Pakistan reported 11 new cases of polio on a single day last week, bringing this year’s official count to 138, a four-fold increase from last year, as the crippling disease spreads amid Islamist militancy and suspicion.
All the cases were reported in the north, Ayesha Raza Farooq, head of the Prime Minister’s Monitoring & Coordination Cell for Polio, said by phone in Islamabad. Eight came from tribal areas that lie on the border with Afghanistan.
Once driven to the brink of extinction, the polio virus has mounted a comeback in some parts of the world, prompting the World Health Organization to declare its spread a global health emergency in May. Pakistan, Cameroon and Syria pose the greatest risk of exporting the virus to other countries and should ensure that residents have been vaccinated before they travel, the WHO said at the time.
A ban on vaccinations by a Taliban leader in retaliation for U.S. drone strikes, and attacks on health-care workers after a fake vaccination campaign was used to hunt down Osama bin Laden, have hurt eradication efforts and enabled polio to spread inside Pakistan.
The latest cases have come after the monsoon rains, a “high season” for polio cases in South Asia, said Sona Bari, spokeswoman for the polio eradication program at the WHO in Geneva. Another cause of the recent surge in polio cases is that people from areas with militant activity, where vaccination has been banned for two years, have been displaced to other parts of the country, she said.
“We knew this was a huge risk,” Bari said. “Which is why, in fact, Pakistan had vaccination posts at all the roads leaving” North Waziristan, she said. “Everybody was vaccinated -- hundreds of thousands of people.”
The 138 cases so far this year compare with 34 in the same period last year, according to Farooq. She said more than 34 million children under the age of five in Pakistan are being targeted by different immunization programs. These programs normally begin in November and last through the following March.
Pakistan has a population of about 196 million.
“This year we ran the most intensive campaigns in the country’s history -- three national immunization drives and five sub-national,” Farooq said.
Militants have targeted these drives, and 61 polio workers and their escorts have been killed since 2012.
“These attacks started in July 2012 because of the Shakil Afridi episode,” Farooq said, referring to the doctor who helped track the al-Qaeda leader using a fake polio immunization campaign. “That is when the program suffered a huge setback, when the suspicion around polio vaccine started, workers were not only killed, they were threatened, attacked and injured.”
Eight of the 11 cases reported on Sept. 5 came from the tribal areas of North Waziristan, South Waziristan and Khyber Agency, she said. The rest were reported from different areas of the northern Khyber Pakhtunkhwa province.
The militants’ ban on vaccinations in North Waziristan is “still in place, but since most of the population has left, now the risk is really that the unimmunized population has left and threatens the rest of the country,” the WHO’s Bari said. “It’s the instability in Pakistan that is more of a larger risk than sort of isolated militant bans,” she said.
“Pakistan has, first of all, declared an emergency, and they’ve said that people should be vaccinated,” Bari said. “I think that what they need to do better is work on stopping transmission within the country. Until that happens, they will be considered a country that has put the rest of the world at risk.”