In the ongoing campaign to eradicate polio, authorities in one province of Pakistan are taking a controversial approach: imprisoning parents. The government in Sindh has introduced a bill that, if passed, would result in parents being jailed for up to one month if they fail to have their children vaccinated against polio or eight other common diseases. However, experts at the World Health Organization (WHO) and elsewhere express concern that this strategy may undermine trust in the polio vaccine. Many people in Pakistan believe false conspiracies about vaccines, and dozens of vaccinators have been killed in the country.
Complicating matters further is the fact that oral polio vaccines themselves now cause the majority of polio cases worldwide. The WHO’s polio director in the Eastern Mediterranean, Dr. Hamid Jafari, warns that this new law could have adverse effects. According to him, coercion is counterproductive, and health workers have been successful in raising immunization rates by identifying and addressing concerns and involving trusted leaders in discussions. Jafari believes that Pakistan may simply want this legislation as a precaution, and he doubts their willingness to enforce coercive measures.
Pakistan and neighboring Afghanistan are the only countries where polio transmission has not been stopped. Polio is a potentially fatal disease that primarily affects children under the age of 5 and spreads through contaminated water. Since 1988, the WHO and its partners have administered billions of vaccine doses in an effort to eradicate the disease. This initiative costs nearly $1 billion annually, with funding primarily provided by donor countries and organizations like the Bill & Melinda Gates Foundation. The oral vaccines, given as drops in the mouth, have reduced polio cases by over 99%. However, in rare cases, the live virus in the vaccine can cause polio or mutate and trigger new outbreaks.
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So far this year, there have been seven cases of polio caused by the wild virus in Pakistan and Afghanistan, while more than 270 cases have been linked to the vaccine in 21 countries. In January, approximately 62,000 parents in Sindh province refused to have their children vaccinated, prompting the proposal of this new law with penalties. If passed, parents who fail to vaccinate their children could face up to a month in prison and a fine of up to $168. The legislation also includes other diseases like measles, pneumonia, and pertussis. An expert from London expressed disappointment in the lack of trust people have in the government but emphasized that imprisoning parents will not solve the issue. Heidi Larson stated that not only is this approach ineffective, but it is also likely to incite anger among the population.
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