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Pakistan accused of cover-up over fresh polio outbreak

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Officials in Pakistan have been accused of covering up an outbreak of the most dangerous strain of polio and planning a covert vaccination programme to contain the disease.

According to a source in Pakistan’s polio eradication programme and documentation seen by the Guardian, a dozen children have been infected with the P2 strain of polio, which causes paralysis and primarily effects those under five.

Dr Malik Safi, coordinator of the national emergency operation centre of the Pakistan polio eradication programme, confirmed the P2 outbreak, but would not give any further comment.

The P2 strain had previously been eliminated from the country. However, the new cases were allegedly kept hidden from the government and from international donors, including the UK’s Department for International Development, under direct instruction from Babar Bin Atta, the prime minister’s focal representative on polio eradication, who was last month forced to resign after he was accused of corruption. DfID has donated millions to Pakistan’s polio eradication programme.

The alleged cases, which have all resulted in paralysis, have been discovered mainly in Diamer district, with one in the capital, Islamabad.

Under Pakistani law, every new case of polio in the country has to be officially registered with the government, which then alerts international health bodies. “But to hide their negligence and their poor performance, Babar Bin Atta decided not disclose the cases to anyone,” said the source.

The re-emergence of P2 would not only be a dramatic step back in Pakistan’s fight against the polio, it would also be symptomatic of what those in the programme have described as “terrible mismanagement” under Bin Atta.

Alongside Afghanistan, Pakistan is one of only two countries in the world that has not entirely eradicated polio. It was a key milestone in 2014, when Pakistan officially declared it had entirely eradicated P2 polio.

Polio exists in three different strands, P1, P2, and P3, with P2 notorious as the most contagious and most vicious in its impact on those infected.

According to the source within the programme, the renewed outbreak of the P2 strand came from a mismanagement of vaccines, which carry a live strain of the disease to create immunity.

After the strand was eliminated from Pakistan five years ago, all P2 vaccines should have been collected from hospitals and clinics and not used. However, it appears a P2 vaccine was administered accidentally and a child became a carrier for the disease. Tests on the new cases allegedly show the children are all carrying a form of the disease that originates in vaccine form.

“Somewhere, somebody has inaccurately used this vaccine and because of this negligence … this virus was brought back into the environment and our children are again getting infected with P2,” alleged the source.

However, it is understood that, instead of publicly declaring the renewed outbreak and beginning a public vaccination campaign, a “secret” vaccination campaign will begin on Monday in Rawalpindi and surrounding cities in an attempt at containment. It is understood that only senior members of the polio programme are aware of the P2 campaign, with others – even those who will be administering the vaccines – led to believe it is a standard P1 and P3 polio vaccination programme.

“This P2 outbreak can only be contained if they do a quality vaccination campaign, and how can you do a quality campaign if you are carrying it out in secret, without any awareness or accountability?” said the source.

“If anything goes wrong and this P2 polio spreads throughout the whole country, who will take responsibility? Will they just keep telling more lies to cover up their mistakes and put more children at risk?”

Since 2018, there has been an “alarming” rise in polio cases in Pakistan, according to experts, with 77 official cases this year. Senator Ayesha Raza Farooq, who served as the prime minister’s focal person on polio eradication from November 2013 to August 2018, said Bin Atta had “ruined” the programme through corruption and mismanagement.

Farooq accused the prime minister, Imran Khan, of refusing to listen to complaints against Bin Atta for the past 10 months. “PM Khan did not take heed to the programme and ignored the complaints which were coming to him against Babar Bin Atta,” she said. “They covered up the refusals and they allegedly used fake markers on kids’ to show they were vaccinated who actually were not. The damage that has been done to the programme has literally reversed many of our achievements.”

https://www.theguardian.com/global-...accused-of-cover-up-over-fresh-polio-outbreak
 
Pakistan accused of cover-up of fresh dangerous Polio outbreak

Why is the medical system in Pakistan such a big mess - first the HIV news & now this!
 
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Special Assistant to the Prime Minister on Health Dr Zafar Mirza and the prime minister's former focal person on polio on Friday denounced a report published by British daily The Guardian, in which the publication had accused Pakistani officials of "covering up" a polio outbreak.

The report in question, published in The Guardian on November 7, accused Pakistani officials of "covering up an outbreak of the most dangerous strain of polio and planning a covert vaccination programme to contain the disease".

According to The Guardian, an outbreak of the P2 strain of the virus was allegedly kept hidden from the government as well as international health bodies and donors "on the orders of Babar bin Atta", who was the prime minister's focal person for polio eradication until he resigned last month.

"[In order to] hide their negligence and their poor performance, Babar Bin Atta decided not disclose the cases to anyone," The Guardian quoted an unnamed source as saying. The report further said that the virus was believed to have reemerged because the vaccine to prevent its spread was misused.

"Somewhere, somebody has inaccurately used this vaccine and because of this negligence […] this virus was brought back into the environment and our children are again getting infected with P2," the report quoted the source as saying.

Pakistani officials rushed to correct the record today. "[There has been] absolutely no cover up," Dr Mirza responded to the story in a tweet earlier today.

Talking to Dawn earlier, Dr Mirza had said that seven new cases of the vaccine-derived poliovirus Type 2 had been detected in the country.

"This is not a wild poliovirus outbreak. It is an outbreak of the Sabin-Like Type 2 Derived (SLT2D) [strain]," he said. "Similar outbreaks [of SLT2D] have been recently reported in Philippines, China, Indonesia, Nigeria, Democratic Republic of Congo and several other countries in Africa which have [otherwise] completely eradicated the poliovirus."

"SLT2D virus outbreak in Pakistan is vigilantly being monitored and appropriately responded," he assured in a tweet.

There are three serotypes of the wild poliovirus, Type 1, Type 2, and Type 3.

Pakistan has been immunising against Type 1 and Type 3 viruses through oral polio vaccines (OPVs). It had stopped administering vaccines for Type 2 virus in 2014 after it was believed to have been eradicated. The virus could not be found even in environmental samples since 2016, officials said.

The Type 2 vaccine was discontinued as it contains specimens of the virus that can spread disease if not used appropriately.

"However, suddenly cases have been reported from different areas, which means there was some vial [of Type 2 vaccine] left in some laboratory or somewhere else and started spreading due to human error," Dr Mirza told Dawn.

"Just after getting the cases — which cannot be included in the number of wild polio virus [cases, as The Guardian has alleged] — we sent samples to the Centres for Disease Control and Prevention (CDC), Atlanta, and after getting confirmation that children were paralysed due to Type 2 polio virus, we have started polio campaigns," Dr Mirza said.

Babar rejects allegations
Separately, Babar rejected the allegations against him, calling them "absolutely baseless". He said that he was writing to the British daily to set the record straight.

"The Guardian report is absolutely baseless. I am writing to them to correct the record and issue an apology, failing which I shall pursue my legal options. I shall be sending relevant documents to @guardian to prove their 'He Said - She Said' report wrong. Enough of this slander," he said in a tweet.

In another tweet, Babar pointed out that though the reporter, Hannah Ellis-Petersen, was based in New Delhi according to her Twitter profile, she had not contacted him for a comment on the matter.

He also accused her of "misreporting [the incidence of] circulating vaccine-derived polio viruses (VDPV) as [the] P2 virus".

The SLT2D strain, which has been found circulating in Pakistan, is a VDPV.

"[The reporter] did not mention same VDPV contamination in India 2018; hid the fact that VDPV does not add to [a country's official] polio case tally; did not mention same VDPV strain [is also] found in [otherwise] polio free countries," he pointed out.

Babar also rubbished the charge that he could have covered up polio cases, pointing out that the monitoring of cases is done by external agencies that he has no control over.

"[...] Surveillance is a World Health Organisation subject. What authority does an honorary "Focal Person" have to instruct a United Nations agency?" he asked in a tweet. "[The UK] Department for International Development (DFID) pays to the Global Polio Eradication Initiative (GPEI), not to Pakistan directly [...] They should have contacted me for a version, I would've educated them."

Working to enhance immunisation coverage: PPEP
In an official statement, the Pakistan Polio Eradication Programme said that the seven cases of SLT2D poliovirus which had been detected were present "mainly in the northern parts of the country".

"The only way to reduce the risks of further transmission is to address gaps in immunisation coverage. The programme is working on a comprehensive outbreak response that includes rounds of vaccination in the area to protect every child under the age of five years.

"The programme has also enhanced its acute flaccid paralysis (AFP) surveillance by active search for additional cases, increasing testing of contacts of cases and strengthening environmental surveillance."

During the current year, 80 polio cases have so far been reported in Pakistan.

https://www.dawn.com/news/1515632/a...s-denounce-the-guardian-for-incorrect-article
 
Why would you cover up? You can get more foreign aid specifically from Gates foundation for this..
 
<blockquote class="twitter-tweet" data-lang="en"><p lang="en" dir="ltr">89/ Absolutely no coverup. Sabin-like type 2 derived virus outbreak in Pakistan is vigilantly being monitored & appropriately responded. Such outbreaks are being reported from countries even after Polio eradication e.g. Nigeria, China, Indonesia, Congo. <a href="https://t.co/2P3GVpMKPs">https://t.co/2P3GVpMKPs</a></p>— Zafar Mirza (@zfrmrza) <a href="https://twitter.com/zfrmrza/status/1192627275180711936?ref_src=twsrc%5Etfw">November 8, 2019</a></blockquote>
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Govt offers to investigate former PM’s focal person on polio

ISLAMABAD: After criticism from the opposition parties on the floor of the Senate, the government on Monday offered to hold an inquiry against the prime minister’s former focal person on polio Babar Bin Atta for alleged corruption.

Minister for Parliamentary Affairs Ali Mohammad Khan agreed that an inquiry should be initiated against the former focal person. If the house directs the government to hold an inquiry it will be initiated, he added.

The house was discussing a motion moved by PPP Senator Sherry Rehman regarding an increase in polio cases in the country.

The minister said the house can also refer the matter to a parliamentary committee for a probe and the committee can summon Mr Atta.

He appreciated the previous PML-N government for doing a good job and reducing the number of polio cases, but claimed that the PTI government would eradicate the virus.

The minister said due to the Covid-19 pandemic the polio vaccination drive remained halted for almost five months. He said there were almost same cases in Khyber Pakhtunkhwa ruled by the PTI and Sindh where the PPP is in power.

Senator Rehman said former prime minister Benazir Bhutto had started the polio vaccination programme. She said cases had re-emerged during the tenure of the PTI.

“We never heard the name of Babar Bin Atta but he was appointed as the PM’s focal person on polio. As many as 30 million children were missed during the vaccination drive just because a social media manager was appointed as the polio manager. Even international organisations pointed out corruption in the polio programme due to which finally Mr Atta resigned,” she said.

Senator Ayesha Raza Farooq, who remained the PM’s focal person on polio during the tenure of the PML-N, said in 2017 only eight cases had reported in the country but after the PTI came to power the cases again increased.

She said till the end of the PML-N government’s tenure in 2018 there were only three cases in a small area of Balochistan. But during the tenure of the PTI the cases have increased to 12.

“You appointed a focal person who brought shame to the country. It was your prerogative to appoint anyone but you appointed a person who played with the health of the children of Pakistan. We took the PTI and PPP onboard to eradicate the poliovirus but you did not bother to build a political consensus. Even thousands of community workers have been dismissed,” she said.

Ms Farooq said former special assistant to the prime minister on health Dr Zafar Mirza had contacted her and said he wanted to build political consensus. She said a national advisory council on polio was established but till date it has not held even a single meeting.

“The government, which changed three health ministers and five health secretaries, cannot ensure continuity in its policies. However, I am still hopeful as it is never too late,” she said.

PTI Senator Dr Meher Taj Roghani said it was unfortunate that the country even failed in routine immunisation.

“The rate of routine immunisation is 50 to 60 percent despite the fact that it should be 100pc. Around 15,000 children are born per day and each of them should be vaccinated in one week,” she said.

PPP Senator Quratulain Marri said two deaths had been reported in Lahore due to polio. She said even former minister Azam Swati had said action will be taken against Mr Atta but so far no action has been taken.

Senator Mushtaq Ahmad Khan said the World Health Organisation (WHO) has observed that the government has made polio a political football.
https://www.dawn.com/news/1574995/govt-offers-to-investigate-former-pms-focal-person-on-polio
 
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