175,000 children missed out on anti-polio campaign, at risk of disability

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-CM Murad makes polio vaccine mandatory in all schools, orders action against refusal
-Anti-polio immunity missed by 175,000 out of 7.3m children

KARACHI: Sindh Chief Minister (CM) Syed Murad Ali Shah has said that Sindh reported one polio case in Karachi in 2018 which is a historical low for the province and no case has been reported this year yet all six districts of the city are still classified as `districts of high risk’ so strict measures would have to be taken to bring the menace at zero.

This he said on Thursday while presiding over a meeting of provincial Task Force for Polio Eradication here at the CM House. The meeting was attended by Provincial Health Minister Dr Azra Pechuho, Chief Secretary Mumtaz Shah, Principal Secretary to CM Sajid Jamal Abro, provincial secretaries, Education, Finance, Health, Local government, Divisional Commissioners, Secretary Abdul Wahab Soomro CEO of PPHI, Provincial Coordinator Shahnaz Wazir Ali, Aziz Memon of Rotary, representatives of federal government, UNAID, Unicef, WHO, Bill & Miranda Gates and other concerned.

CM Murad declared polio vaccination mandatory in all public and private schools, adding that the schools which dare to refuse immunity against polio would be liable to strict actions.

The CM was told that globally, Pakistan and Afghanistan were the only remaining countries with polio. In 2019 to this date, Pakistan has one polio case from Bajour while one case has been reported from Afghanistan. In 2018, Pakistan reported 12 cases including six in Khyber Tribal District (KTD), two in Khyber Pakhtunkhwa (KP), three in Balochistan, one in Sindh and one in Punjab.

In Sindh all six districts of Karachi are still classified as `Tier 1’ core reservoir, that is the district of high risk. The chief minister said that it was something to be worried of but “we would take drastic measures with proper planning and focus,” he said.

It was pointed out that in 2019 no polio case has been reported from Sindh, last year one polio-case was reported from Karachi, the Gadap area. The virus has been isolated from environmental sites (taken from sewage system) which indicated on-going virus transmission.

The chief minister was told that in Karachi samples were taken from 11 sites every month. In January Gadap all three sites, Sohrab Goth, Khamiso Goth, Machhar Colony, Baldia, SITE and Saddar town declared positive. In rural areas of Sindh, samples were taken from six sites, results of three received out of which one from Sukkur declared positive.

Assessment: The chief minister was told that the epidemiological situation in Karachi deteriorating as the virus from six sites became positive and negative from four and one was pending in Karachi.

The campaign quality has further improved, eradication levels are still not consistently achieved because of a high number of missed children due to refusals.

Mr Shah said that after the outbreak in three districts of lower Sindh – Badin, Thatta, Sujawal, between September to December 2016, were provided with significant human resources, monitoring and supervision system which resulted in subsequent improvement in performance quality. This improvement has been sustained. In Northern Sindh, all polio eradication activities were well managed. Similarly, we have to work hard in Karachi and make it sustainable, the chief minister said.

It was noted that routine immunisation needs to be intensified further because it still leaves too many young children without immunity against polio. Large efforts have been made together with the EPI programme to improve the situation, progress remains to be guarded. Pre-campaign activities of large-scale measles campaign are being jointly conducted in the entire province by EOC and EPI.

Giving a presentation to Sindh Chief Minister, Provincial Coordinator EOC Umer Farooque Bullo said that post Campaign Monitoring (PCM) has revealed that 96 per cent children have been vaccinated from September 2018 to Jan 2019. He disclosed that in January 2019 88472 children were not at home while 86863 children refused to take the vaccine.

At this, the chief minister expressed displeasure and said that out of 7.3 million children, 175,00 were at risk of developing a disability due to refusals and not being present at home.

He directed the chief secretary to take drastic measures so that nobody could dare to refused to immunize his child. “This is a jihad for saving our future generation and our people and even schools refused to immunize their children,” he surprised.

The World Bank representatives appreciated the performance of the Sindh government saying that the chief minister was holding regular meetings, therefore the divisional and district administration was taking an effective part in the campaign. This has made a great difference and today no case has been reported.

The chief minister said that continuous positive environmental samples and community resistance to polio vaccine (refusal) were big challenges. He directed IG Police to provide adequate security to the polio teams moving from one place to another for vaccination.