On April 28, 2014, the WHO emergency committee met with officials from countries endemic to the polio virus, including Pakistan, Syria, and Cameroon. The committee concluded that these countries were contributing to the global spread of the wild polio virus strain, while other affected countries were not. As a result, on May 5, 2014, Pakistan was subjected to travel restrictions.
Polio primarily affects children, although adults can be carriers of the virus. The committee identified that last year, 60% of polio cases were linked to adult international travelers. Despite being polio-free for a period, Pakistan saw a surge in cases, reporting 58 new polio infections in just the first quarter of 2014, breaking a decade-long record.
In response, Saira Afzal Tarrar, the Minister of State for National Health Services, assured the WHO that the government would take strong actions to stop the spread of the virus. A follow-up WHO assessment was scheduled for three months later, at which point the travel restrictions would be reviewed.
WHO Recommendations
The WHO recommended that travelers from Pakistan who had not received the oral polio vaccine (OPV) or inactivated polio vaccine (IPV) within the last 4 weeks to 12 months must receive a dose before traveling. Frequent travelers should also obtain an International Certificate of Prophylaxis as proof of vaccination. The committee set criteria for lifting travel restrictions, which included:
- At least 6 months without any new cases exported.
- Documentation of effective eradication efforts in all high-risk areas.
Additionally, countries like Saudi Arabia and India have required vaccinations for Pakistani travelers. Since 2000, Saudi Arabia mandated that all Pakistanis receive OPV before entry. India demands that Pakistani citizens receive the OPV at least six weeks prior to their visit.
Government Measures and Vaccination Protocols
To address the situation, the Pakistani government has ensured that citizens and foreign nationals who have been in Pakistan for more than 4 weeks must receive a polio vaccination before international travel. The vaccination should occur at least 4 weeks prior to travel, and polio vaccinations are available for free at government hospitals. Travelers will receive a vaccination certificate, valid for one year, which must be presented to security officials at airports.
For domestic travel, the Pakistani government has implemented measures such that travelers from Sindh, FATA, KPK, and Balochistan must provide proof of immunization when arriving in Punjab, which has recorded the lowest polio cases. Those without proof can obtain polio drops at kiosks located at airports.
Ongoing Challenges
While the government is treating this issue as a priority, there are ongoing challenges, including the effectiveness of the vaccines used and the internal displacement of children missing their vaccination doses. Additionally, there is hostility towards polio vaccinators in FATA and KPK, largely due to concerns stemming from past incidents where US operatives disguised as vaccinators were involved in espionage. The Pakistani government has asked the US to make sure that similar incidents do not happen again in the future.
