FOR several years now, any progress on Pakistan’s anti-polio efforts has been followed by several steps backwards. At one point, there was hope that the crippling disease would soon be eradicated in this country. Instead, along with Nigeria and Afghanistan, we remain one of the world’s last three polio-endemic countries. Formidable challenges have raised their heads on numerous fronts. On the side of the state, these have included vaccinating teams missing children because of the remoteness of their area of residence and interruptions in the cold-chain storage system. Immense damage has also been done to the vaccination campaign by the rhetoric of hard-line clerics in the northwest that the drops would harm children. To add to this, the Pakistani Taliban ‘banned’ polio vaccinations in areas under their thrall, while a jirga decided that they too would resist the campaign unless drone strikes were halted.

All this has meant that cases of polio are being reported in an increasing number of spots in the country with alarming frequency. Now, it seems, officialdom has realised that in the north, Peshawar is a ‘polio reservoir’, with at least 10 new polio cases reported over the province’s five districts having originated in the provincial capital. Reportedly, the provincial health secretary chaired a meeting and ordered that special anti-polio drives should be initiated in 42 high-risk union councils. Further, it was decided that records would also be kept of those children that had missed vaccinations. This last step may prove useful in identifying the trends in the failure to administer the drops and to create more targeted interventions. No doubt the challenges are myriad but they must be surmounted. The resistance to polio vaccinations may actually be growing in Pakistan, as indicated recently in a survey conducted in Karachi: of well-off parents interviewed in five large shopping malls across the city, 72 per cent believed that the vaccine was harmful while 8.5 per cent said it was unnecessary, indicating that the problem is not one of low-income or the lack of education. This profoundly depressing finding should add to the impetus of anti-polio efforts.