Global Health Press
The last stand

The last stand

Pakistan’s failure to eradicate the polio virus may have some serious implications – ones that go far beyond the medical. The Independent Monitoring Board (IMB) of the Global Polio Eradication Initiative (GPEI) has recommended that there be international travel restrictions on every adult or child travelling outside polio-endemic Pakistan. Afghanistan and Nigeria are also recommended for a travel ban. The purpose of such a Draconian move is to prevent the virus from travelling to countries that have fought hard to free themselves of it and who now do not wish to jeopardize their polio-free status. The recommendation in the IMB report, titled ‘The Last Stand?’, says that no country should allow citizens of a polio-endemic state to cross their borders without a valid certificate of polio vaccination.

The world is tantalizingly close to eradicating polio, but the final push needs a mighty effort. The persistence of the virus in Pakistan is linked to the poor security situation – two vaccinators were murdered in Karachi and Quetta – and resistance by elements that see polio vaccination as some diabolical western plot to sterilize Muslims. The risk of transferring the virus into currently virus-free countries is huge. Most global populations have what is known as ‘herd immunity’ but we do not. There are parts of Pakistan where vaccinators cannot go and where local populations are under the sway of ill-educated and paranoid religious leaders. Our population is highly mobile, both domestically and internationally, and any ban on the movement of the people of Pakistan is going to have an immediate and deleterious effect on individuals, the economy, politics and even diplomacy. Concern is expressed in the IMB report that the federal government, distracted by the forthcoming elections, is going to take its eye off the polio ball. Resources to eradicate polio must be firewalled, protected from being knocked off-course by other events. Across the world there were 175 cases of polio thus far in 2012, around half the number reported in 2011. Pakistan accounts for 56 of them, with another 10 ‘Sabin-like’ cases in Balochistan. Eradicate polio or face severe restrictions on overseas travel – the choice is stark.

Source: The News International