December 2012, Volume 62, Issue 12

Student's Corner

The polio bomb: What must Pakistan do?

Madam, in 1988, Global Polio Eradication Initiative was started by World Health Organization in collaboration with different health agencies. In the following years, the number of polio cases dwindled from 350,000 in 1988 to 1643 by January, 2009. Polio is now limited to only three countries: Afghanistan, Nigeria and Pakistan.1
Pakistan is home to Wild Polio Virus (WPV) serotypes 1 and 3 and is last reservoir of WPV serotype 3 in Asia. Apart from causing disease and disability in the native population, polio virus strains have been isolated from neighbouring countries. The isolation of strains endemic to Pakistan from Chinese population in western Xinjiang province serves as an example of the threat reservoir countries are to the world population.2
In Pakistan, polio is endemic to three regions. These are Karachi, Quetta block (Quetta, Pishin and Killah Abdullah district) and FATA and Peshawar district. Several factors are held responsible for polio thriving in these areas. These include low socioeconomic status of the families, lack of awareness regarding danger posed by polio and disinformation by local influential people about how polio vaccines produce harm.1
Eradication of polio virus requires efforts to be made at various levels. At grass root level, intensive epidemiologic monitoring of polio cases coupled with counseling by health care service providers is needed. These health care service providers include doctors, nurses and lady health workers. This form of social mobilization has been shown to be effective in influencing the understanding of risks of polio and changing responses about vaccination.3 An essential factor in overcoming hurdles during vaccination campaigns is resistance faced by the vaccination teams from local populace. Counseling sessions held with community and religious leaders with proper technical information will aid in more reasonable response by the local residents. The use of social media and technology will be of immense assistance not only in recruiting volunteers for campaign supervision but also increasing public awareness. These campaigns on television and radio have been shown to influence the response of population towards polio vaccination.3,4 The responsibility of State is to spearhead efforts in eradication of Polio. Effective liaison services between different health agencies and State departments are imperative if we are serious about polio eradication. Vaccination alone can do nothing in achieving our goal. Supplementing it with social mobilization and effective communication at all levels is needed to engage the people.

Maroof Hassan, Muhammd Farhan Khaliq, Muhammad Muslim Noorani
4th Year Students, Dow Medical College, Dow University of Health Sciences, Karachi.
Corresponding Author: Maroof Hassan.


1. WHO. WHO Global Polio Eradication Initiative 2011. Geneva: World Health Organization, 2011.
2. Kew O. Reaching the last one per cent: progress and challenges in global polio eradication. Curr Opin Virol 2012; 2: 188-98.
3. Sengupta B, Sinha RN, Sarkar GN, Biswas AB, Mukherjee KL. Perception and practice regarding pulse polio immunisation in an urban community of Calcutta. J Ind Med Assoc 1998; 96: 247-8.
4. Cheng W. When every child counts: engaging the underserved communities for polio eradication in Uttar Pradesh. India, 2004.

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