In the last stage of polio eradication, Pakistan continues to implement an intense vaccination campaign schedule focused on operational improve-ments to achieve high population immunity in the core reservoirs of Karachi, Khyber-Peshawar and the Quetta block, and to keep the rest of the coun-try polio-free.
The goal of ending polio is in sight. Government's commitment to the National Emergency Action Plan, implemented via focused Emergency Opera-tions Centres (EOCs) at National and Provincial levels has been the driving force behind the recent programme's progress. Thanks to the EOCs and the "one-team" approach, the programme is now driven by high-quality data and comprehensive, real-time risk assessment and monitoring, resulting in better campaign quality and better response to outbreaks. Consequently, the number of children paralysed by the wild poliovirus (WPV) has dropped from 306 in 2014 to 54 in 2015 to 20 in 2016, and only 2 in 2017 so far.
Moreover, out of 535 environmental samples tested from the sewage water in 2016, only 12% were positive for WPV compared to 19% in 2015 and 38% in 2014. Currently, there are 53 environ-mental detection sites in a total of 33 districts / towns of the country, making it the lamest polio en-vironmental surveillance network in the world. As such, more virus is being revealed but notwith-standing the increase in samples, frequency and methods used in highest risk areas, the proportion of positive samples in Q1 2017 (18%) has remained broadly similar to Q1 2016 (15%), showing that there is not an increase in intensity of transmission.
Access and security are no longer barriers to fur-ther progress by the programme whose focus is on local female community-based vaccinators to ensure comprehensive coverage and identify missed children in high-risk areas. Moreover, the programme continues to identify and vaccinate high-risk mobile children at their point of arrival or departure. From January-March 2017, 4.13 million children were vaccinated at Permanent Vaccination Points (PTPs) set up along country and district borders and transit areas across the country.
Pakistan has very high levels of acceptance and intent to vaccinate amongst caregivers and par-ents, including oral polio vaccine (OPV) and inacti-vated polio vaccine (IPV), which has been used in selected campaigns to give children stronger pro-tection against polio.
