Taliban stance on polio threatens children worldwide

http://centralasiaonline.com/

By Ashfaq Yusufzai

The Tehreek-e-Taliban Pakistan's staunch opposition to the vaccine is a roadblock to eradication of the disease.

Tehreek-e-Taliban Pakistan (TTP) opposition to polio vaccination endangers children in Pakistan and around the world, officials say. "The Taliban are proving to be bitter enemies of children, on whom our future hinges," Rafiq ul Haq, a vaccinator in Khyber Agency, told Central Asia Online. Only a few weeks into the new year, Pakistan has registered four polio cases in North Waziristan. The newly infected children live in Taliban-controlled areas and did not receive vaccine, officials said. The problem exists because militants have threatened vaccinators or forced them to leave the areas they control and also have run anti-vaccine propaganda to misguide parents.

Spreading the disease

The Taliban's hard-line opposition to the vaccine is preventing global polio eradication, Muhammad Saleem, an official at the Expanded Programme on Immunisation (EPI) in Mir Ali Tehsil, North Waziristan, said, noting that the thousands of unvaccinated children could transmit the virus to other parts of the country and foreign countries.

In fact, Peshawar, a city adjoining the tribal areas, has become the world's largest polio virus reservoir, the World Health Organisation (WHO) says.

"Not only has the Taliban's [intimidation] crippled more children, but they are responsible for transmitting the virus," Dr. Kamran Shah, an official at the directorate of health for Federally Administered Tribal Areas (FATA), said. To illustrate how the disease's prevalence in one area can make trouble elsewhere, he observed that, in 2013, more than two dozen polio cases detected in Syria and Egypt originated in Pakistan.

In 2013, FATA had 65 cases (35 in Waziristan alone), followed by 10 from Khyber Pakhtunkhwa, nine in Sindh and seven in Punjab.

Seven of the nine children who tested positive in Sindh matched the FATA virus, according to reports from the National Institute of Health Islamabad. "Genetic sequencing of the virus detected in seven children in Frontier Region Bannu showed a resemblance to the virus of North Waziristan," Kamran said.

Crippling their own children

Children in Taliban-controlled areas are vulnerable to falling ill because their parents failed to have them vaccinated, Kamran said.

"We have to vaccinate all target children in FATA to be able to eradicate the disease," he said. The TTP's stance against polio has wrought suffering not only among innocent families but among its members' children too.

"The Taliban's own children are among the infected lot," Saleem said. "We have not tested them, but the signs and symptoms we observed resembled those of polio-affected children."

Vaccination hasn't taken place in North Waziristan for 19 months, he said, noting that he examined two children in Sara Melowa, a village and Taliban hub in North Waziristan, suffering from what appeared to be polio.

"We asked the local clerics in Waziristan to encourage the Taliban to allow vaccination, but indications are that the requests will fall on deaf ears," Juma Khan, a Waziristan-based malik, told Central Asia Online. "Now our main concern is the safety of children who live in areas controlled by the Taliban because they face real risk."

The adamant stance taken by the Taliban against vaccination is utterly reprehensible, Kamran said.

"They don't care about their own children, so how can we expect them to care about other children?" he asked.

Thwarting eradication

The Pakistani Taliban are a serious threat to the country's plan to eradicate polio in 2014.

"Pakistan's plan to eradicate polio will remain a distant dream as long as the Taliban's [intimidation] continues," Kamran said.

FATA has been a stumbling block in the way of global efforts to eliminate polio from Pakistan, one of only three countries where polio remains endemic.

In 2013, Pakistani authorities registered more than 100,000 children whose parents refused vaccination under the misconception that vaccine was formulated to render its recipients sterile. Health workers could not reach another 600,000 children because of security concerns.

"We are able to vaccinate 35m children countrywide, but the unvaccinated children are the real threat to the eradication effort," Dr. Noor Shah of the WHO said. "As long as the virus remains in one child, we have to administer [oral polio vaccine] to all children."