Polio eradication: A true story

Prof Tariq Iqbal Bhutta - With around 40 years of experience in the field of Pediatrics and Public Health heading different medical institutions in the country, I feel it is my responsibility to provide a true perspective to the anti-Polio effort that has saved millions of children from falling prey to permanent irreversible disability.
In January 2014 India completed its polio free status. Now only three countries that is Pakistan Nigeria and Afghanistan are endemic for wild polio virus. Afghanistan had only thirteen cases in 2013, sadly  all of them genetically linked with virus in Peshawar.  The country is likely to be declared  free of endemic  polio this year. This will leave us and Nigeria is the only countries with endemic circulation of wild polio.
In 1952, USA had the biggest polio epidemic in its history . Of nearly 58000 cases reported that year, 3145 patients died and 21,269 were left paralyzed. Most of them were children. According to a PBS documentary in 2009, America’s greatest fear after atomic bomb was the fear of Polio.
If Hygiene and sanitation alone were sufficient to control polio epidemic it would not have caused major outbreaks in USA and many other western nations before the development of polio vaccine. And India would never have reached polio free status. Soon after Dr Jonas Salk developed his vaccine in which almost two million children participated, the vaccine was found to be effective and safe. When he announced the success of his vaccine, he was hailed as a hero.
In the meantime, Dr Albert Sabin was working on an oral polio vaccine by weakening the polio virus but keeping its capacity to induce the body to produce antibodies against the wild polio virus, thereby protecting the recipient of the vaccine against polio. Its advantage over injectable polio was that it worked in the intestines and protected it from letting the wild polio virus to multiply and pass out in the stool and spread to other children. This vaccine was tested on at least 100 million people between 1955 -1961 in USSR, Mexico, Singapore and Holland. And it was found to be extremely effective and safe.
These two vaccines together have helped in eradication of polio from most countries of the world since WHO in 1988 passed a resolution to target polio eradication by 2000. Unfortunately, this target could not be achieved but the number of cases were reduced from 350,000 every year to less than 10,000 a year, a drop of more than 97%. All this was the miracle of these vaccines. And the efforts of tens of thousand of scientists, health workers and millions of volunteers who went door to door to give polio drops to children sometimes under the most challenging conditions.
 Rotary International provided almost one billion US dollars to help in this effort, so did Bill Gates and Melinda Foundation and many countries. All these people are seeing the results of their contribution and are likely to achieve the goal of polio eradication. The most worrying situation is in our own country where every child is not being reached due to ban by militants and refusal by ignorant parents.
In Pakistan polio workers have been targeted by militants and almost forty workers both male and female and many police officers have been killed while performing their duty. This has caused a serious setback to our polio program and in many areas, polio workers are not reaching out to the families due to security reasons.
Taliban have banned the administration of polio drops in areas under their control with the result that wild polio virus has taken hold in those areas particularly in Waziristan resulting in the largest number of polio cases in 2013.
There is a strong Anti Vaccines lobby in some countries which is against all kind of vaccines and want people to stop giving the vaccines to children. These misguided people tell all kinds of lies and pseudo-scientific  papers  to prove their arguments against using vaccines.
One Egyptian doctor Katme working as a psychiatrist and an office bearer of Islamic Medical association of UK says that All vaccines are Haram and all Muslim parents should not give vaccines to their children. He is neither an expert on immunization nor a Muslim  scholar.
He has been criticized by British Medical Association and the Dept of Health UK saying that his suggestions are likely to increase infection rates in Muslim communities.
Muslim Ulemas from all over the Muslim world have given fatwas about the safety and efficacy of polio vaccines. They have declared that these vaccines do not contain any Haram ingredient. And all children should be given these vaccines to protect against polio. It is high time we all launched a final blitz to eradicate polio forever.

n    The author is Chairman National Immunization Technical Advisory Group

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