Unidentified gunmen killed one vaccinator and two policemen in two separate attacks on polio vaccination teams in northwestern Pakistan on Friday. In Swabi in Khyber Pakhtunkhwa province, two policemen were killed as they headed to provide security for a vaccination team.
The other attack happened in Jamrud, in the outskirts of Peshawar, where a vaccinator was shot dead on his way home. All three killed were part of a three-day inoculation campaign in Pakistan’s tribal region to vaccinate around 727,000 children under the age of 5 by Sunday.
The two attacks follow a series of attacks on polio vaccinators in Pakistan and Nigeria over the past one year. More than 20 polio workers have been killed in Pakistan over the past year, while nine women vaccinators were killed in two shootings in Kano, northern Nigeria in February this year.
The Nigeria killing was spurred by rumours that the vaccine caused infertility, but in Pakistan, vaccinators became targets ever since US intelligence officials used a fake vaccination programme as cover to collect DNA samples from Osama bin Laden’s family in Abottabad, which led to him being shot in 2011.
Along with Nigeria and Afghanistan, Pakistan is one of the three countries where the polio virus survives in the wild. Of the 359 polio cases reported worldwide in 2013, Pakistan accounts for 74. Nigeria has 50, and Afghanistan 11.
Polio is vaccine-preventable viral infection that cripples, paralyses and kills children, often within hours of infection. The virus lives in an infected person’s throat and intestines and spreads through contact with contaminated faeces and saliva. Children who survive are usually disabled permanently.
This week, India closed its borders to unvaccinated Pakistan nationals. Beginning January 30, 2014, Pakistani travellers need to carry a certificate of vaccinated against polio to enter India. Saudi Arabia had made polio vaccination mandatory for Pakistanis in 2009.
For India, which has been free of polio for almost three years -- the nation’s last polio case of a two-year-old girl in the Panchla block of Howrah, West Bengal, was reported on January 13, 2011 – the fear of re-infection is very real. This year, Somalia reported 183 cases – more than endemic Nigeria, Pakistan and Afghanistan put together -- after being polio free since 2007. Genetic sequencing of the virus traced the polio strain to Nigeria.
The polio strain that has crippled 17 children in Syria this year originated in Pakistan and is now spreading across the Middle East. Again, DNA analysis shows the strain found in Deir al-Zor in Syria, where an outbreak was detected in September, was of Pakistani origin and similar to the virus found in sewage in Egypt, Israel and Palestinian territories in the past year. Closely-related strains of the polio virus from Pakistan have also been detected in sewage in Israel, the West Bank and Gaza Strip since February 2013.
But India’s problems are not just from across the border. In Bihar and Uttar Pradesh, India’s two most densely populated states, refusing polio vaccination has become the newest form of protest across several districts. Entire villages are refusing to get their children vaccinated to force the government to meet completely unrelated civic demands, such as ration cards, better roads, electricity supply, new bridges, etc.
On November 24 this year, 30 villages in the Sambhal district of Uttar Pradesh boycotted vaccination to force the government to make their villages a part of the Moradabad district. The inane protest included stopping sending their children to school. During the November 16 round alone in Bihar, villagers in Bariyarpur block of Munger district, Udakishunganj block of Madhepura district, and Sadar and Ratani Fardipur blocks in Jehanabad district refused to get their children vaccinated for a mix of these reasons.
In June 2013 pulse polio round, villagers in the Sikandra Rao block of Hathras district boycotted immunisation to push their demand for electricity and roads.
Vaccination works. Since the launch of the UN-backed Global Polio Eradication Initiative in 1988, cases have dropped by 99%, from 3.5 lakh children paralysed or killed annually in 125 countries in 1988 to 359 cases in eight countries in 2013.
India’s less than a month away from being declared “polio free”, a certificate it will deserve for keeping the nation free of polio for over three years. Just four years ago, in 2009, India had 741 cases, when was almost half (46%) of the global total of 1,604 cases. Attacking the programme for petty protests can throw the gains away within days.