ISLAMABAD: An estimated 500,000 Pakistani children missed polio vaccinations during this month’s countrywide inoculation drive, the country’s chief health official confirmed this week, attributing it mostly to people refusing vaccines or being unavailable due to traveling when the campaign was launched. 

Pakistan has reported 48 polio cases this year, with 23 of those reported from the country’s southwestern Balochistan province, 13 from Sindh, ten from Khyber Pakhtunkhwa (KP) and one each from Punjab and Islamabad.

The alarming surge in cases prompted Pakistan to conduct a countrywide anti-polio vaccination drive from Oct. 28 to Nov. 3, aiming to inoculate over 45 million children against the infection.

Pakistan remains one of only two countries worldwide where polio remains endemic. Misinformation about vaccinations and attacks by religiously motivated militants on polio teams have been major impediments to immunization campaigns.

“This year I don’t have the exact figure but we are expecting around 500,000 refusals, unavailability [of people for vaccinations],” Malik Mukhtar Ahmed Bharath, coordinator to the prime minister on national health services, told Arab News in an exclusive interview. 

“But we are not going to leave them [children] we are going to chase them, we are going to track them, trace them and we are going to get them vaccinated for this polio.”

Since late 2018, Pakistan has seen a resurgence of poliovirus cases, highlighting the fragility of gains achieved in the preceding years when cases dropped in 2023 to six, 20 in 2022 and just one in 2022.

Attacks on polio vaccinators and security teams deployed to protect them have also increased. 

Seven people, including five children, were killed when a bomb targeted police traveling to guard vaccine workers this month. Days earlier, two police escorts were gunned down by militants.

The official regretted that over 90 polio vaccinators have been killed in the country since 2012. 

“[Overall] more than 90 have been martyred just because they are serving the nation and I do not think so anywhere in the world this happens,” Bharath said. 

Speaking on the recent surge in polio cases, Bharath said there was nothing wrong with Pakistan’s polio program, adding that the country has one of the best surveillance systems to monitor the disease. 

He said one of the major causes of the surge in polio cases this year was due to a repatriation drive launched in 2023 by Pakistan against “illegal immigrants,” causing many Afghan refugees who were not vaccinated against polio to travel to other parts of the country and spread the infection. 

“The major factor is the Afghan refugees’ repatriation program started [last year],” Bharath said. “Because they were unvaccinated, they just traveled from south Khyber Pakhtunkhwa KP to all over Pakistan to just escape from that repatriation, and that is one of the biggest causes of this spread of poliovirus across Pakistan.”

He said another reason for polio spreading countrywide was because of vaccine refusals in some tribal areas of the country, where the polio teams could not administer drops and due to the deteriorating security situation which made some areas inaccessible for volunteers.

Bharat said the prime minister’s focal person on polio, the country’s polio team and the Ministry of Health developed a strategy in July and August to target previously inaccessible areas with vaccination drives. 

These were the Karachi, Quetta and south KP divisions, the official said.

“The main areas of concern were the Quetta block, that is Quetta, Chaman, Killa Saifullah, Killa Abdullah and adjoining areas,” he said.

Bharath said 64 union councils in Pakistan’s largest city Karachi, seven districts in southern KP were some areas where the government had been unable to eliminate polio for a very long time.

“To deal with the situation, we are working on a different plan for each area,” Bharath said. “In South Punjab, there is a different plan and If we are going in south KP, there is a different plan,” he added. 

He said authorities were determining which programs, influencers or Islamic scholars should be involved in each area to achieve better results.

“There is a segregated campaign for south KP from 11th or 12th [November] which they are going to start in five or four districts,” he informed. 

Bharath said synchronized campaigns with Afghanistan to target polio were “crucial” to eliminate the disease.

“We are going to hold a dialogue in the first week of December in Doha, Qatar, along with WHO and we are going to discuss how we are going to have synchronized campaigns,” he said.