Editor's note: From Jawahir Habib of the United Nations Children's Fund (UNICEF) in Pakistan, the blog entry below shares perspectives on efforts to deliver the oral polio vaccine (OPV) within the remaining polio-endemic countries in the context of the Global Polio Eradication Initiative (PEI). (Click here to see the blog site for all of this author's Communication Initiative blogs.)


"Polio has been 99% eradicated, this line often encourages me when i travel this last mile to eradicate the One percent.  Pakistan, India, Nigeria and Afghanistan are the only four countries where polio virus circulation has never been interrupted.  India has shown a remarkable progress as the clock strikes 12 this New Year even hopefully India will be standing with one polio case in 2011; it’s the same country where back in 2009 more than 400 cases of polio were confirmed in the two endemic areas UP and Bihar.

Situation in Pakistan has been the opposite, specially the part of Pakistan where I work for Polio eradication, Balochistan. Cases in Balochistan in 2011 have increased more than five times than that in 2010. 69 cases of polio have been confirmed in Balochistan a province where population is not more than 6 million. The concentrations of cases have been more in the Quetta Block a region of three districts which borders to Afghanistan. The Quetta Block has some peculiar features which places it at a greater risk of virus transmission and a threat to global polio eradication initiative.

Travelling the last mile hasn’t been easy, it has its toll on the workers, and a recent research conducted by UNICEF on motivation of the healthcare workers and volunteers shows a grim picture. Community fatigue is evident with the increased number of cases. Lack of accountability and ownership of the polio eradication initiative has resulted not only in diminishing quality of campaigns but also has affected the overall health system at the district level.

Rumors and misconceptions regarding OPV have filled the operational gaps, community sees the initiative as something that is forced on them and does not see polio as their problem. The threat susceptibility and severity as compared to other diseases as dengue, malaria and tuberculosis is perceived by community as very low which is another area where communications for PEI campaigns are struggling.

The last mile demands not only new and innovative approaches, out of the box strategies and strong micro-plans. But it also demands commitment from everyone…"

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