Triumph over adversity: Pakistan's successes against polio
Authors: Hafsa Mohiuddin, Ansab Godil, Muhammad Yusuf Hafiz
Journal: The Lancet Global Health (2016)

In 2014, 306 polio cases were reported across Pakistan, which dropped to only 54 in 2015 and 16 as of Nov 16, 2016, in contrast to the 40 cases reported by the same time in 2015.1Global Polio Eradication InitiativeData and monitoring: polio this week.http://polioeradication.org/polio-today/polio-now/this-week/Google Scholar The proportion of reported cases originating from the Federally Administered Tribal Areas (FATA), a WHO-declared polio-endemic block1Global Polio Eradication InitiativeData and monitoring: polio this week.http://polioeradication.org/polio-today/polio-now/this-week/Google Scholar, has declined from 179 [58%] out of 306 in 2014 to 16 [30%] out of 54 in 2015 and 2 [5%] out of 40 as of Nov 16, 2016. These statistics show a heartening trend towards polio eradication in the largest remaining reservoir of the polio virus. Effective nationwide policies featuring improved immunisation infrastructures and increased awareness of polio and its prevention have accounted for the declining number of polio cases. A major hindrance to effective immunisation campaigns was the religious conservatism amongst some civilians, particularly in the FATA. In 2015, Pakistan's government arrested 471 non-conforming parents in a bid to coerce them into vaccinating their children, which would have increased resentment towards vaccination drives.2Junaidi I Year's first polio cases reported in Pakistan, Afghanistan.http://www.dawn.com/news/1237788Google Scholar Thankfully, this policy was replaced with counselling and peaceful persuasion of parents by enlisting the support of local clerics and religious scholars, who have been endorsing polio vaccination in their Friday sermons and accompanying health workers on polio drives to convince hesitant parents about vaccination.3Mahmood W Dispelling myths about polio drops in Punjab.http://nation.com.pk/lahore/11-aug-2014/dispelling-myths-about-polio-drops-in-punjabGoogle Scholar Due to the Taliban's killing of health workers, polio eradication teams were reluctant to tour high-conflict zones for vaccination drives. That is a major reason why peripheral zones of the country have remained inaccessible to immunisation campaigns. Although terrorism is still a looming threat, as evident by the suicide bombing outside a polio vaccination centre in Quetta in January, 2016,4Mehsud IT Suicide bomb near polio center in Pakistan kills at least 16.http://www.nytimes.com/2016/01/14/world/asia/pakistan-quetta-suicide-bombing-polio.html?_r=0Google Scholar the army offensive launched against the militants and revamped security measures for polio teams have enabled health workers to become more actively engaged; the accessibility of remote areas has also improved. Furthermore, the Punjab Government has started using a smartphone application to register immunisations, collect and assess data regarding actual vaccinations, monitor dosages delivered to each child, and send out reminders to parents to notify them of the date of follow-up immunisations.5Shah B In Pakistan, a final push to wipe out polio.http://www.nytimes.com/2016/01/21/opinion/international/in-pakistan-a-final-push-to-wipe-out-polio.html?_r=0Google Scholar We believe that Pakistan's efforts in its battle against polio should be applauded. The country has been brought a step closer to becoming polio-free, and will yield a positive impact on global health. We declare no competing interests.