Campaign to stamp out polio in remaining hot spots has become ‘a horror story’, report warns

The campaign to stamp out polio in its last haunts has become a “horror story” in the past year, a stark independent monitoring report has warned.

Public suspicion, political infighting, mismanagement and security problems have undermined eradication efforts in Pakistan and Afghanistan and made the final defeat of the crippling virus “considerably longer than it could have been”.

The warning from an independent monitoring board of five medical experts set up to check progress by the Global Polio Eradication Initiative (GPEI) came as £2bn more was pledged to beat poliovirus.

Donor governments and philanthropists gave the money for a campaign that has taken decades to reach what global health specialists say is now the “last mile”.

The funding announced at a meeting in Abu Dhabi included £800m from the Bill and Melinda Gates Foundation, £400m from the UK, £167m from the United States and £123m from Pakistan.

A three decade-long international campaign to eradicate the virus through vaccination has seen cases fall from around 350,000 cases in 1988 to just 33 in 2018. Afghanistan and Pakistan are the only two remaining countries harbouring cases of the wild poliovirus.

Yet the final steps to see off the virus have proven frustratingly difficult, with cases now rising again. Pakistan saw 12 cases in 2018, but has already seen 82 so far this year.

The hike in cases and a growing pool of unvaccinated Afghan children vulnerable to the virus in now represent “a massive reversal of the trajectory to global polio eradication”.

“It is important to make clear that the resurgence of polio is not some sort of biological mystery,” a 64-page report by the monitoring body said.

“It should not have happened. It need not have happened. It is a source of public embarrassment for the GPEI and the two countries’ governments.

“It is no exaggeration to describe it as a crisis.”

The monitoring board led by Sir Liam Donaldson, a former Chief Medical Officer of England, said it still believed eradication was possible, but the events of the past year had set efforts back.

Dr Rana Muhammad Safdar, Pakistan's national coordinator on polio, admitted the report made grim reading.

He told the Telegraph he was attending a polio oversight board meeting in Abu Dhabi “with a plan to transform” Pakistan's efforts.

The World Health Organisation also admitted the blunt assessment was “probably very accurate”.

The monitoring body said that in Pakistan, the national polio programme had over estimated its success in recent years and underestimated the public suspicion and hostility surrounding the vaccination programme. It had also become riven by political infighting which had undermined the work.

Fake reports that polio drops cause vomiting, fainting, sterility or even death have been circulated on social media and added to parents' fears. The extent of the problem became clear in April when worried parents took 25,000 children to hospital in a single day in Peshawar, after fake reports circulated saying drops had poisoned schoolchildren.

The campaign has also become a bargaining chip for villages and neighbourhoods who used the threat of refusing to take part to try to exact concessions from local officials.

Sajid Hussain spokesman for the Ministry of Health in Islamabad said research for the monitoring report had been conducted six months ago and the programme had since been overhauled. “We have reviewed and revised whole strategy of the campaign to make Pakistan polio free and this project totally depoliticised.”

The world would see the difference “in the coming months,” he said.

“In many ways, the Pakistan programme is a nice analogy to the global effort,” said Christian Rosenbauer, a spokesman for the WHO.

“Twenty-five years ago, poliovirus paralysed more than 30,000 children across the entire country. This year, fewer than 100 cases were reported, primarily from a handful of districts. That is tremendous progress, by any objective measure. But not if you are trying to eradicate a virus. Not if you are trying to interrupt person-to-person transmission of this pathogen. There is virtually no room for error.”

A spokeswoman for the Department for International Development said the GPEI had cut polio cases by 99.9 per cent since 1988.

“There is, however, still more work to do. Conflict and insecurity make it extremely hard to reach children at risk of wild polio in Pakistan and Afghanistan, but UK aid is supporting the GPEI to adapt to meet these challenges.”

Meanwhile research has found that majority of ads spreading misinformation about vaccines on Facebook are funded by just two US anti-vaxx groups.

Researchers found that 54 percent of anti-vaccine ads were bought by The World Mercury Project, spearheaded by Robert F Kennedy Jr, and Stop Mandatory Vaccinations, led by David Cook.

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