Pakistan’s Sindh province has introduced a controversial bill that could result in parents being imprisoned for up to one month if they fail to vaccinate their children against polio or eight other common diseases. While the government’s aim is to increase vaccination rates, health experts, including those at the World Health Organization (WHO), express concerns that this unconventional strategy may erode trust in polio vaccines.
Pakistan, along with neighboring Afghanistan, remains the only countries where polio has not been eradicated. Polio is a potentially fatal disease that predominantly affects children under the age of 5 and typically spreads through contaminated water.
The global campaign to eradicate polio, initiated in 1988, has made significant progress, reducing polio cases by over 99%. However, the oral vaccines used in this campaign have, in very rare instances, been linked to polio cases or have mutated into new strains, sparking outbreaks. This year, seven cases of polio caused by the wild virus have been reported in Pakistan and Afghanistan, while over 270 cases have been attributed to the vaccine-linked virus in 21 countries across three continents.
The new bill, which is in the final stages of becoming law after being approved by the provincial assembly in August, imposes penalties on parents who fail to vaccinate their children against specific diseases, including polio. Those who refuse vaccination could face up to a month in prison or fines of up to 50,000 rupees ($168).
One of the challenges in Pakistan is widespread vaccine hesitancy, fueled by suspicions regarding the source of vaccine funding and the government itself. Some individuals believe in false conspiracy theories, such as the notion that vaccines are part of a plot by Western entities to sterilize people.
Health workers distributing vaccines have also faced threats, with militant attacks on vaccination campaigns and suicide bombings targeting those protecting the health workers.
Dr. Hamid Jafari, WHO’s polio director in the Eastern Mediterranean, cautioned against coercion and emphasized the importance of addressing people’s concerns to build trust. He expressed doubts about the willingness to enforce such coercive measures.
Heidi Larson, director of the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine, noted that punitive measures could exacerbate mistrust and suggested that trust-building efforts would be more effective.
Efforts to combat polio in Pakistan have been met with challenges, but many health experts believe that continued vaccination is crucial to preventing the resurgence of the disease.
Despite the challenges and controversies, vaccination campaigns remain a vital tool in the global battle to eradicate polio and protect the world’s children from this debilitating disease.