The programme to eliminate polio from the world received a setback as Pakistan recorded its firth case, and a fatality, as it was not confirmed until Friday that the patient had suffered polio, even though he had died 17 days before. The onset of paralysis had taken place on April 29, and though the patient, a two-year-old boy from a village in Quetta, died on May 23, the diagnosis was not confirmed until well too late.
There seems to have crept in a sort of complacency, which can perhaps be understood, but which could prove very dangerous. If cases are not suspected until too late, and if cases are then subjected to over-rigorous confirmation procedures, it is likely enough that false alarms will be avoided, Physicians must be saved from such pressures, and encouraged to act as if the worst is true. After all, though polio has long been known as a crippling disease, it should not be forgotten that it can kill. The effort to eliminate polio has now been narrowed down to Afghanistan and Pakistan. Indeed, it should not be imagined that the disease occurs all over the country. It is limited to what might be described as the borderland between the tw2o countries. This forms one tribal belt. Pakistan has to take up some of the slack of Afghanistan, and cover for the inefficiencies of the Taliban government. Another problem is the fencing of the Durand Line, which has made illicit crossings a problem. Without a more vigorous approach to this problem, there is very danger it may get out of hand. The highly desired aim of complete elimination means that there will be more effort involved in tackling the last cases.
As the elimination goal comes in sight, the need for the government to keep sight of it becomes all the more necessary. Apart from the achievement inherent in the elimination of a disease which has killed and crippled millions, the government needs to understand that from a healthy productive member of society, polio changes the individual to someone who needs special treatment all his life. That means there must be none of the relaxation of effort even when Pakistan reaches the position of having no polio cases, and then waits out the year of freedom from disease that will mark the achievement of elimination.
