Case Study: Polio in Pakistan and the Global Polio Eradication Initiative
This section focuses on polio in Pakistan and international efforts to eradicate the disease from the region. This section will serve as an introduction to polio, Pakistan, and the Global Polio Eradication Initiative. The News Analysis looks at the ways in which various news sources use social media and photography to report on polio in Pakistan. The Career Biography section examines Svea Closser’s work with public health in Pakistan. Finally, the Anthropological Analysis will compare Closser’s findings to media reports and examine any consequences that arise from the discrepancies.
Polio, or poliomyelitis, is a disease caused by a virus that attacks the human nervous system. Once infected, a person can experience total and irreversible paralysis within just a few hours (World Health Organization, Media Center, 2012). Only 1 in 200 infections leads to irreversible paralysis and among that population, about 5-10% die of paralyzed breathing muscles. Other symptoms include vomiting, neck stiffness, headache, muscle spasms, pain in the limbs, fever, drooling, mood swings, and fatigue.
Polio mainly affects children under 5 years of age, who are also the main target of global vaccination campaigns. Although the vaccine, if administered repeatedly and correctly, can prevent infection for life, there is no cure for polio.
The effects of polio can extend far beyond the infected individual. Areas with high polio presence experience decreased productivity because of increased incidence of physical limitations.
Polio is spread via person-to-person contact or in an oral-fecal manner, meaning people contract the poliovirus when they come into contact with infected mucus, phlegm, feces, or contaminated food/water (Perlstein, 2012). For this reason, polio is able to spread quickly through areas with poor sanitation and limited access to safe water.
There are two types of vaccines available to protect against polio: inactive polio vaccines (IVP) and oral polio vaccines (OVP). A person is considered fully immune when they have received no less than three doses of IPV or OPV, or four doses of IPV and OPV in combination (Centers for Disease Control and Prevention, 2012).
The polio vaccination is an attenuated vaccine, which means it contains a live virus. The polio virus is weakened so that it stimulates the body’s immune system but does not actually cause the disease (UNICEF, 2012).
The Global Polio Eradication Initiative
The Global Polio Eradication Initiative was officially launched in 1988 at the 41st World Health Assembly and by 1998, all polio-endemic countries were carrying out mass vaccination campaigns. The World Health Organization, Rotary International, the United States Center for Disease Control and Prevention, and the United Nations Children’s Fund lead the project’s funding, planning, implementation, and evaluation.
The following map displays the countries with polio in 1988 and 2010. India no longer has cases of polio, so, as of 2012, there are only three countries that still report active cases of polio.
The objectives of the Polio Eradication Initiative are as follows:
- to interrupt transmission of wild poliovirus as soon as possible;
- to achieve certification of global polio eradication;
- to contribute to a health system development and strengthen routine immunization and
- surveillance for communicable diseases in a systematic way.
(World Health Organization, Media Center, 2012)
The characteristics of the poliovirus and the vaccine cause eradication campaigns to be most effective when health workers go door to door to administering vaccines to all children under five. When children are not home, health workers have to return in subsequent days to find the unvaccinated children and properly administer the vaccine. Furthermore, workers record household demographics and the ages of children vaccinated.
The Polio Eradication Initiative has a wide range of successes including saving more than 1 million children with the administration of vitamin A with the polio vaccine, adding to demographic knowledge of rural and hard to reach areas, increased local capacity to carry out thorough and long-lasting health initiatives. A full list of their accomplishments can be found here.
Dr. Bruce Aylward is the Assistant Director-General for Polio, Emergencies and Country Collaboration for the World Health Organization. His goal is to unite polio-affected countries, The Polio Eradication Initiative, and other humanitarian response to eradicate the disease. In this powerful TED Talks clip, he talks about why “close” isn’t good enough for polio eradication.
Case Study: Pakistan
Pakistan is one of three countries that still has wild poliovirus. The virus has, however, been successfully contained to just three groups of districts: Karachi city, districts within Balochistan Province, and districts within the Federally Administered Tribal Areas and the North-West Frontier Province.
Pakistan only reported 198 cases in 2011 and only 15 so far in 2012. More information on the current status of polio in Pakistan and vaccination campaigns can be found here.