Author: Sajjad Ahmad did his Master in public health (MSPH) from SZABIST, Karachi. Currently enrolled as an MScN scholar at Aga khan university hospital, School of Nursing and Midwifery, Karachi. He did his BSN from Dow University of Health Sciences, Karachi. Having almost 5 years of experience in teaching at different nursing institutions in Karachi.
Poliomyelitis, also known as Polio is an infectious disease that affects the nervous system of the human body that is caused by a virus called Poliovirus and is transmitted through the fecal-oral route from one person to another.(Ahmad et al., 2021). Polio has been an epidemic before the campaign Global Polio Eradication Initiative (GPEI) back in 1988 and it caused the death of thousands of individuals around the globe before the vaccine.(Hussain et al., 2016). To date, the polio virus has been eradicated 99% of the world however Pakistan, Nigeria, and Afghanistan were still under the attack of the polio virus despite the different campaigns by the government to vaccinate children under 5 years.(Ahmad et al., 2021). Immunization is considered the highly effective and primary method to encounter the disease to reduce the incidence and death rates. Immunization has been observed as a highly effective process to reduce the rate of disease under 5 years of age. (Basharat & Shaikh, 2017). Pakistan was observed as highly at risk in 2014 as the cases of polio were at their peak, immunization played a vital role to control the cases and decreased the number of cases from 306 in 20 to 54 and 20 in 2015, and 16 respectively. (Waheed, 2018). There have been multiple factors and barriers to the persistence of polio cases in Pakistan including awareness, political instability, and weak policies of the government in this regard. The argument “Government should prefer the awareness rather than enforced vaccination” is been discussed in the paper.
Many parents choose not to protect their children from this deadly disease with vaccinations. due to cultural and religious beliefs and some are afraid of the side effects that have been wrongly portrayed to them. The parents deny and respond ridiculously to the teams. 3000 parents who refused were found only from Sindh province in 2017. (Waheed, 2018). Many misconceptions about the polio vaccine have been rumored and fixed in the mind of the public belonging to areas with low literacy rates; areas with problems of accessibility; and some religious rumors that the vaccine contains pig fat, infertility-causing agents, etc. (Basharat & Shaikh, 2017).
Secondly, security issues have been one of the challenges in the execution of Polio vaccination in Pakistan. There has been a very big gap in the policymaking and implementation of the polio vaccine campaign. Corruption in the system and policy-making areas is a factor in the declination of the public’s trust. (Basharat & Shaikh, 2017). The Gross National Product (GNP) budget allocated for health is 2% which is insufficient for the execution of the system of care in the remote areas of the country. (Hussain et al., 2016). Some conspiracy theories that were developed in militant aspects also impacted the campaign as Osama Bin Laden’s death was a mystery. It was hypothesized that underground activities were executed in the Abbottabad area: Dr. Shakil Afridi (who led the underground activity). The spy was acting as Polio workers in the areas to get geographical closure to bin Laden. (Andrade & Hussain, 2018).
On the other hand, Pakistan had improved somehow in polio statistics. The increase in security for the vaccination teams has made an impact on the increase in vaccination and the decline in polio cases i.e. over 80% of eradication in cases was seen in 2015. The numbers dropped to 40 in 2015 from 306 in 2014 in FATA.(Hussain et al., 2016). The issue of religious aspects has also been addressed gradually. Different religious institutions issued a “Fatwa” in favor of Polio vaccination. Such as Al Azhar University, Grand Mufti of Saudi Arabia, Darul Uloom Deoband in India, and Ulama Council in Pakistan have shown a positive approach and issued fatwas to the public to eradicate the misconceptions. Saudi Arabia has made it compulsory for all immigrants to be immunized against Polio Virus.
Conclusion
Finally, these arguments reveal that the misconceptions and propaganda regarding the Polio Vaccine campaign are not a challenging task. The government of Pakistan can eliminate the Polio virus and can address the above-mentioned challenges but it requires a multifaceted approach; including the awareness and education of the community about the Pros and Cons of Polio Vaccination. The government should engage the community representative i.e. politicians, Scholars, teachers, and social workers in this regard. The Government needs to address the challenging part of the system by improving the infrastructure and firming the health care system and ensuring the safety and security of the Polio workers. These challenges may take time but are possible to achieve.
References
Ahmad, S., Babar, M. S., Ahmadi, A., Essar, M. Y., Khawaja, U. A., & Iii, D. E. L. (2021). Perspective Piece Polio Amidst COVID-19 in Pakistan : What are the Efforts Being Made and Challenges at Hand ? 104(2), 446–448. https://doi.org/10.4269/ajtmh.20-1438
Andrade, G. E., & Hussain, A. (2018). Polio in Pakistan : Political, Sociological, and Epidemiological Factors. 10(10). https://doi.org/10.7759/cureus.3502
Basharat, S., & Shaikh, B. T. (2017). Polio immunization in Pakistan : ethical issues and challenges. Public Health Reviews, 1–6. https://doi.org/10.1186/s40985-017-0049-4
Hussain, S. F., Boyle, P., Patel, P., & Sullivan, R. (2016). Eradicating polio in Pakistan : an analysis of the challenges and solutions to this security and health issue. Globalization and Health, 1–9. https://doi.org/10.1186/s12992-016-0195-3
Waheed, Y. (2018). Polio eradication challenges in Pakistan. Clinical Microbiology and Infection, 24(1), 6–7. https://doi.org/10.1016/j.cmi.2017.09.008
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