The meeting of International Monitoring Board on Polio that concluded on Thursday at London highly appreciated the progress made by Pakistan during last low season and was especially impressed by program capacity to pre-empt risks, identify and address gaps on real time basis.
The commitment from Prime Minister Nawaz Sharif and the critical role of Security forces to provide space for health was also acknowledged.
The board showed full confidence in strategies outlined in National Emergency Action Plan to interrupt virus transmission during 2016. To make it happen, besides maintaining quality all across, we will need to focus on Karachi, North Sindh, high risk mobile populations especially on Pak Afghan border.
IMB also urged GPEI and donors to fully support Government of Pakistan in outstanding work for children of the world. Emphasised that resource constraints must not be an obstacle to the great work in progress.
The Board observed that there is no resource gap at the moment but all aggressive approaches outlined in the Plan would be supported through additional Grant assistance. IMB thought it appropriate to advise potential donors on this.
Minister for National Health Services Saira Afzal Tarar, Senator Ayesha Raza Farooq, Prime Minister’s spokesperson on Polio Eradication and Secretary, Ministry of National Health Services Muhammad Ayub Sheikh represented Pakistan in the crucial meeting alongwith National Coordinator of National Emergency Operation Centre Dr Rana Muhammad Safdar and Provincial Secretaries of Health.
The Minister for National Health Services Saira Afzal Tarar said the program had travelled great distance over the past eighteen months to overhaul programme performance management and accountability systems and structures as well as personnel. Our core strategy as elaborated in the National Emergency Action n Plan for Polio, is to root out the virus in the reservoirs, detect and react aggressively to outbreaks and to maintain population immunity levels elsewhere in the country.
Change has been transformational and incremental. In no area of the programme have gains not been made and in no instance have gains been made which have not been sustained, the Minister said.
She said we are satisfied with the turnaround and rapid progress but recognises that polio interruption and eradication is a zero sum game and we are not yet at zero.
The Minister said inaccessible children have been reduced to negligible levels. All of our security forces have contributed to provision of the safe and secure environment within which vaccination teams work. We recognize that success on the doorstep between a vaccinator and caregiver leading to successful, repeated vaccination is the key to sustaining our performance. An increased proportion of local, female staff and supervisors, improved retention, enhanced training and more timely payment are each contributing to a better capacitated and motivated workforce, the Minister said.
Speaking on the occasion, Prime Ministers’ Focal Person on Polio Eradication said between July 2015 and June 2016, the programme made further steady progress towards the interruption of poliovirus transmission in Pakistan. The major paradigm-shift from “coverage” to the “missed children” has driven the program operations in all provinces with very encouraging results.
She said our programme strengthened and expanded a number of key innovations over the past year. Most notably, the programme implemented a community-based vaccination initiative that has provided the programme with a real edge when it comes to delivering high quality vaccinations in the core reservoir zones. Although initiated as a complementary strategy, it is now the foundation upon which all programme operations in these zones are built with more than 11,000 staff tracking and vaccinating 2.3 million children.
The programme performance has been sustainably transformed with no inaccessible children, and the number of still missed children steadily reduced through a combination of updated micro-census and extended and persistent catch-up, she said.
She said the complementary strategy for vaccinating high risk mobile populations was revitalised with a new focus on vaccinating children in transit during SIAs, systematic mapping of mobile populations, rationalising the number and positioning of Permanent Transit Points and improving performance at the Afghanistan – Pakistan border. Between December 2015 and May 2016, over three million missed children were vaccinated and the numbers vaccinated have grown by over 25% since January. Over 22 million children were vaccinated at Permanent Transit Points during the past year.
She said the number of confirmed wild poliovirus cases in Pakistan continued to decline in 2016, environmental surveillance data mirrored a similar story and a deeper analysis of genetic variations of viruses has shown that for the first time ever, poliovirus genetic diversity fell during 2015. The number of clusters identified has reduced to four.
Secretary Ministry of National Health Services said The five strategic objectives of the programme elaborated in the National Emergency Action Plan include the primary targets for each of the three core areas of work that is programme operations, risk assessment and decision support and management oversight and accountability. This management piece crystallizes the scale and scope of the direct governmental contribution to ensure the programme stays on track and takes the necessary corrective action.