Polio in Pakistan: One more Way in Which Pakistan Fails its People
As Reported by The Economist
For a symptom of Pakistan’s problems, consider the spread of poliomyelitis. This week brought the 115th confirmed case of polio, a crippling and at times fatal disease passed on virally, mainly through bad hygiene. The tally is well up on last year.
In most countries polio is barely a memory. Rich countries had largely eliminated it by the 1970s, and many poor countries soon followed suit. Three decades ago the world saw an estimated 400,000 polio cases a year. Thanks to a cheap and effective vaccine, administered by two drops into a child’s mouth and washed down with dollops of public and private money, the annual global number is now roughly 1,000.
Only in South Asia and Nigeria is it still endemic, though it occasionally flares elsewhere. Since even wretched countries such as Sudan and Myanmar are rid of polio, doctors dream it could follow smallpox and rinderpest to become the third disease wiped from the planet. For hope, look at India. Last year it had just 44 cases of polio, down from an estimated 250,000 three decades ago. Sarah Crowe, of UNICEF in Delhi, credits “one of the biggest mass mobilisations ever for public health”. This year teams of workers headed to train stations, schools and villages, mostly in Bihar and Uttar Pradesh, dosing children with vaccines and promoting habits like soapy hand-washing. Pitiful levels of sanitation persist: fewer Indians (about 50%) have toilets than have mobile phones. But this health campaign is working.
By contrast Pakistan flounders, even though the president, Asif Zardari, declared a national polio emergency in January and received help from the United Nations and the Gates Foundation. “Definitely the cases are on the rise”, says a glum Dr Altaf Bosan, who heads the government campaign.
Blame insecurity most. Three-quarters of last year’s cases were in conflict-ridden areas. The ignorance of religious leaders does not help, with their suspicion of foreign ways. Nor does poor government management. The World Health Organisation thinks that over 200,000 Pakistani children missed their polio vaccinations in the past couple of years. The worst-affected spots are Baluchistan, beset by sectarian massacres and police killings, and the unstable Federally Administered Tribal Areas near the Afghan border. Southern Sindh, deluged by two years of floods, has also been hit.
As more people migrate—because of violence, floods or economic need—the virus has travelled north, to Khyber Pakhtunkhwa, Gilgit-Baltistan and beyond. Ten polio cases reported last month in the Chinese region of Xinjiang, which borders Pakistan, were the first in China since 1999. Eastern Afghanistan also struggles with eradication, given insecurity and its porous borders. But the heart of the problem is Pakistan. Officials conceded in January that the country could be “the last remaining reservoir of endemic poliovirus transmission in the world, and the only remaining threat to achieving global polio eradication.” That is no distinction to savour.