Poliomyelitis was responsible for paralysing and killing up to half a million people every year before the development of the poliovirus vaccine in 1955. By 2000, through mass vaccination campaigns of oral polio vaccines, the world had almost eradicated poiliovirus barring a few regions.
However, the global fight against polio has encountered a significant setback, as cases of the disease have begun to rise again in Pakistan. Despite being on the brink of eradication in 2023, with only six reported cases of the wild form of the virus, the number of cases has surged to 73 in 2024. This alarming trend has prompted concerns among health experts, who point to the ongoing conflict in Afghanistan as a major factor contributing to the spread of the disease.
Per data from the WHO, infectious diseases such as pneumonia, dengue fever and measles have also been on the rise in Afghanistan since the last six months.
Zulfiqar Bhutta, a renowned expert on child immunisation strategies in conflict zones, said that the genetic strains of wild poliovirus in Pakistan are all from Afghanistan, per a report on Deutsche Welle.
Bhutta, who has worked extensively in the region, attributes the resurgence of polio cases in Pakistan to the spillover of the virus from Afghanistan. “It has spread to all districts of Pakistan. We’ve snatched defeat from the jaws of victory,” Bhutta lamented.
“It’s a virus that does not want to be eradicated, so give it an inch and it will take a yard,” Bhutta said.
The challenges facing polio eradication efforts in the region are multifaceted. Bhutta cites the Taliban’s restrictions on female health professionals, poor sanitary conditions, and regional insecurity as significant obstacles. The lack of reliable data on poliovirus cases in Afghanistan further complicates efforts to combat the disease.
Pakistan has invested heavily in poliovirus immunisation programs, with an estimated $10 billion spent since 2011. Despite these efforts, the country’s progress in eradicating the disease has been uneven, with varying immunisation rates across provinces. In Punjab, 85% of children are vaccinated, while in Balochistan the rate is as low as 30%. Until the coverage reaches 85-90% in all provinces, it is not possible to eradicate it, Bhutta said. He also emphasises the need for a comprehensive review of immunisation strategies, highlighting the importance of strengthening routine immunisation programs for all infectious diseases, not just polio.
Bhutta’s expertise in working with the Taliban in Afghanistan offers valuable insights into the complexities of delivering healthcare services in conflict zones. He stresses that the Taliban are not the enemy and that they share the same health concerns as everyone else. Bhutta’s experience in working with the Taliban to deliver smallpox vaccines during periods of negotiated peace underscores the potential for collaboration in addressing health needs.
The resurgence of polio cases in Pakistan serves as a stark reminder of the need for sustained efforts in combating infectious diseases. Bhutta’s call for a comprehensive review of immunisation strategies and his emphasis on addressing broader health needs in the region offer a way forward in the fight against polio. Ultimately, eradicating poliovirus in the region will require a concerted effort from international and local health authorities, as well as collaboration with the Taliban government in Afghanistan.
