Global Polio Board says ‘more needed’ to end polio in Pakistan

Islamabad: The Polio Oversight Board of the Global Polio Eradication Initiative (GPEI) has called upon the PM’s Special Assistant on Health to strengthen government leadership of the Polio Eradication Programme by appointing senior officers of the Ministry of National Health Services to the National Emergency Operations Centre (NEOC) for Polio Eradication; ensure regular engagement at the NEOC, and participate in review meetings with provincial Chief Secretaries and Ministers of Health following Supplementary Immunization Activities (SIAs).

Visiting members of the Polio Oversight Board—the highest decision-making body in GPEI— concluded an important meeting here in Islamabad, offering strategic direction to Pakistan’s future efforts for polio eradication with a set of recommendations encompassing three key stakeholders—the government of Pakistan, GEPI partners, and the NEOC.

According to a copy of the recommendations exclusively available with ‘The News,’ the POB has encouraged the government to continue domestic financing of the polio programme in 2022 through development of a PC1. Importantly, it has also advised NEOC to update the National Emergency Action Plan (NEAP) for Polio Eradication on priority basis, capturing agreed activities of the entire partnership; and to signal any updated resource requirement on an urgent basis for 2021 and 2022.

The POB has recommended that the Chief Secretaries and Ministers of Health in Khyber Pakhtunkhwa and Sindh “protect their hard-won gains by routinely reviewing the programme’s success in reaching chronically missed children in priority communities,” and that the Chief Secretary and Minister of Health in Balochistan engage Deputy Commissioners on performance management accountability linked to quality improvements in the polio programme.

While the POB has acknowledged the government’s commitment at the national and provincial levels to end polio, the POB believes “more is needed to reach the levels of government leadership, drive, and use of real-time data” as efficiently witnessed in the country’s Covid response.” Similarly, while energetic leadership is available at the NEOC and PEOCs, “more government staff need to be engaged in the programme at all levels.” The POB sees the current trough in virus transmission as an important opportunity to be capitalized because the “next six months are critical to setting up the programme to stop transmission in 2022.”

Recommending the completion of ongoing transformation of NEOC by end-June, the POB has called for a simplified management structure at NEOC and “consolidation of diffused task teams into consolidated areas of work.” The NEOC has been advised to regularly update its reservoir analysis until virus circulation is interrupted; to develop a contingency plan to address the risks associated with population movement including cross-border movement with Afghanistan; and to continue to systematically report on progress in reducing the number of missed children from priority communities.

The POB has also advised NEOC to quickly assess the impact of the post-June campaign in fostering community acceptance for the polio programme and prioritize activities that result in reaching missed children in priority communities.

The GPEI partners (WHO, UNICEF, nSTOP and BMGF) have been urged to optimize their technical support by assigning best people to the most difficult tasks; and to adopt the ‘one team’ approach and hold staff accountable to ensure this happens. To capitalize on the current epidemiology, the POB has recommended that GPEI partners re-prioritize support around activities that improve the reach of the programme in priority communities to vaccinate missed children.

The presentation of the POB recommendations coincided with launch of the Polio Eradication Strategy 2022-2026 by GPEI at a virtual event also attended by leaders from Pakistan and Afghanistan—the two countries yet to interrupt wild polio transmission.