the picture with Australian Captain Michael Clark Polio Eradication? in Dubai on Oct 21, 2014) By Dr. Rana Muhammad Safdar, National Programme Manager, Expanded Programme on Immunization

levels. As majority of the developing countries have already demonstrated, we need to pursue the ‘four pillars of Polio eradication’ namely; i) strong routine immunization, ii) high quality supplementary activities, iii) effective surveillance and iv) well-targeted mop-up campaigns. A cornerstone of the polio eradication strategy is the need to ensure more than 80% immunization coverage of children in the first year of life with that encompasses at least four doses of oral polio vaccine as part of the national routine immunization schedules. While it cannot eradicate the disease alone, good routine oral polio vaccine coverage does increase population immunity, reduce the incidence and make eradication feasible. In the absence of uniformly high immunization coverage, pockets of non-immunized children continue favouring the spread and outbreaks of the poliovirus. For strengthening routine immunization, the development and endorsement of the national comprehensive multiyear strategic plan 2014-18 by federal and provincial Governments as well as partners is a great opportu- nity and so is the recently committed GAVI support to introduce one dose of IPV in routine immunization. It is therefore, a high time to capitalize by building effective EPI – PEI synergies; may be by utilizing the Emergency Operation Centres. High quality supplementary activities emerge from effective pre-campaign planning. The peculiar challenges of security compromised areas need to be tackled effectively through locally tailored solutions with the meaningful involvement of local community as well as the security agencies. The plans must be invariably validated at the Union Council level to ensure feasibility. Within the national and provincial strategies, a space should be provid- ed to apply interventions such as offering a Polio plus package, use of Injectable Polio Vaccine, negotiated Hujra and even self vaccination etc. as required. The campaign monitoring mechanism and post campaign evaluation must be designed on more scientific ground allowing space for randomized LQAS and Spot surveys. For the high priority reservoir areas, a third party independent monitoring mechanism must be seriously considered. Surveillance acts as the eyes and ears for the Polio eradication. Besides active surveillance for acute flaccid paralysis already underway, the environ- espite 99% reduction in number of Polio cases since the launch of Polio eradication initiative in 1988, the mental surveillance needs to be further emphasized including areas carrying relatively lower risks as well. The Dwiping off virus from the globe still remains a global dream mostly because the extremely contagious virus earliest and effective response to a positive sample helps in halting further viral transmission and must never be still holds sway in three countries - , Nigeria and Pakistan. Recording more than 85% of the global compromised. With the good quality laboratory capacity available at the National Institute of Health, indigenous Polio cases during 2014, Pakistan is being considered as the “greatest single risk” to eradicating the crippling research on circulating wild and vaccine viruses must be initiated to keep an eye on the evolving viral epidemi- disease because of issues such as continued militancy and insecurity to Polio workers not allowing access to ology for a timely action. about 300,000 children since last two years. The 209 cases of paralysis caused by wild polio virus during the current year in 26 districts/agencies is the highest number on record during last one and a half decade. Of these In order to ensure that our efforts are based on strong ‘four pillars’; there is a great need to optimally operation- 138 (66%) cases were reported from FATA, 43 (21%) from Khyber Pakhtunkhwa and 19 (9%)). Additionally, alize the oversight and accountability mechanism laid down in the National Emergency Action Plan 2014 at the Baluchistan has reported 6 polio cases (3 from Killa Abdullah and 3 from Quetta) and Punjab 3 polio cases; one federal, provincial, district and union council levels. The experience of the national campaign control centre each from Chakwal, Bakkar and Sheikhupura. activated at the federal EPI during recent NIDs has clearly indicated the need to revitalize this system. Instead of merely data collection and onward dissemination, the district Polio control rooms must be capable of undertak- The strongest hubs of Poliovirus circulation is in FATA (North Waziristan, South Waziristan and Khyber Agen- ing a quick analysis and initiate requisite remedial measures within the shortest possible time. cies and their adjacent areas); district Peshawar in central and in southern Khyber Pakhtunkhwa, and Gadap in Karachi. These areas are currently the most substantial challenge to eradication and have not just har- Similarly, the Emergency Operation Centres at the federal and provincial levels should be optimally equipped bored the poliovirus transmission for a substantial time but have amplified and exported the wild poliovirus to to collect, segregate and analyze data by district and union council. Think tanks comprising of subject matter other areas of the country. The spread of virus from here has also been confirmed to Israel, West Bank and Gaza, experts must be there to guide evidence based actions without any time lag. Iraq and Syria as well. The Quetta block in Balochistan including districts of Quetta, Pishin and Killa Abdulla is The upcoming low transmission season is of utmost importance for Pakistan and carries a “make or break” rank another block of concern due to reintroduction of poliovirus after remaining Polio free for more than 2 years. for us to stop wild polio virus transmission. There is never a wrong time to do the right thing. Let’s act with an Whereas very child deserves the right to run and play without polio, whatever reasons may be; the spread of the eye to results as now we as a nation have a once-in-a-lifetime opportunity to rid the world of the evil of polio. The virus across the country has affirmed that the efforts being undertaken currently by all partners do not match resources, vaccines and the tools to achieve this are available and all we need is to dedicate ourselves to writing the challenge. It is therefore, a high time for all stakeholders including Government, International partners and the final chapter thereby closing the book on polio forever. the civil society to critically review as to what has gone wrong during planning and execution of strategies at all

Noor Zaman Noor Wali Habibur Rehman Rasul Khan Dosali, Mandi Khel, Mirali, North Waziristan Darpakhel village, Miranshah, Machi Khel, Mirali, North Waziristan North Waziristan North Waziristan

“I have two children. I have not seen polio teams in “I shifted to Karak two months ago after situation “I shifted to Patul Khel, a village in UC Domail, “In Darpakhel area vaccination activities took place my area since 2003. Poor security situation in my in our Agency deteriorated. We were anticipating Bannu, due to poor security situation in our village under a cloud of fear. But situation was worse in ad- town scared away polio and health teams. military operation for a long time ago. We are living where the militants had strong presence. joining areas where vaccination activities were sus- here in a rented apartment. I have seven children, pended due to unfounded opposition by the clerics As long as I lived in village Dosali, misconceptions Some members of militant groups and their allied two of them including Noorul Amin and Robina, and security situation. were deep rooted. People had perceptions that Oral groups spread disinformation about vaccination. who are under five years of age, did not receive Polio Vaccine (OPV) made children sterile. And unfortunately their propaganda was taken se- The outbreak of polio cases is serious in North Wa- polio drops or any vaccine because teams stopped riously by the poor villagers. ziristan it is only due to ban on polio vaccination. A few days ago God has blessed me with a daugh- coming to our village some four years ago. The situation in villages of Eidak, Gariom, Shawal, ter. The vaccinator here has vaccinated both of my I am very excited to see doctors visiting door to I am grateful to the government health teams who Degan and Machis is alarming as all these areas are children against measles and polio. Now I feel that door in Patul Khel, Domail. I have eleven children, are vaccinating our children free of cost in Karak a hub of militancy. Except Miranshah and Mirali my children are safe. one of them is less than five years. Now I believe district. The doctors are going door to door in no public hospitals existed in entire agency. There- our children, who were at the mercy of diseases, are I don’t know how long we are going to stay in Ban- Karak, DI Khan and Peshawar and I appeal to all fore people had to suffer a lot. I believe vaccination being taken care of by the health teams.” nu, therefore I have obtained vaccination cards of the parents to vaccinate their children mandatori- is the only way to protect my five children and all my children and information material to help stay ly. It is so important for us to protect our children other children in the country from life-threatening safe from diseases.” from polio and other diseases.” diseases.”