Visa rules aren’t vaccines. War against polio cannot stop at India-Pak border

RASHMEE ROSHAN LALL December 16, 2013

child-polio-drops-logo-illustration-art-backgroun-31817052If there’s anything that underlines the great gulf between India and Pakistan, it is the new requirement that all Pakistanis prove they’ve been vaccinated against polio before they set foot in India.

The chasm seems enormous. India is jealously safeguarding its polio-free status after decades as the epicentre of the disease. But Pakistan is one of the world’s three polio-endemic countries, Afghanistan and Nigeria being the others.

Polio is a disease that reaches back down the arches of the years. A stone engraving from Egypt, dating to 1400BC, shows a priest with a withered leg typical of paralytic polio. The disease has existed as long as man but became a major public health issue in late Victorian times with major epidemics in Europe and the United States. It causes spinal and respiratory paralysis, can kill and remains incurable but preventable. That is the frustrating juncture at which the world stands today – with polio almost totally eradicated except for Pakistan, Afghanistan and Nigeria.

It seems positively mediaeval that as recently as 2011, nearly a third of the world’s 647 cases (spread across 17 countries) were in Pakistan. That was also the year the virus from Pakistan re-infected China, which had been polio-free for more than a decade.

Unsurprisingly, India is worried because until polio is eradicated there will always be the danger the virus will be reintroduced across the border from Pakistan. As the World Health Organisation says, “…as long as a single child remains infected with poliovirus, children in all countries are at risk of contracting the disease…Failure to eradicate polio could result in as many as 200 000 new cases every year, within 10 years, all over the world.”

The problem, of course, is that all three polio-endemic countries have a huge political problem to overcome before they can fight the disease. In Afghanistan, immunisation drives has been hampered by years of conflict and security concerns. In Nigeria, local opposition affected immunisation efforts. But Pakistan has a number of issues. In 2011, it abolished its federal health ministry. Meanwhile, the Taliban began a campaign against polio eradication campaigns in Khyber Pakhtunkhwa and FATA regions because the US government used a fake vaccination programme to harvest bin Laden family members’ DNA. The price has been paid by workers in the field – and the children left unvaccinated. The good news is a recent fatwa by Sami-ul-Haq, head of the powerful Darul uloom Haqqania, which declared that polio vaccines are not un-Islamic, though that did not deter attacks on Friday, December 13, on two separate polio vaccination teams operating in northwestern Pakistan. One vaccination worker and two police guards died.

Even so, faith may not always move mountains – stop gunmen or eradicate a disease – but it can help more Pakistanis get themselves and their children vaccinated.