Ending Polio

 
Recent polio progress in Pakistan (as at early May 2015)
District Polio Chair, Rob Byrne provided this update at the Presidents' Meeting on 7 May.
 
He said that "with these great results in Pakistan, and only one case outside Pakistan this year, we have never been this close to eradicating polio.  Now's the time to make sure we finish the job.
 
Then? Then the hard part begins, maintaining focus for three years to be sure the job really is finished.
 
At the end of April, the Pakistan Government provided the Independent Monitoring Board with an update of its program to eradicate polio*.   Here is a summary of the status:
  • 2014 saw Pakistan's worst result in over 15 years — 327 cases < > cases were reported to the end of April 2014 — the low season!
  • 2015 has been significantly better (down 62%) — 22 cases YTD (most cases from mid Feb to mid March;  Khyber-Pakhtunkhwa—9,  FATA—6,  Sindh—4 and  Balochistan—3)
  • In 2014:
    • North Waziristanwas the 'epicenter' of the outbreak
    • Karachi was the 'amplifier' (population double Sydney's in an area a quarter the size)
    • for over six months now, neither has reported a single case
  • sewerage sampling indicates levels of virus in environment significantly reduced
  • just one case reported in Pakistan in over a month!  (in Peshawar, 29/3)**
  • if this indicates cessation, it may have occurred just in time — low season is now over
    all agencies of FATA are now accessible to health workers! (Federally Administered Tribal Area)
  • the number of inaccessible children has dropped from 250,000 to 48,000!    81%!
  • Jamrud (near Khyber Pass) should soon be accessible — military operations underway to flush out militants
    improved security coordination and planning between government agencies:
    • Interior Ministry
    • Emergency Operations Centres, and
    • law enforcement agencies
  • 'Religious Supoport Persons' have been assigned to high risk union councils — very significant drop in religious refusals — no longer the major cause of refusals
  • overall, refusals have reduced by two-thirds (note: many hundreds of refusers jailed)
  • 1,000+ additional Community Health Workers now working in high risk areas in Karachi
  • introduction of tracking mechanisms and technology to better identify continuously missed areas and children.
With these great results in Pakistan, and only one case outside Pakistan this year, we have never been this close to eradicating polio.  Now's the time to make sure we finish the job.  Then? Then the hard part begins, maintaining focus for three years to be sure the job really is finished.
 
Rob Byrne
District Polio Chair, D.9685
8th May, 2015
 
** But note:  a worrying number of cases (300+) of acute flaccid paralysis have just been unofficially reported in the press for the month of April;  they are currently being tested for polio.  In a normal month you might expect about 200 cases of AFP from non-polio causes (~65 million kids aged 0–14  @  ~2 cases per 100,000  =  1,300pa).