Hurdles to the global antipolio campaign in Pakistan: an outline of the current status and future prospects to achieve a polio free world

Abstract

The Global Polio Eradication Initiative to eradicate polio completely by the year 2000 has been successful, except for three endemic and some non-endemic countries. Pakistan, one of the three endemic polio reservoirs, is posing a serious threat to the success of the initiative. Currently, the expanded programme on immunisation has been geared to win the race over polio virus in Pakistan. After the remarkable decrease in polio cases from 198 in 2011 to only 58 in 2012, Pakistan seemed to be at the verge of success. However, hurdles continue to retard the campaign. The war against terrorism, misconceptions about polio vaccine, religious misinterpretations, frustration among vaccinators, lack of awareness, social considerations, natural calamities, inaccessibility, and inefficient vaccines and so on are continually rupturing the foundations of the worldwide initiative in the country. Weak health management is found at the hub of majority of the challenges. Stricter policies, well managed and supervised plans and strategic actions, risk analysis and enhanced communication may help giving the final punch to polio virus in the country. Analysis suggested that there is some literature available on the challenges to polio elimination, yet there is not a single publication up to date that considers all the possible hurdles in a single manuscript. This paper sorts out the breaches that hamper the goal of eliminating polio from Pakistan. We have evaluated all the possible barriers and explained them with a perspective that will help develop area specific strategies against polio virus and thus eradicate polio virus from the world.

An Assessment of Religious Impediments to Polio Vaccination in Tehsil Khwazakhela, Swat

“…Out of total 5.5% respondents were of the opinion that all clergies were agree with polio vaccination, 85.0% were against and 9.5% were Uncertain. These findings clearly supported Khan and Qazi [25] who reported that misconceptions about the nature of polio drops, and religious misinterpretations in masses and religious leaders, are the major obstacles in the real success of vaccination campaign. Regarding another statement that masses are in favor of "fatwah" given by Ulama against vaccination, majority i.e.79.5% respondents showed agreement, 5.5% were against and 15.0% were uncertain to it.…”

“…Likewise, the relation that all Mullas (clergies) were agreeing with polio vaccination and impediments to polio vaccination was found non-significant (p>0.05). It could again be attributed in similarities to findings that misconceptions about the nature of polio drops, and religious misinterpretations in masses and religious leaders, are the major obstacles in the real success of vaccination campaign [25]. However, relationship of masses are in favor of "fatwa" given by Ulama against polio vaccination and polio impediments to polio vaccination was found significant (p<0.05).…”

Measles outbreaks in pakistan: causes of the tragedy and future implications

“…The substandard performance of expanded program on immunization (EPI) in Pakistan has resulted in failure against vaccine preventable diseases including Measles and Polio [12,25]. The WHO recommends two doses of measles vaccines and vaccination coverage up to or above 95% with both doses for interrupting endemic transmission of measles in many countries [26].…”

“…Although there is a lot of literature published on the breaches and suggestions to improve health infrastructure of Pakistan [12,25,[38][39][40], yet no significant measures have been taken so far to mend them. The need of the hour is to get out of the paperwork, reports and surveys, and put some practical strategies right away to implement the basic reforms already suggested by many analytical and systematic reviews [21,40].…”

End of Year 2015 in Polio Endemic Pakistan: Yet Another Beginning Towards End

“…However, this local context of problem influencing polio campaign in FATA and KP should not be confused with a larger threat of mismanagement throughout campaign structure, miscalculation in vaccination coverage estimates, and poor quality of vaccine administered across the country (Khan and Qazi 2013). Year 2014 not only threatened the world of a possible polio outbreak from Pakistan but also provided the catalyst for the government to once again start working for polio eradication in full gear.…”