Pakistan’s polio eradication campaign has hit serious problems with an alarming spike in reported cases that has raised doubts over the quality of vaccination reporting and prompted officials to review their approach to stopping the crippling disease.
The country is one of only three in the world where polio is endemic, along with neighbouring Afghanistan and Nigeria, but vaccination campaigns have cut the disease sharply, with only a dozen cases last year compared with 306 in 2014 and more than 350,000 in 1988, according to Pakistani health officials.
However, there has been a worrying jump this year, with 41 cases recorded, 33 of them in the northwestern region of Khyber Pakhtunkhwa, where many people resent what they see as intrusive and coercive vaccination campaigns often involving repeated rounds of visits, officials say.
Just as alarming for health services, environmental sampling has shown the presence of the virus in areas across the country, a clear sign of gaps in vaccination, which must cover the entire population to be effective.
Hopes that transmission of the disease could be ended this year have been abandoned.
“We need to take the bull by the horns and accept there are problems,” said Babar Atta, Prime Minister Imran Khan’s point person on polio eradication.
As well as the difficulty in reaching very remote areas and keeping track of people moving through big cities like Karachi, there have been problems in collecting reliable data, exacerbated by resistance to efforts to force vaccination.
Efforts to eradicate the disease have for years been undermined by opposition from some Islamists, who say immunization is a foreign ploy to sterilise Muslim children or a cover for Western spies.
Local officials say parents suspicious of mass immunization campaigns have been getting hold of special markers, used by health workers to put a coloured spot on the little fingers of children who have been vaccinated.
“They themselves would mark the fingers of their children, in case of any official visit to countercheck the vaccinated children,” one official associated with an international organisation told Reuters in the northwestern city of Peshawar.