The International Monitoring Board (IMB) of the Global Polio Eradication Initiative has acknowledged the great progress made in Pakistan’s polio situation to date and called for more innovative approaches to end polio in the country once and for all. Minister for National Health Services Saira Afzal Tarar warmly welcomed the IMB assessment and recommendations saying this was a recognition of the turnaround made possible under the leadership of Prime Minister Nawaz Sharif. The government is fully committed to this battle against the crippling virus until its complete eradication said the Minister. “There are no magic solutions to achieve this public health milestone for Pakistan and the world, just continued hard work and dedication” said Senator Ayesha Raza Farooq, Prime Minister’s Focal Person for Polio Eradication while commenting on the findings of the Independent Monitoring Board. Appreciation was expressed for Polio Management Team led by its National Coordinator.
In its report titled “Every Last Virus”, the IMB commended the strong performance of the Pakistan polio eradication programme while noting that it benefits from the exceptional political leadership, skill and commitment on the part of the Health Minister, the Prime Minister’s Focal Person for Polio Eradication and the Provincial Secretaries. An important and recent innovation in programme governance has been the effective engagement of Commissioners at the Divisional level.
The report noted that in reviewing Pakistan, the IMB has gained the strong impression of a high-performing programme which is backed up by the available data. The programme has had two cases of paralytic polio associated with wild poliovirus in 2017, both of which were outside the endemic reservoirs and subject to a very aggressive response. Immunity data are the ultimate arbiter of protection and study results show high levels of protection in every province tested except for the Quetta block. The IMB also acknowledged that the current scale of environmental sampling in Pakistan is unprecedented. The report noted that there can be no room for complacency about the positive environmental samples recorded but two years ago, the presence of these samples would have sparked cases of paralytic polio. They have not this time around, at least as has been identified so far.
While highlighting the progress at all levels across the country, the IMB did voice concern over programme quality in the Quetta Block which is still well below peak performance and contains the highest number of susceptible children. For a variety of reasons, transformative change has not yet been achieved. The IMB also noted that the single biggest issue confronting the polio programme in Pakistan is how to effectively reach the large numbers of children on the move with their families and therefore, do not receive the polio vaccine. The report recommended a paradigm shift in approach to this population that puts major emphasis on finding and vaccinating children in their residential bases, no matter how short their stay is. The report also recommended an immediate and major boost to the quality of routine immunization in the polio reservoirs which could be the decisive blow to the poliovirus.
The Independent Monitoring Board (IMB) was constituted in November 2010 at the request of the World Health Assembly to monitor and guide the progress of the Global Polio Eradication Initiative’s 2010-2012 Strategic Plan. The IMB releases quarterly reports to provide an honest and transparent external assessment of the progress being made towards polio eradication.
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