June 2, 2011
In the last year, as Pakistan has lost favor with the US and UNICEF, polio virus has paralyzed increasing numbers of Pakistani youth, casting doubt on the good intentions of those who fight polio. To make matters worse, most of the new cases have occurred in children already vaccinated. Is the US attempting to fight Pakistan by tainting inoculation doses?
The medical data suggests that the vaccine has changed in its efficacy against the disease. Last year, there were 136 cases of infected youth, and 107 of these had been administered multiple polio vaccinations. These figures are the largest the Polio Global Eradication Initiative has seen since 2006, despite heavy treatment in the most affected areas, South Punjab and the Federally Administered Tribal Area (FATA).
Even the more peaceful provinces have suffered. As reported by the Pakistan Daily times, there were 10 cases of polio in Sindh province in the first four months of the year. The article morbidly notes each of the cases, citing the children’s names and the number of vaccinations they had received before the onset of polio virus: “Mohammad Asif, aged 40 months with all his limbs affected… was administered oral anti polio vaccine (OPV) four times… The three and a half years old Ameera… had one of her arms and legs paralyzed… Ameera was first of the confirmed cases of polio during the current year.”
As one might imagine, Pakistani citizens are beginning to suspect foul play. Dr. Mazhar Khamisani, a manager of the health department in Sindh has noted that he has seen Pakistani parents begin to refuse treatment and do so on repeated occasions. And how could we, when confronted with the facts, ask them to do otherwise?
The type of polio vaccine administered may be a significant cause of the problem. There are two main types of polio vaccine, Inactivated Polio Vaccine (IPV) and Oral Polio Vaccine (OPV). The first of these uses dead cells of poliomyelitis. IPV was developed by Jonas Salk before being disseminated throughout the US in the 1950s, to quell the outbreak that was then infecting roughly 22,000 American children each year. Within 20 years, polio was all but forgotten in America.
However, The Polio Global Eradication Initiative chooses to use the second type, Oral Polio Vaccine. OPV was developed by Albert Sabin and runs the virus through a number of animals in order to weaken the strain rather than kill it. The weakened strain is then injected into children, whose immune systems are strong enough to defeat the infection. It is easy to see how treatment could backfire, in cases when the strain has not been weakened enough for human contact.
Despite the fact that it was not widely disseminated in the US, possibly because of the dangers associated with its use, OPV is the vaccine of choice in countries like Pakistan because, soon after vaccination, weakened virus can be found in children’s fecal matter. Immunity can then spread to communal water sources and increase immunity for greater portions of the population. So even if parents refuse OPV treatment, their children may still receive it indirectly through the drinking water.
Historically, there have been cases of outbreak when a weakened strain becomes strong enough to infect rather than immunize. In these cases, OPV is typically replaced by IPV because it is no longer considered safe. But OPV is still the vaccine of choice in Pakistan, even as it continues to prove its potency to the Polio Global Eradication Initiative. Why?
One explanation is that researchers have not collected enough data yet to say with certainty whether the vaccine is causing the outbreak. But how much longer will this go on?
It is equally plausible that the vaccine is not being handled properly. If the requisite temperature is not maintained, the vaccine can be rendered completely ineffectual. In remote areas, where power can be disrupted for hours and even days, the OPV treatments may have exceeded their temperature requirements and consequently lost their usefulness from temperature fluctuations. But surely, medical practitioners would know if their vaccine had potentially been compromised.
Unfortunately, both of these possibilities point to some kind of negligence. Either the doctors administering treatment are aware that their vaccine may not have the capacity to immunize their patients, or the people in charge are disseminating harmful vaccinations, then playing the victim to the ‘inconclusiveness of the data’ when it is clear that something has gone awry.
The Polio Global Eradication Initiative receives the majority of its funding through UNICEF and the US, both of which are beginning to look at Pakistan as an enemy, rather than a friend. Are political relations trickling down to the medical practitioners who are supposedly fighting a disease, not a country?
This article was posted: Thursday, June 2, 2011 at 3:26 am