February 6th, 2021 

Bureau Report 


The Independent Monitoring Board (IMB) has noted that Lahore has become the epicenter of polio transmission in Punjab, casting doubt on the efficacy of the provincial government’s anti-polio eradication program.

In its 19th monitoring report, the IMB noted that Punjab had remained free of sustained wild poliovirus transmission for more than two years, until mid-2018. “Lahore has become the epicenter of this transmission, with continuous detection of positive environmental samples and periodic incidence of polio cases,” the board said. According to the IMB assessment, the suboptimal quality of anti-polio eradication campaigns in parts of Lahore, many with migrant Pashtun communities, is largely responsible. The board warned that ‘it puts Lahore at risk of becoming an endemic reservoir like other provincial capitals that reinfect other parts of the country’.

The board said there is ongoing wild poliovirus transmission in southern Punjab as part of the central Pakistan outbreak, with most cases contributed by Punjab during the last six months. Well-coordinated and intensive response vaccination campaigns are usually effective in stopping these outbreaks. However, the provincial Polio Programme needs to give particular attention to sustaining quality in districts with weaker health systems, it said.

Punjab govt reviewing report: spokesperson

Responding to the IMB report, a provincial polio program spokesperson told Voicepk.net that the Punjab government was reviewing the report and will finalize a response shortly.

Karachi hotbed of polio

In its assessment of the Sindh province, the IMB said the province was heavily infected by the spread of the polio outbreak from southern Khyber Pakhtunkhwa. “From Sindh’s only reported polio case in 2018, together with a few environmental positives from sites in Karachi and northern Sindh, it was plunged into wild poliovirus outbreaks, affecting both central and northern Sindh in 2019,” the report noted, adding that the outbreak peaked in December 2019 but continued as a mainly northern Sindh outbreak in 2020.

Outbreaks in central Pakistan (that includes northern Sindh, southern Punjab, and adjoining districts of Balochistan) have been stopped in the past by well-coordinated and intensive outbreak responses. However, gains are seldom sustained in these areas, which are difficult to operate in, the board said. The IMB warned that parts of Karachi remain persistent hotbeds of polio. These areas are populated by migrant Pashtun communities from tribal districts of Khyber Pakhtunkhwa and Balochistan. The IMB said refusals and vaccine avoidance behavior are common in the province.

“Potentially transformative actions aimed at winning over disaffected and mistrustful communities, together with building a coalition of powerful will among political and civil society groups, must be rigorously pursued with determination on a daily basis, not just intermittently,” the IMB said.

No solution to repeated infections within Quetta Block

In Balochistan, the IMB said the provincial government has found no comprehensive solution to longstanding problems associated with persistent or repeated poliovirus infection within the Quetta Block comprising parts of Quetta City, Chaman tehsil in the district of Killa Abdullah and Pishin district. “The IMB considers the jury to be out on whether the political leadership and technical program capability has the quality to deal with the complexities of the polio context of their province and come out on top,” the report said.

KP govt must take concerted actions

In Khyber Pakhtunkhwa, the IMB said the government of Khyber Pakhtunkhwa must take concerted political, administrative, and community-oriented actions to address long-standing programmatic weaknesses and vulnerabilities in the south of the province.

“This means providing essential public services and putting a stop to the activities of factions looking to use population access to the polio vaccine as a bargaining tool. The social engagement of communities is vital. It is essential to involve locally respected community members, influencers, and tribal leaders, as well as political and government administrative leaders; they too must be mobilized,” the report said. The board urged the provincial health minister to be part of the provincial task force on polio.