Study of polio in Pakistan shows insecurity a barrier to eradication

A team of researchers from Canada, the U.S. and the U.K. has found that insecurity in a country or region can be a barrier to eradication of a disease such as polio. In their paper published in Proceedings of the National Academy of Sciences, the team describes their study and what they found about the relationship between social insecurity and polio incidence in northwest Pakistan.

Polio is a crippling viral disease transmitted through feces, generally under unsanitary conditions. It has been nearly eradicated due to an effective vaccine developed in the 1950s. Today, the disease exists in just three countries, Pakistan, Afghanistan and Nigeria—all of which have populations living with insecurity due to violence from militants. Despite health worker efforts, the disease has persisted. In this new effort, the researchers sought to find if it truly was insecurity preventing the eradication of polio in Pakistan by comparing eradication campaigns with military casualty records and polio infections rates in northwest Pakistan—militants there have been waging a war against government soldiers since 2004.

The team compiled polio infection rates on a district-by-district basis for the years 2007 to 2014, and eradication campaign data for the years 2007 to 2009. They compared what they found against reports of armed violence in the region for roughly the same time periods. They found that when eradication campaigns were carried out during times of higher insecurity (due to military conflict), vaccination rates declined by 5.3 percent on average, which resulted in an increase in polio rates of 73 percent. The team noted that in many cases, eradication teams continued with their efforts in spite of the danger, though there were times when the danger was too great, resulting in cancellation of efforts. The team estimates that up to 250,000 children in the region have missed out on being vaccinated due to insecurity. They note also that there is room for error in their statistics due to the tendency of some eradication officials to falsify records to improve their apparent results.

The researchers conclude that insecurity does, indeed, appear to be a factor in preventing the eradication of polio in Pakistan, which suggests the disease will not be eradicated until armed conflict in the region ends.