Combating polio

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Why the Durand Line matters?

 

 

This week, Pakistan will become the second polio-endemic country to introduce the inactivated polio vaccine (IPV) into its routine immunisation system. More than half the global birth cohort is now receiving at least one dose of IPV through routine immunisation systems as a result of the biggest globally synchronised vaccine introduction in history.

Nigeria recently celebrated one year without any reported polio case, despite the political unrest and firm opposition against the drive to eradicate polio. The only three countries which, until last year, were still crippled by this endemic included Pakistan, Afghanistan and Nigeria. Nigeria claiming no reported polio cases over the year leaves behind Pakistan and Afghanistan; neighbouring, troubled countries with similar national security issues.

These three states suffered from political unrest, poor health infrastructure, and government negligence; thus leading to the failure to eradicate this disease once and for all. But the cause analysts cite most often is opposition from religious militant groups. However, the scenario has changed with Nigeria exterminating polio completely despite having similar issues. The time has come for the two states to step up the fight against this disease which continues to thrive in the region.

The only three countries which, until last year, were still crippled by this endemic included Pakistan, Afghanistan and Nigeria. Nigeria claiming no reported polio cases over the year leaves behind Pakistan and Afghanistan

Pakistan and Afghanistan both have reported cases from areas where the government has poor control hence giving non-state actors room to obstruct anti-polio measures. The World Health Organisation (WHO) recently called upon both countries, demanding them to intensify efforts to halt the spread of this crippling disease, inclusive of better screening of everyone travelling abroad from both states.

In Pakistan the reasons for failure to achieve polio eradication also show the importance of non-health sector issues such as access in war and conflict zones; especially the Federally Administered Tribal Area (FATA), refusal of parents to vaccinate their children and problems with cross-border movement of nomadic populations from Afghanistan pouring in through due to the extremely porous nature of the border.

Apart from these obvious reasons there are other factors which continue to disrupt all campaigns of eradicating polio by the government and the civil society. “Talibanisation” and misinterpretation of religion by the madrassas, which are multiplying at an alarming rate, has led more than 90 percent of the clergy in not only the conflict-ridden zones but urban cities as well to campaign against polio vaccination on a wide scale, causing parents to refuse vaccination for their children on the mistaken grounds that it is haram (forbidden by the religion). With the spreading wave of “Talibanisation” outside Pakistan’s specially administered areas and the indoctrination of these beliefs among illiterate populations, this unfortunate notion is likely to spread across the country. While socio economic problems threaten the country in many ways, they also pose a challenge for global health and jeopardise worldwide efforts aimed at eradicating polio.

The porous nature of the border gives militants opportunity to find sanctuaries in the region where there is little government control. This further makes it extremely easy for the refugees and citizens of both states to move back and forth making it difficult to keep a check on people who have contracted polio moving transversely. The question which can be raised here is whether Pakistan can, being a sovereign state, legally fence its border without Afghanistan’s consent – in order to comply with international laws and regulations regarding terrorism, insurgency and in this case health care.

In 2006 America unilaterally started constructed a fence on the US-Mexico border that been made lawful under the Secure Fence Act 2006. This act has been deemed lawful under international law since US, being a sovereign state, is entitled to protect its territory, integrity and national security through the implementation of immigration policy.

Other than unilaterally fencing its borders, Pakistan needs to take additional steps which should be enforced immediately in order to meet the requirements of the World Health Organisation and the growing concerns of the Secretary General of the United Nations

Similarly Hungary, in consequence of the influx of illegal immigrants and asylum seekers pouring in from war-torn regions of the Middle East and North Africa, is considering the possibility of deploying armed forces on the border along with fencing it. Hungary is already in the process of erecting a razor-wire fence by the end of this month on its Serbian border, with a second, taller fence planned to be built behind it by the end of November in order to control the movement on the border.

Likewise, Pakistan can thus unilaterally fence its border with Afghanistan due to its pressing national security imperatives and in furtherance of not only the fulfilment of its international legal obligations to effectively counter terrorism but also to meet the requirements of eradicating polio from its territory.

Other than unilaterally fencing its borders, Pakistan needs to take additional steps which should be enforced immediately in order to meet the requirements of the World Health Organisation and the growing concerns of the Secretary General of the United Nations. Weakness in other government services, apart from health, has also affected polio control efforts. In addition, the government should commit to providing maximum resources to ensure a seamless supply chain that includes airlifting of vaccines, access to areas on horseback and possible imposition of a military curfew for the duration of the campaign. The most essential measure is to create awareness in the general public to combat this deadly disease. Polio further violates the inherent right to life which has been protected by various International Human Rights Law Treaties along with the Constitution of Pakistan, which lays a responsibility on the government to take appropriate measures in order to eradicate this disease.