The commitment to eradicating polio from Pakistan is now a national cause led by the prime minister himself.
The question that I ask myself every day since assuming office is that Pakistan’s polio programme is 25 years old, but why haven’t we been able to eradicate polio till this day?
The answer is complicated, to say the least.
My days and nights are consumed in brainstorming strategies and constructing innovative methodologies on how to reach all the children of Pakistan consistently, so one day in the near future I can hand over the keys of the Emergency Operation Centre (EOC); the headquarters of the polio eradication in Pakistan, to the prime minister and we raise the flag of a polio-free Pakistan.
To begin explaining the scope of the problem, it’s important to understand the enemy you are dealing with. The poliovirus is ferocious and with evil-intelligence leaves crumbs behind for us to follow. One of our biggest mistakes has been taking its bait, fighting it in territories that it poses to be its home. While it has kept us engaged fighting its proxies, it has multiplied and expanded its arsenal to the extent that we now have to revise our strategy to counter it, more aggressively in it is home. We have had 158 cases of polio in the last five years, and 64 this year alone.
To me, the number of cases is not mere statistics or a reputation hazard, but these figures represent actual children that have been paralysed for life. We must acknowledge it for what it really is — a daunting and horrific reality of what this virus is capable of, and a stark reminder of just how urgently we need to bring polio to an end.
But the cases are a mere symptom of the number of children we are missing in every polio campaign — this is where the real problem begins.
The current outbreak the country is facing was not unpredictable. The Independent Monitoring Board (IMB), one of the highest bodies that evaluate the success of the strategies countering the poliovirus, had predicted the outbreak a year earlier than it actually happened.
The fact is that the data being collected during polio eradication campaigns had been misleading operational priorities. The number of children recorded as ‘missed’ aided by fake finger markings has had disastrous connotations on campaign quality and in return has not accurately reflected ground realities leaving hundreds and thousands of children unvaccinated and vulnerable to the virus. The root cause of which boils down to the communities resistance to being vaccinated.
This past year saw an upsurge of anti-vaccine propaganda spreading like wildfire on social media platforms. As time went on, community distrust in the programme fueled by propaganda ended up sparking catastrophic incidents like the one in Peshawar on April 22, 2019. Consequently, motivation levels of polio eradication teams dwindled as refusals to the vaccine continued to spike across the nation.
I am no newcomer to the programme. I have been associated with polio eradication efforts for over eight years. In all that time I’ve seen people committing the same mistakes over and over again, with my voice unheard. It was immediately clear to me that our traditional approaches had failed. We had to think out of the box and the transformation had to happen soon.
To this end, I am proud to say that the Pakistan Polio Eradication Programme has worked long and hard over these past few months to adapt to the growing myriad of challenges and to transform and re-vitalise its efforts to bring polio to a halt.
The commitment to eradicating polio from Pakistan is now a national cause led by none other than the prime minister of Pakistan, Imran Khan, himself. Such is the commitment that the premier asks for text updates on an almost daily basis and this goes all the way down, right to the frontline workers.
To make the requisite changes for the desired impact, I have been personally involved in the review of the entire programme structure. This review has already identified many of the operational deficiencies embedded within the programme, including issues with programme structures and has reconfirmed the fault-lines that were evident to everyone but were never fixed.
But, I believe that there needs to be an accountability framework that not only measures our success but also guarantees that everyone is accounted for their assigned role and nobody is allowed to play with the future of our children.
A 24/7 WhatsApp helpline has also been established to provide direct responses to all parent and caregiver queries, concerns and complaints. Any and all queries, concerns or complaints are logged by the programme, responded to instantaneously, or then forwarded to district officials for remedial follow-up. The Polio Helpline is being initiated in the following months as a 24/7 call centre as well.
I also believe that one of the biggest hindrances to the success of the polio programme is the way it is perceived in the eyes of the masses. For this, my team is working with the most creative minds in this country to design and launch a Perception Management Initiative which does not only aim to counter propaganda and helps builds trust within the community but aims at creating demand for the polio vaccine, which has been only a topic of several discourses but not been achieved to date.
I am confident that this transformation of the programme will deliver the results we desperately need. I reassure all Pakistani citizens that I along with my team will not sit idle until Pakistan is certified polio-free.
The writer is prime minister’s focal person on polio. He tweets at @babarbinatta.