Pakistan children against polio
ARACHI, Pakistan To combat the persistent challenge of eradicating polio that has plagued Pakistan for decades, authorities in a province are exploring an unconventional approach – using prisons.
In the preceding month, the Sindh provincial government presented a bill, which, if passed, would result in the potential imprisonment of parents for up to one month in cases where they do not ensure that their children receive vaccinations against polio or eight other prevalent diseases.
World Health Organization
Experts from organizations like the World Health Organization and other institutions express concerns that this unique approach may exacerbate the erosion of trust in polio vaccines, especially in a nation where a significant portion of the population subscribes to unfounded conspiracy theories surrounding them.
Moreover, the country has witnessed numerous tragic incidents where vaccinators have been subjected to violence, including fatal shootings.
Worldwide Polio Cases
Compounding the challenges experts encounter in their efforts to convince people of the safety of these vaccines is that oral vaccines are currently responsible for most polio cases worldwide.
The Director of Polio at the World Health Organization in the Eastern Mediterranean region cautioned against the potential negative consequences of the new law.
Dr. Hamid Jafari stated, “Coercion is counterproductive.” He emphasized that historically, health workers have effectively increased immunization rates in areas where vaccine hesitancy exists by identifying the underlying reasons for people’s reluctance and addressing those concerns.
This approach often involves engaging trusted political or religious leaders in discussions with the community, fostering a sense of trust and understanding.
In my opinion, Pakistan seems to be considering this legislation as a precautionary measure, keeping it available as an option if needed,” Jafari remarked. ”
Notably, Pakistan and its neighboring country, Afghanistan, remain the only nations where polio transmission has not yet been halted. This debilitating and potentially fatal disease primarily affects children up to the age of 5 and typically spreads through contaminated water sources.
World Health Organization (WHO)
Since the initiation of efforts to eradicate polio in 1988, the World Health Organization (WHO) and its collaborators have administered billions of vaccine doses.
This undertaking incurs an annual expenditure of almost $1 billion, with a substantial portion of funding originating from donor countries and private entities, including the Bill & Melinda Gates Foundation.
These vaccinations, typically administered as oral drops to children, have successfully decreased polio cases by over 99%. However, it is essential to acknowledge that in extremely rare instances, the live virus present in the vaccine can lead to polio or undergo mutation, potentially resulting in the emergence of a new outbreak.
Pakistan and Afghanistan
Up to this point in the current year, seven instances of polio have been attributed to the wild virus, with all cases reported in Pakistan and Afghanistan. Conversely, over 270 points have been associated with a virus linked to the polio vaccine, affecting 21 countries across three continents.
In January, approximately 62,000 parents, primarily in Pakistan’s Sindh province, declined to have their children receive polio vaccinations. This prompted local authorities to propose the introduction of the new law, which includes penalties as a means to address this issue.
The bill has progressed to its final stages of becoming law, gaining approval from the provincial assembly in August. Under this proposed law, parents who do not ensure the vaccination of their children against specific diseases could face imprisonment for up to one month, coupled with fines of up to 50,000 rupees ($168).
While the primary objective of this legislation is to increase polio immunization rates, it also encompasses other diseases such as measles, pneumonia, and pertussis.
Rukhsana Bibi, a healthcare worker based in Karachi, is hopeful that the new law will reduce vaccine refusal rates and provide enhanced protection for healthcare personnel. Karachi is identified as a high-risk area for a potential resurgence of polio.
Bibi pointed out that in previous instances, parents who displayed abusive or threatening behavior were apprehended by the police. Subsequently, they were released under the condition that they ensured their children were immunized and actively assisted the polio team in their community outreach efforts.
Several factors contribute to vaccine hesitancy in Pakistan.
Suspicion surrounds the foreign entities providing funding for vaccines and the Pakistani government itself. Additionally, there are “fringe elements” who subscribe to a baseless conspiracy theory, believing that vaccines are part of a Western conspiracy to sterilize people, as acknowledged by Bibi.
Nonetheless, many parents desire the government to offer improved healthcare, food, or financial assistance as a preferred alternative.
Parents are under the impression that the government prioritizes polio vaccines due to the availability of grants and donations, often neglecting fundamental healthcare,” Bibi explained. “This perception fosters suspicion among parents.”
U.S. Central Intelligence Agency
Public confidence in vaccine campaigns faced a significant setback in 2011 when the U.S. Central Intelligence Agency orchestrated a deceptive hepatitis vaccination program to gather intelligence on Osama bin Laden, the former leader of al-Qaida. Furthermore, militants have targeted healthcare workers involved in vaccine distribution, leading to fatal shootings and even suicide bombings targeting the police vehicles safeguarding them.
In certain areas within Sindh province, the rejection rate for the polio vaccine stands as high as 15%, as disclosed by a government official who, while not authorized to comment publicly, spoke to The Associated Press on the condition of anonymity. To achieve the goal of polio eradication, it is imperative that over 95% of the population receive immunization.
The Sindh official clarified that parents who decline the vaccine would face penalties, but doses would not be administered to their children without explicit consent.
Dr. Paul Offit, the Director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, emphasized the formidable challenge of rebuilding trust through punitive measures.
“While the oral polio vaccine may not be the ideal choice, it still represents a significantly better option than not receiving any vaccine at all.” Offit further noted, “It ultimately falls upon governments to safeguard the well-being of children, and we understand that failing to vaccinate a certain percentage of children increases the risk of polio resurgence.” Notably, the virus was detected in affluent nations such as Britain, Israel, and the United States last year, marking its return after nearly a decade.
Muhammad Akhtar, a father of three residing in Karachi, strongly believes in the significance of polio vaccination, primarily influenced by his cousin’s previous affliction with the disease.
However, Akhtar opposes the notion of punitive measures, asserting that parents should have the autonomy to choose their children’s vaccines.
On the other hand, Khan Muhammad, a father from Benaras Town near Karachi, subscribes to unfounded conspiracy theories. With seven children to care for, he perceives polio as another debilitating disease.
Muhammad maintains a viewpoint that places trust solely in divine protection, stating, “Allah blessed us with these children, and He alone will safeguard them. Ultimately, it is God’s will.”