Pakistan’s polio battle is close to finish line. From 306 cases in 2014, Pakistan has made immense progress by bringing the toll to 15 as of this day.

Polio survives only among the world's poorest and most marginalized communities, where it stalks the most vulnerable children. And embarrassing part is that only two countries in the world are now left with transmission of polio – Pakistan and Afghanistan.

Polio was once feared worldwide, paralyzing people for life. Since the launch of Global Polio Eradication Initiative, cases have dropped by 99 per cent between 1988 and 2016, from around 350 000 cases in 1985 to 54 in 2015.

Pakistan has declared polio a national emergency and devised a National Emergency Action Plan outlining detailed strategies for programme’s operational, management and communication components. As part of NEAP, the Emergency Operation Centre was set up in Directorate General Health Services bringing together dedicated professionals from government and international development partners working under one-roof with government providing strategic leadership. The experiment was one of its kind and proved to be a unique model of performance and efficiency. The induction of mid-career professionals from specialised disciplines turned out to be inspiring experience for the government as well.

In line with the Polio Eradication and Endgame Strategic Plan 2013-2018 plan, Pakistan has also introduced (inactivated injectable polio vaccine) IPV for children above 14 weeks of age.

Another milestone was that global switch from tOPV from bOPV was also complete in April 2016.The switch was a historic moment in human history. Of the 3 strains of wild poliovirus (type 1, type 2, and type 3), type 2 was eradicated in 1999 and case numbers of type 3 were down to the lowest-ever levels as no cases was reported since November 2012. This was a kind of elimination of one strain of polio virus and it seems the remaining two strains will also be eradicated very soon.

Punjab has been a trail blazer in Pakistan’s battle against polio. It was the first province using GPS tracking of vaccinators with Punjab Information Technology Support. The android-based application E-vaccs developed by PITB has been a game changer in routine immunization. By providing a GPS-based tracking of vaccinator performance, the vaccinator attendance improved to 97 per cent from just 40 per per cent in 2014. The routine immunization coverage recorded a vertical boost, rising from 64 % by 2014 to over 86 per cent in first quarter in Neilsensurvey conducted with DFID support in first quarter of 2016.

In order totrack the presence of polio virus in the environment, the environmental samples are collected from drainage sites from different areas. Overall there were 36 positive environmental samples in the country in 2016. Most were in Peshawar (6), Quetta (5), Karachi Gadap (4) and Pishin (3).

In Punjab a total of 6 environmental samples were positive (2 in Rawalpindi, 2 in Faisalabad, 1 in Lahore and 1 in DG Khan). In the last two years, the origin of all cases in Punjab was linked with virus transmission in reservoir areas in other provinces, mostly to KPK/FATA and Balochistan.

Even though Permanent transit points have been set up at strategic routes at borders of Punjab, tracking movement of population at such large scale has its limits.

Given the epidemiology of the disease, Punjab alone cannot eradicate polio as population movement is a continuous activity. Hundreds of thousands of travelers move in and out of Punjab to reservoir areas all through the year. Seasonal migrants in bordering areas also come for short time.

Experts believe the polio programme is a major beneficiary Operation Zarb-i-Azab as FATA with 179 cases, recorded the most number of cases in the country in 2014. This year it has recoded just one cases. With all focus on Khyber Pakhtunkhwa and Sindh, it appears Pakistan will soon rid itself of polio.

The writer is attached with Punjab’s Polio Programme