Help Pakistan walk polio-free

What brings India and Pakistan together? The usual stuff, of course — colonial legacy, cricket, Track II diplomacy, peaceniks, shared love of Bollywood and tandoori chicken. Add to that, quirks of nature as during the “great onion crisis” of 2010 when heavy rains devastated India’s onion crop, leading to a sharp spurt in prices and heartburn across the country. Pakistan stepped up to the plate — lorries laden with onions were ferried across the Wagah border, restoring calm to our cooking pots.

Now, it is the turn of microbes to act as peacemaker in our troubled neighbourhood. India is off the World Health Organisation’s list of polio-endemic countries. The last polio case from India was reported on January 13, 2011, while Pakistan battles on. The two wary neighbours know all too well that microbes respect no borders, and that they need each other to quell the common enemy — polio, a highly contagious viral infection that can lead to paralysis, breathing problems, or even death.
Last week there was public acknowledgement of that mutual need before a gathering of Indian and international delegates at Delhi’s Vigyan Bhavan. Polio diplomacy flickered when the official spokesperson of the ministry of external affairs tweeted “WHO’s map of polio cases during last year” — a reference to a map in a WHO official’s presentation about polio cases in the last 12 months worldwide. India was on the clear.
At the Polio Summit 2012, organised by the ministry of health and family welfare and Rotary International, Pakistan’s minister for inter-provincial coordination, Mir Hazar Khan Bijarani, lauded India for doing a “marvellous job by bringing the number of polio cases to zero during the last one year”, and sought India’s help.
Mr Bijarani said Pakistan would like to learn from India’s experiences in raising its routine immunisation coverage which is the backbone not only of polio eradication but also elimination of measles and neo-natal tetanus, the other killers. “It is a matter of serious concern for us that despite our best efforts, the number of polio cases in Pakistan has been going up for the last three years,” he added.
Pakistan is not the only country wanting to know how India has tackled resistance to polio vaccination and all the other challenges on the ground. Afghanistan and Nigeria, the other two polio-endemic countries, also want to learn from India’s experience. Worldwide, obstacles to polio eradication have a lot to do with politics. India has had to deal with the politics of fear and conspiracy theories in its efforts to eradicate polio. It was not easy, but through trial and error, India learnt how to deal with these roadblocks. And now it is ready and willing to extend all possible support needed for global elimination of polio, especially in its neighbourhood — Afghanistan and Pakistan, as well as Nigeria.
Celebrations are in order. As recently as 2009, India reported almost half the world’s polio cases — 741, out of the global total of 1,604. Many health experts were convinced that India would be the last country to eradicate polio. In 2012, amid all the bad news that we were inundated with, there was a shining sliver of hope. India had passed one full year without recording any cases of polio. But it is necessary to strike a cautionary note. We need to maintain our record for two more years before we are definitively “polio free”.
Polio virus can travel easily to polio-free areas. Virus of Indian origin reportedly travelled to far-flung countries in Africa. But in this age of migration, the polio virus can also come back through the same routes, and therefore the vital need is not to drop one’s guard.
A host of agencies, both national and international, have put in humongous efforts into making India polio-free. A whole range of scientific, administrative and socio-cultural innovations were put in place to deal with the last mile. Now there is an acute need to sustain the momentum of vaccinating every child by stepping up routine immunisation and to guard our borders.
How can India continue to inspire the remaining polio-endemic countries? In this country, routine immunisation must be improved drastically — a healthier child can fight the polio or any other virus far better. We need the science, the technology, the vaccines, the army of volunteers, the resources to give the final blow to polio in this region and worldwide. But we also must make sure that we tackle politics as well.
At the Polio Summit, there were fascinating insights into some of the things that have helped. Agencies like Unicef and Rotary came together to mobilise the Muslim clergy in a big way in districts where the polio vaccine was viewed with great suspicion. Maulana Khalid Rasheed Faringimahli, president of the Ulema Council of India, described how Muslim doctors, academics and Islamic scholars joined the fight. They came to polio immunisation booths with their own children, gave them polio drops, and told the people that even sick children should be vaccinated against polio. These gestures went a long way in making sure that all the other strategies worked. The number of polio cases dropped 30 per cent in the first three months of 2008 alone. Convincing all sections of society, especially community leaders, is the only way forward.
To return to Pakistan. Last year there were 198 confirmed polio cases in Pakistan. This year, the number has already reached 11. Mr Bijarani said that Pakistan’s “fight against terror” had made a number of areas in Khyber Pakhtunkhwa and Balochistan provinces bordering Afghanistan highly volatile and that it was not possible for health workers and vaccinators to reach all children. He also said that a large influx of people from these troubled areas as well as routine seasonal migration from one region of the country to another created easy opportunities for the polio virus to travel to new areas.
One can point out that Pakistan is not the world’s only strife-torn country. Many others living with conflict have managed to get rid of polio. Sri Lanka, for example, has been polio-free since 1993. But irrespective of what one thinks of Pakistan’s disheartening record, we cannot afford to not pay attention to what is happening there. Our common border ensures Pakistan’s polio problem is not just its own. Some measures are being taken — children on cross-border trains and border posts are being vaccinated. The need for extreme alertness is highlighted by the fact that polio has recently spread from Pakistan to China’s Xinjiang province — the first confirmed cases in China since 1999, according to WHO.

The writer focuses on development issues in India and emerging economies. She can be reached at patralekha.chatterjee@gmail.com