Wednesday, May 27, 2020

The plight of Pakistani children — poliovirus


Forgive me for shedding light on Poliovirus in the midst of novel coronavirus but when I heard of the first positive case of coronavirus in Pakistan, I was shaken to my core and for the right reasons. Pakistan is a country which has until now, lost its battle against Poliovirus. As long as there is even one child who contracted Poliovirus, the battle is considered lost. The reason is simple: children are precious to Pakistan, they’re the future and as long as they’re under the threat of this crippling virus so is Pakistan’s future.
It must be emphasised that the fight against COVID-19 is important and the entire world is combating it but we have more battles to fight because we have failed to fight and we have those to protect whom we have failed to protect and while the developed nations of this world are fighting against COVID-19 with their full might, Pakistan can’t do the same. Pakistan needs policies and initiatives to protect its vulnerable children and to safeguard their lives. Pakistan must not win the battle against coronavirus only to lose the battle against Poliovirus, a battle which this nation was on the verge of winning. Pakistan must beat both the viruses.
The UNICEF report of May 2020 states, ‘the COVID-19 crisis is a child rights crisis. We need an immediate, medium and long-term response that not only addresses the challenges created by the pandemic and its secondary impacts on children, but also outline a clear version for building back a better world when the crisis finally recedes…It is our shared responsibility today, to reimagine what the world will look like tomorrow’.
Polio, the deadly viral disease, was very close to being eradicated states UNICEF, but that was before the outbreak of novel coronavirus struck the world.
According to the World Health Organisation (WHO), Pakistan is one of only 2 remaining countries in the world with ongoing wild poliovirus transmission, Afghanistan being the other.
Nevertheless, my heart sank when I read a statement by Polio Oversight Board on the 2nd of April 2020 that the countries planning to conduct poliovirus preventative campaigns postpone these campaigns until the 1st of June 2020, they further stated, ‘we take this decision with deep regret, knowing more children may be paralyzed by polio as a result.’
If proper measures are not taken, poliovirus cases will surge, just like the novel coronavirus which went from 1 positive case to thousands in a span of weeks. Pakistan has to make efforts to nip the surge in the bud, before the cases increase to a significant extent.
History has evidence, in 2014, the number of poliovirus cases stood at 306 which dropped to 8 in 2017, and 12 in 2018. However, in 2019 there was a significant spread of the virus and 144 polio cases were reported across all provinces of Pakistan, as reported by the WHO. Currently (2020), the total number of poliovirus cases stand at 93 according to the Pakistan Polio Eradication Programme.
As long as the virus continues to circulate in Pakistan, no child in Pakistan is completely safe from contracting the poliovirus. This is why it is the shared responsibility of all Pakistanis to ensure that all vulnerable children under the age of five are vaccinated against this deadly disease, states UNICEF.
The latest update of May 2020 on Polio Eradication Programme Continuity: implementation in the context of the COVID-19 by Polio Global Eradication Initiative (GPEI) states that, ‘it is imperative for the polio eradication teams at the country, regional and global levels to build and implement robust systems for context and programme monitoring, and to adapt the eradication service delivery strategies to effectively mitigate the polio transmission risks…’
The children of Pakistan can not be ignored and hence allowed to be collateral damage in the war against novel coronavirus, Pakistan needs victory against both viruses or else, its economy will recover only to plummet again as a consequence of an increase in the number of poliovirus cases and that cannot be allowed. Poliovirus should not be completely ignored or the consequences will be wide ranging and severe.
Polio, the deadly viral disease, was very close to being eradicated states UNICEF, but that was before the outbreak of novel coronavirus struck the world
According to the National Emergency Action Plan For Polio Eradication (NEAP) 2020, after the increase in poliovirus cases in 2019, President Dr. Arif Alvi and Prime Minister Imran Khan personally took stock of the situation and the country decided that the programme shall be forthcoming on what’s not working, boldly address the underlying challenges, invest in people and systems, and rise above all affiliations, including political ones, to unite against this deadly virus.
The President and the Prime Minister should stay true to their intention and bowl out polio from Pakistan once and for all. The government needs to implement the guidelines on polio eradication programme in the context of the COVID-19 as stated in latest update of May 2020 on polio eradication programme continuity which rests the final decision on altering the implementation of polio eradication in the interim period of COVID-19 pandemic with the national authorities and includes, observing the principles of “duty of care” and “do no harm” to frontline workers and ensuring adequate residual capacity to manage, implement and regularly review the polio eradication programme’s continuity plan. This should include the capacity to effectively coordinate and oversee polio eradication activities included in the continuity plan.
The guidelines further state mobilising the government, healthcare providers and communities to develop flexible and safe polio eradication programme delivery strategies, aligned with broader immunization services tailored to the local COVID-19 epidemic situation and capacities.
Furthermore, all the polio personnel should be provided with the necessary briefing on adjustment of their roles in the context of COVID-19 outbreak. They should receive training, materials, protective equipment, and logistical support to ensure safe and effective delivery of their duties.
Certain measures need to be taken, which include, physical distancing, hand hygiene, respiratory etiquette, ensuring only the physical proximity that is essential/unavoidable for delivering vaccine or specimen collection and handling.
Face masks, gloves, eye protection equipment and other gear appropriate to avoid the risks of COVID-19 need to be supplied. Hand hygiene supplies: e.g. hand sanitizers need to be distributed to the teams interacting with populations, soap should be distributed if access to water is guaranteed.
UNICEF reports that Pakistan is one of the South Asian countries with the highest expected numbers of births in the nine months since the COVID-19 pandemic declaration, which is 5 million. Pakistan needs to implement initiatives to safe its precious children from the Poliovirus.
The government needs to act in line with the guidelines as soon as the 1st of June 2020 and no later than that since according to the guidelines, delay of polio immunization campaigns will likely result in an increased geographic spread of the virus and an increase in the number of children paralyzed by wild and circulating vaccine-derived polioviruses. While the Chief Justice of Pakistan is busy taking suo moto actions on opening of markets on Saturday and Sunday in Pakistan, he needs to pay attention on poliovirus. My deepest sympathies remain with the patients and families of those affected by the novel coronavirus but my sympathies also remain with those affected by the Poliovirus.

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