A few days earlier, a high-level meeting was arranged on polio eradication. According to media reports, the meeting compared the polio cases data for the first three months of the ongoing year with the last three months of 2024 and expressed great satisfaction that there was an 80% decrease in the number of polio case when comparing these two quarters.
Where political leaders and non-technical persons could be excused for not knowing the science behind this apparent “improvement”, the health team should have briefed their leaders that the reason we have six cases in the first quarter has nothing to do with the quality of polio campaigns in these months.
But today proceedings of another high-level meeting have been published by the newspapers. The meeting was headed by Prime Minister Shehbaz Sharif, who was pleased to learn that only six new cases of the deadly virus have been identified in the first three months of 2025 when compared with the last three months of 2024.
These talking points for the prime minister or other high-level officials as well as press briefings are normally carefully prepared and vetted by technical teams to ensure that there is no scientific inaccuracy. However, it seems that non-existent credit is being claimed – intentionally.
It’s important for our readers to know that the decrease in the number of polio cases in the early months of the current year is not due to the improvement of polio campaigns, but the fact is that polio has a seasonal effect, and we were passing through a low transmission season.
In cold and dry periods where fewer people are mingling, the polio virus has fewer opportunities to survive and infect others. However, it has longer survival and greater opportunities to infect larger populations in warm and humid months. That is the reason why we saw more reporting of cases in the last quarter of 2024 compared to the first quarter of 2025. In the first quarter of 2024, only five polio cases had been reported compared to six in 2025.
That is why any disease with seasonal patterns needs to be compared season to season and not month to month. Any first-year student of epidemiology and public health learns this in their first month of school. So why are highly educated technical teams in polio eradication in Pakistan and abroad are not correcting their leaders on this particular aspect?
Recently a provincial minister had held a press conference flanked by multiple pediatricians, with him challenging WHO notification of a polio case in Punjab. The minister was apparently angry and claimed that the infected child ‘is walking normally and has resumed body strength’. He thus insisted that ‘it can’t be polio’, and that WHO should revise the criteria for defining someone with polio.
Once again, a political leader does not know that in the majority of cases, polio has no apparent signs and symptoms in its patients and only few will develop permanent paralysis. But if we want to eradicate a disease, we need to eliminate transmission from these otherwise asymptomatic cases too because they could infect others who may not be that lucky. It’s like a recovered Covid-19 patient does not mean that he didn’t have Covid to start with. That also shows complete lack of awareness even at the top level about how polio is spread and how it could be controlled.
What’s really happening in the case of polio eradication in Pakistan is that we have soaring polio positivity in sewerage testing across the country, including big cities where there are no law and order issues. This year again, 70 per cent of the districts where environmental sampling was done were found positive for the poliovirus. This story is not shared with us.
More than 10 billion dollars have been spent on polio eradication efforts in Pakistan since 2012. All top international organisations are working on it. Then why is there a complete lack of transparency regarding how the money is being spent? Lack of transparency is not just limited to financial reports; even basic polio numbers are not available, which we could use for independent analysis, except for cumulative numbers. Detailed environmental sampling data is not publicly available either.
Unless we want to live in this cycle of grand illusions, which always end in failures and disappointments, let us first have the Government of Pakistan take the ownership of the polio eradication programme in the country, and then shift the leadership to Pakistani public health professionals from top to bottom, with other departments fully supporting them but not leading them.
Moreover, make polio data freely available in a form that it could be analysed by independent public health professionals who could then help the Government of Pakistan in improving strategies. And please stop congratulating yourself before it’s time for it!
#grand #illusion #polio #eradication
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