Pak poses risk of polio re-infection to India

Pakistan is India's biggest threat to stay polio-free because the neighbouring nation is the world's largest reservoir of wild polio virus at the moment.

Globally, the annual number of polio cases has fallen from 350,000 in 1988, to 416 in 2013, and 243 so far in 2014 – a drop of more than 99 per cent. All but three countries – Afghanistan, Nigeria and Pakistan – where polio was firmly entrenched, have eliminated the virus within their borders.

But with 206 cases already reported in 2014, Pakistan is the world’s largest remaining reservoir of polio, said Unicef executive director Anthony Lake.

The transmission of wild polio virus dropped significantly in the recent past. While Nigeria had only six cases this year, down from 49 in 2013, transmission in Afghanistan reduced to a very low levels, with most cases linked to Pakistan.

“It is highly likely that endemic transmission will continue in Pakistan into 2015, particularly in some areas of FATA, notably North Waziristan, where polio immunizations have been suspended since June 2012,” Bruce Aylward, World Health Organisation's assistant director general in charge of polio and emergencies told Deccan Herald.

“This (Pakistan) is also the most infected area of the world. From here, polio virus has repeatedly spread into neighbouring Afghanistan, into other areas of Pakistan, and the outbreak in the Middle East is also linked to transmission from this area,” he said.
Pakistan today accounts for 85 per cent of the world’s polio cases, which is a cause of concern for its eastern neighbour.

“India, as all countries, must continue to be vigilant against polio importations until the disease has been completely eradicated. The risk of re-infection is high,” Aylward said.
As Pakistan Prime Minister Nawaz Sharif launched a state-funded “national emergency action plan - 2014” to eliminate transmission of wild polio virus by 2018, India offered to chip in.

Offering full co-operation, Union Health Minister Harsh Vardhan said, “Pakistan has resolved to set up monitoring cells at the grassroots level. They are also talking of involving social groups, a strategy which worked wonderfully in India.”

“Unless all stakeholders in society, most importantly in Pakistan’s context, her religious clergy, are involved, it would be impossible to achieve total polio eradication,” he added.
While polio remains endemic only in three countries, it continues to pose a risk to children all over the world, especially in countries which have not made routine immunisation a priority like South Sudan, the Central African Republic and Ukraine. Outbreaks in Syria, Iraq, Cameroon, Equatorial Guinea and Somalia can be traced to Pakistan and Nigeria.