Progress in Pakistan
As of the end of June 2016, 12 cases of wild poliovirus type 1 have been reported, a 57% reduction from the same time in 2015. This improvement was attributed by the TAG panel to the united front now being presented by the team of partners working together under the leadership of the Government of Pakistan through the network of emergency operation centres. Progress was also ascribed to other strategies, such as the expansion of community-based vaccination and health camps, which have helped with enhancing community ownership of the programme interventions. In addition, thousands of trained and dedicated frontline workers have ensured that 280 million children have received polio drops during 9 campaigns conducted in the low transmission season. The successful campaigns of the inactivated polio vaccine in targeted high-risk areas of Karachi, Khyber Peshawar and Quetta block helped in quick immunity boosting of approximately 3 million vulnerable children.
The strengthened level of coordination between Pakistan and Afghanistan programmes to address risks in the common reservoirs was also highlighted as impressive by the TAG. Chairman Jean Marc Olive said the continued commitment to coordinate in response to epidemiological developments, on transit vaccination and synchronization of supplementary immunization activities will remain increasingly important in the coming low season.
“The Government of Pakistan will remain committed to achieving our collective goal of polio eradication and thanks all our partners for their technical, financial and political support as we approach a significant milestone in global health,” said the Prime Minister’s Focal Person for Polio Eradication, Senator Ayesha Raza Farooq at the TAG meeting.
Overcoming the remaining challenges
The National Coordinator of the emergency operations centre Dr Rana Safdar outlined the overriding priorities for the National Emergency Action Plan for 2016–2017 as to ensure all children are vaccinated, especially the youngest in the most high-risk districts; the detection of every signal of the poliovirus and any emerging immunity or performance gaps; and to respond rapidly, aggressively and comprehensively to every significant event with implications for interruption of the wild poliovirus.
The TAG recommended that efforts continue to be made to strengthen community-based vaccination and mobile team performance, to reach every last child in all districts. They highlighted that stopping transmission in North Sindh was of utmost importance. Recommendations were also made to strengthen surveillance, to coordinate with Afghanistan along border areas and to strengthen routine immunization through the community-based vaccination initiative. Additionally, it was recommended that the programme maintains good performance in Tier 2,3 and 4 Districts and take action to address low performing Uniopn Councils in these areas.
The TAG also voiced appreciation for the commitment of the Chief Secretaries and provincial government in driving operations and innovations down to the Union Council level, which has resulted in improved overall performance and motivation of staff, but urged the programme to maintain the quality of campaigns by focusing on improving the overall performance and decreasing the number of missed children in the core reservoir areas, and to identify and address the residual risks and to act swiftly in response.
In closing, TAG Chairman, Jean Marc Olive said that Pakistan is still within reach of eradication. “I've never been so optimistic about the ability to interrupt the transmission of polio virus in Pakistan. The Government of Pakistan should be extremely proud for what has been achieved so far. We all know it's not done and there is always going to be challenges and surprises as we draw closer to eradication, but we learn from surprises”
TAG draws high-level delegation of partners
WHO Regional Director for the Eastern Mediterranean Dr Ala Alwan addresses TAG meeting in PakistanA high-level delegation from the Government of Pakistan and key partner agencies to the Polio Eradication Initiative, including Minister of State for National Health Services, Regulation and Coordination, Mrs Saira Afzal Tarar and the WHO Regional Director for the Eastern Mediterranean Dr Ala Alwan joined the closing session of the 2-day meeting in Islamabad.
Speaking to the delegation Dr Alwan said: “Polio eradication is one of WHO’s top priorities and it is one of the top priorities in this Region. This is a turning point in the global struggle against polio. The epidemiological situation is the best ever achieved now; there is no doubt that there is improvements in performance, and with the impressive government ownership of the programme, I think we can say that much of the remaining challenge is operational.”
WHO Representative to Pakistan Michel Thieren told the meeting that WHO stands committed to see Pakistan cross the finish line for polio eradication, which means finding the gaps and addressing them. “It is imperative that all efforts be made, not only at technical and operational levels, but also at political and administrative levels, to redress those pockets of failure, which will seriously hamper our capacity to win this last battle.”
The TAG was established to review progress towards polio eradication in specific countries, assess implementation of previous TAG recommendations, discuss planned activities and issue recommendations to address constraints facing national programmes in achieving their targets. TAG meetings are attended by country-specific TAG members, national representatives and partner organizations, both international and regional.
