An article here on the progress and changes in the Polio Eradication Programme in Pakistan from 1999 to 2023. The Author provides a comprehensive overview of the systematic changes made to the Programme over the past two decades, and highlights the impact these changes have had on reducing the burden of polio in the country

By Muhammad Noman

Healthcare System, CHIP Training and Consulting

Quetta, Balochistan Pakistan

The Polio Eradication Programme in Pakistan 

Systematic Critical Analysis from 1999 to 2023

                                         

This article turns the spotlight on the Polio Eradication Programme in Pakistan, whereby the various strategies and approaches used to address the complex challenges of polio eradication in the country are highlighted, including the engagement of community health workers, the use of new communication and vaccination strategies, and the strengthening of surveillance and laboratory capacity. The Programme also underscores the importance of sustained commitment and collaboration among all stakeholders in achieving the goal of a polio-free Pakistan.

Given the complexity of the global strategy, a comprehensive overview of the systematic changes made to the Programme over the past two decades could be of interest. In this connection, a bulleted list is provided as follows:

1. Establishment of a National Immunization Coordination Committee (NICC) to oversee polio eradication efforts.
2. Development of a National Emergency Action Plan (NEAP) to guide polio eradication activities and adapt to changing circumstances.
3. Creation of a Polio Eradication Cell within the Ministry of Health to coordinate polio eradication efforts at the national level.
4. Introduction of new technologies, including geographic information systems (GIS) and mobile data collection tools, to improve surveillance and monitoring.
5. Implementation of a national Polio Eradication and Endgame Strategic Plan (PEESP) to guide the final stages of polio eradication.
6. Strengthening of the routine immunization system to increase overall vaccination coverage and provide a platform for delivering polio vaccines.
7. Establishment of a network of social mobilizers and community-based organizations to promote vaccine uptake and address vaccine hesitancy.
8. Engagement of religious leaders and scholars to promote vaccine acceptance within communities.
9. Development of an e-registry system to improve the monitoring and evaluation of vaccination activities.
10. Deployment of mobile vaccination teams to reach children in hard-to-reach areas, including nomadic populations and those affected by conflict.
11. Introduction of the bivalent oral polio vaccine (bOPV) to improve vaccine efficacy and reduce the risk of vaccine-derived polio.
12. Collaboration with neighbouring countries, including Afghanistan and Iran, to strengthen cross-border surveillance and vaccination activities.
13. Strengthening of the cold chain system to ensure the safe storage and transportation of vaccines.
14. Expansion of the use of environmental surveillance to detect the presence of poliovirus in sewage samples.
15. Development of a national Emergency Operations Centre (EOC) to coordinate polio eradication activities during outbreaks and other emergencies.
16. Introduction of the inactivated polio vaccine (IPV) to provide additional protection against polio and reduce the risk of vaccine-derived polio.
17. Strengthening of partnerships with the private sector to improve vaccine access and delivery.
18. Implementation of a national Independent Monitoring Board (IMB) to provide oversight and accountability for polio eradication efforts.
19. Development of a Polio Eradication and Endgame Strategy for the Post-Polio Certification Era (2023-2030) to guide the final stages of polio eradication and prevent re-emergence.
20. Integration of polio eradication activities with other health programs, including routine immunization, maternal and child health, and disease surveillance.
21. Strengthening of laboratory capacity to improve the quality and speed of poliovirus testing.
22. Introduction of new communication strategies, including social media and digital campaigns, to increase awareness and acceptance of polio vaccination.
23. Expansion of the role of community health workers in delivering polio vaccines and promoting vaccine acceptance.
24. Introduction of new training programs for health workers and volunteers to improve their skills and knowledge related to polio eradication.
25. Development of a national surveillance system to detect and respond to outbreaks of vaccine-preventable diseases, including polio.
26. Strengthening of partnerships with civil society organizations and other stakeholders to promote community engagement and ownership of polio eradication efforts.
27. Introduction of new approaches to monitor and address vaccine hesitancy and refusal, including community engagement and social marketing.
28. Implementation of targeted vaccination campaigns in high-risk areas and populations to maximize the impact of vaccination efforts.
29. Introduction of new approaches to monitor vaccine coverage and identify underserved populations, including the use of mobile phone-based surveys and satellite mapping.
30. Establishment of a polio certification commission to verify the absence of wild poliovirus in Pakistan and other countries in the region.
31. Increased focus on the involvement of women in polio eradication efforts, including as health workers and community mobilizers.
32. Expansion of the role of local government officials in supporting polio eradication efforts at the community level.
33. Implementation of a national communication strategy to counter misinformation and rumours about polio vaccination.
34. Introduction of new approaches to reach children in urban areas, including through mobile vaccination teams and school-based vaccination campaigns.
35. Expansion of the use of social franchising models to improve the quality and availability of health services, including polio vaccination.
36. Introduction of new approaches to monitor vaccine safety and detect adverse events following vaccination.
37. Strengthening of the supply chain system to ensure the timely and efficient delivery of vaccines and other supplies.
38. Implementation of a national emergency response plan to respond quickly to outbreaks of vaccine-preventable diseases, including polio.
39. Integration of polio eradication activities with broader efforts to strengthen the health system and improve overall health outcomes.
40. Continued engagement with international partners, including the World Health Organization and the Global Polio Eradication Initiative, to leverage technical and financial resources to support polio eradication efforts in Pakistan.
41. Implementation of a national polio eradication emergency action plan to accelerate progress towards eradication.
42. Development and implementation of new tools and technologies to improve polio vaccination and monitoring, including the use of mobile phone-based data collection and analysis.
43. Strengthening of cross-border coordination and collaboration to prevent the importation of poliovirus from neighbouring countries.
44. Expansion of the role of civil society organizations in promoting polio vaccination and community engagement.
45. Introduction of new approaches to address the challenges of reaching populations living in conflict-affected and hard-to-reach areas.
46. Establishment of a national laboratory network to improve the capacity for poliovirus testing and surveillance.
47. Expansion of the role of private sector actors, including pharmaceutical companies and corporate foundations, in supporting polio eradication efforts.
48. Introduction of new approaches to address the challenges of vaccine access and distribution, including the use of innovative cold chain technologies.
49. Development of a national vaccine waste management strategy to reduce the wastage of polio vaccines and other vaccines.
50. Strengthening of the national immunization program to ensure the sustainability of polio eradication efforts and the delivery of other vaccines and health services.

 

Overall, the systematic changes made to the Polio Eradication Initiative in Pakistan over the past two decades have been extensive and multifaceted, involving a broad range of stakeholders and approaches. While there have been challenges and setbacks along the way, the initiative has made significant progress in reducing the burden of polio and improving the overall health system in the country. The continued commitment and engagement of all stakeholders will be critical to achieving the goal of a polio-free Pakistan.