Dr. Rana Muhammad Safdar

The Independent Monitoring Board, the body that evaluates the implementation of global polio eradication efforts, has released its latest report entitled “Now is the Time for Peak Performance”. Very simply, the world has never been better positioned to eradicate polio and the remaining sanctuaries for poliovirus in Pakistan and Afghanistan are now the key to achieving that goal.

The Pakistan programme now has all the ingredients required to finish the job. Firstly, it has concerned and well-informed parents who accept vaccine each time it is offered and know that it is the only way to fully protect their children from permanent paralysis. Secondly, it has a dedicated network of frontline health workers who enjoy the acceptance and trust of their communities. These workers are supported by an informed and supportive medical fraternity, civil society, religious leadership and media. Crucially there now exists an enabling security architecture which supports access to practically all children in Pakistan and ensures safety for frontline workers.

All those now contributing to polio eradication are now supported by a dedicated network of Emergency Operation Centres at National and Provincial levels with partners implementing a ‘one team’ approach and bringing together a diverse range of national and international agencies as diverse as the National Laboratory, Survey of Pakistan, Pakistan Telecommunications Authority and Railways Authority in support of this national priority. None of the gains we have made would have been possible without the committed political leadership by Federal and Provincial Governments as set-out and reinforced in the National Emergency Action Plan.

As a result of the coordinated efforts of all of our society, it is the virus that is now under severe pressure.  It is cornered in just three remaining sanctuaries – the Khyber-Peshawar corridor, Karachi and the Quetta block. But we have been here before – three times in the past ten years – and did not fully finish the job. Each time, the virus survived because it found sufficient pockets of under-immunised children.  To finally finish this time, we must sustain our gains. We must not allow these sanctuaries to sustain polio transmission across Pakistan and beyond.  We must remain nimble in our approach and utilize all the energy and tools at our disposal and resolve to beat the virus once and for all.  We must further enhance our performance in the remaining sanctuaries.  Success lies in our ability to remain focused on our strategy while being flexible enough to make changes when needed at the local level in support of parents seeking vaccination of their children and the vaccinators who deliver at their door-step.

The programme has a good track record of reaching and vaccinating every child once included in the local plan.  Recent initiatives have identified tens of thousands of children previously not included in local plans. Tracking and then vaccinating each and every one of the estimated one million under-immunised (or persistently missed children) is essential. Each campaign boils down to the critical contact between a parent and a vaccinator on the door-step: each completed vaccination represents success for both parent and vaccinator.  Strengthening the recruitment, retention, capacity and supervision of appropriate community accepted vaccinators to maximize the chances of success is central to the polio eradication effort.

At the Federal and Provincial levels, we have seen exemplary political commitment and administrative support to solve operational problems and remove obstacles.  We applaud similar leadership at District and Union council level but we must apply this same mindset everywhere.

Whilst we do not under-estimate the remaining challenges, we will not be diverted from our goal of zero.  We thank everyone for their support to this national imperative for the benefit of all our children.

Dr. Rana Muhammad Safdar is Chief of Disease Surveillance & Response Division NIH and National Coordinator of Emergency Operation Centre for Polio Eradication in Pakistan. Having diverse national and international public health experience, he specializes in highly valued areas of Emerging Infectious Disease Epidemiology as well as Health Metrics & Evaluation .Author can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it.