“Three workers in a polio eradication campaign were shot in Pakistan on Wednesday, and two of them were killed, the latest in an unprecedented string of attacks over the past three days that has partially halted the U.N.-backed campaign,” Reuters reports (Ahmad, 12/19). “Earlier on Tuesday, five health workers involved in the vaccination drive were killed in the cities of Karachi and Peshawar,” News Pakistan notes (12/19). Another health care worker was killed on Monday, according to a statement issued Tuesday by the WHO, UNICEF and the Pakistani and provincial governments, which condemned the multiple attacks. “We call on the leaders of the affected communities and everyone concerned to do their utmost to protect health workers and create a secure environment so that we can meet the health needs of the children of Pakistan,” the statement said (12/18). The Associated Press reports the WHO suspended the vaccination campaign in two of the country’s provinces (Khan, 12/19). However, CNN reports the “attacks prompted authorities to suspend the campaign throughout the country” (Khan, 12/19). “Under the canceled program, Pakistani health officials planned to administer millions of ‘polio drops’ to immunize people,” according to International Business Times, which adds, “The program involved 25,000 workers targeting more than 30 million children” (Ghosh, 12/18).
“Gunmen killed five Pakistani women working on a [three-day] U.N.-backed polio vaccination campaign in two different cities on Tuesday, officials said,” the Associated Press reports, adding, “The attacks were likely an attempt by the Taliban to counter an initiative the militant group has opposed.” According to the news agency, “The attacks came a day after an unknown gunman killed a male volunteer for the World Health Organization’s anti-polio campaign in Pakistan’s largest city, Karachi” (Jawad, 12/18). “In Karachi, provincial Health Minister Saghir Ahmed said the government had told 24,000 polio workers it was suspending the anti-polio drive in the province,” Reuters reports. “Some Islamists and Muslim preachers say the polio vaccine is a Western plot to sterilize Muslims,” while “[o]ther religious leaders have taken part in campaigns aimed at debunking that myth,” the news agency notes, adding, “There have been at least three other shootings involving polio eradication workers this year” (Shah et al., 12/18).
The Center for Strategic & International Studies (CSIS) has published a paper (.pdf), titled “The U.S. Role In Global Polio Eradication,” that “provides an overview of the global polio eradication effort, emphasizing the U.S. role,” according to the paper’s summary. The paper, authored by CSIS Global Health Policy Center Fellow Nellie Bristol, aims “to explain how the Global Polio Eradication Initiative (GPEI) came to where it is today and discuss plans for moving it forward.” The summary continues, “The focus on the United States is not meant to detract from the enormous international investments or essential contributions of individuals from other countries. But by highlighting American involvement, the paper aims to help U.S. policymakers understand the costs, benefits, and challenges of polio eradication and plans to complete eradication and transition GPEI methods and resources into other programs” (12/17).
Strengthen Health Systems To Integrate Polio Vaccinations Into Routine Childhood Immunizations, Save The Children Report Says
Speaking at the GAVI Partners Forum in Dar es Salaam, Tanzania, David Olayemi, senior program adviser at Save the Children in Abuja, Nigeria, said fewer than half of children in Nigeria are receiving routine immunizations for diseases such as diphtheria, tetanus, and whooping cough (DTP), and the rate is dropping, Guardian health editor Sarah Boseley reports in her “Global Health Blog.” Launching a Save the Children report that “calls on GAVI to step up efforts to reach the last 20 percent of children across the developing world who are not getting routine immunization,” Olayemi said part of the reason for the lack of coverage are large efforts to vaccinate children against polio, which offer incentives to health care workers to leave clinics to go into the field, leaving no one to perform routine immunizations, the blog notes.
Though “Pakistan has made a lot of progress this year in wiping out polio,” a “recent outbreak of polio there has health officials concerned about the overall effectiveness of the effort to eliminate polio in that country,” NPR’s “Shots” blog reports. According to the WHO, “10 cases of so-called vaccine-derived polio were reported in Pakistan between the end of August and the end of October,” the blog notes, adding this is the first time vaccine-derived polio has been detected in the country and it is a sign of gaps in immunization coverage. “WHO officials say the outbreak, involving a variety of the virus called type 2 polio, illustrates that vaccination campaigns in the area are failing to reach sufficient numbers of people,” the blog writes. “The government of Pakistan launched an aggressive campaign this year, in partnership with international health organizations, to vaccinate children and carefully monitor the virus’s spread,” according to “Shots” (Beaubien, 12/4).
In a post on the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, Christopher Elias, president of global development at the foundation, discusses progress on “the Decade of Vaccines, a vision and commitment to reach all people with the vaccines they need.” He says “the Global Vaccine Action Plan, a roadmap for saving more than 20 million lives by 2020,” as well as the GAVI Alliance, UNICEF, WHO, health experts, dedicated vaccinators and many others,” are helping “vaccines [reach] more children, in more places, than ever before.” According to Elias, the Gates Foundation is “co-hosting a vaccine summit in Abu Dhabi in April” during World Immunization Week. He notes, “We’re holding the summit in Abu Dhabi to recognize that Middle Eastern and Islamic countries are emerging as leaders in efforts to immunize children against polio and other diseases” (12/2).
Nigeria’s Kano State, Dangote Group, Gates Foundation Sign Memorandum Of Understanding To Fight Polio
Nigeria’s Kano State government, the Dangote Group, and the Bill & Melinda Gates Foundation on Monday signed a multi-year memorandum of understanding “geared towards the eradication of polio in Kano State,” Actualite Afrique reports. According to the news service, a statement from the Gates Foundation said the public-private partnership aims to “improve routine immunization and primary health care in Kano State with a goal of reaching 80 percent coverage with basic vaccines by 2015” (11/27). Under the partnership, the organizations “would provide funding, equipment and technical support to the Kano State government to strengthen polio immunization,” Agence France-Presse writes (11/26).
Global Polio Eradication Initiative IMB Report Optimistic But Warns Of Possible Polio Resurgence In 2013
Though there is “significant risk” of a resurgence of polio in 2013, a new report (.pdf) from the Independent Monitoring Board (IMB) of the Global Polio Eradication Initiative (GPEI) is optimistic about the eradication of the disease, noting that 99.9 percent of polio has been stopped worldwide, with 175 cases reported so far in 2012 compared with 350,000 reported in 1988, BBC News reports. Though the IMB’s “target of stopping global polio transmission by the end of the year will clearly not be achieved,” only four countries — Afghanistan, Nigeria, Pakistan, and Chad â€“ reported cases in 2012 and India was declared polio-free in January, marking a milestone taking it off the list of endemic countries, BBC notes.
A “key problem” in reaching the goal of polio elimination “may well be that organizers of the global anti-polio initiative, and of other global health programs, are not listening to the people they want to help — or to each other,” Thomas Abraham, an associate professor in the Journalism and Media Studies Center at the University of Hong Kong, writes in a New York Times opinion piece. “As a result, in many communities targeted by [polio immunization] programs, people perceive a gulf between global programs like polio eradication and more immediate local health needs,” he continues, adding, “It is cold comfort to save a child from polio if the child later succumbs to malaria or diarrhea from dirty drinking water.”
The Washington Post reports on polio eradication efforts in Pakistan, writing, “[O]verall trends in Pakistan, where nearly 30 million children have been vaccinated in recent years, are encouraging.” The newspaper writes, “Last year’s cases numbered 198 nationwide,” adding, “This year’s tally is 54.” However, “the intractability of other social ills, including insurgency, poverty, illiteracy and inadequate sanitation, have conspired to ensure that the country remains years away from meeting its goal of polio eradication by the dawn of 2013,” the newspaper notes. The Washington Post discusses a number of challenges to vaccination efforts, such as a Taliban ban on vaccinations and fear among some parents that “the drops contain religiously proscribed (‘non-halal’) ingredients or are part of a Western plot to spread infertility and limit Muslim population growth.” The newspaper adds, “One key to reducing outbreaks, U.N. health workers say, is to educate parents” (Leiby, 11/16).