Our Global Voices Posts

Overcoming obstacles to polio eradication in Pakistan

Posted on by Alina A. Visram, manager, Pakistan National PolioPlus Committee

Originally published on October 5, 2017 on Rotary Voices

“Coming together is a beginning. Keeping together is progress. Working together is success.”
Henry Ford

When I first joined Pakistan’s PolioPlus Committee (PNPPC) as a manager close to eight years ago, polio eradication seemed within our reach. I used the opportunity to study poliomyelitis beyond just perceiving it as “a crippling disease.” I researched the causes and consequences; the types of poliovirus; modes of prevention; and how elusive the virus can be given the right conditions.

Then in 2012, the dynamics of my country changed. We were faced with hostile militants, who refused to allow polio teams to vaccinate children in their territory. Our front line workers were regularly targeted for their work during campaigns.

Picture of worker bonding with community members at a health camp in Karachi, Pakistan.
Picture of worker bonding with community members at a health camp in Karachi, Pakistan.

Children were deprived of polio vaccine in several regions occupied by the militants making them inaccessible and hard to reach. Common myths and misconceptions were rife in most reluctant communities. Our biggest hurdle was “how do we change their mindset,” while they eyed us with suspicion and disdain.

We expanded our motley crew to a larger team. Together we worked closely with our polio partners to devise strategies and innovative approaches to overcome the odds; through placing Resource Centers in high risk districts; targeting nomads and Internally Displaced Persons (IDPs) through Permanent Transit Posts (PTPs); creating awareness in low- literate communities through speaking books; conducting workshops with enlightened religious clerics; and encouraging Rotary clubs to hold health camps in impoverished districts.

Picture of worker distributing polio advocacy items to children.
Picture of worker distributing polio advocacy items to children.

Meanwhile, polio cases spiraled across the country and in 2014 we reported over 300 cases of the wild poliovirus. In the years that followed, we worked with unwavering diligence and commitment in collaboration with the Government of Pakistan to restrict polio transmission. Today, we have only five cases of polio stemming from the wild virus and only 11 globally, as of the end of September.

World Polio Day 24 October was established by Rotary International to commemorate the birth of Jonas Salk, who led the first team to develop a vaccine against poliomyelitis. It marks the long and arduous journey all endemic countries have struggled against, to eradicate polio.
The last mile is the hardest, but we are so close to the finish line.

For more information about CDC’s Polio Eradication Efforts, visit www.cdc.gov/polio.

For more information about the author and other stories from Rotary International, please visit Rotary Voices.


Rotary International works in conjunction with the CDC, World Health Organization, UNICEF, and the Bill and Melinda Gates Foundation as a partner of the Global Polio Eradication Initiative (GPEI). GPEI is a public-private partnership led by national governments. Its goal is to eradicate polio worldwide. Launched in 1988 after the World Health Assembly passed a resolution to eradicate polio, GPEI, along with its partners, has helped countries to make huge progress in protecting the global population from this debilitating disease. As a result, global incidence of polio has decreased by 99.99% since GPEI’s foundation.

Posted on by Alina A. Visram, manager, Pakistan National PolioPlus CommitteeLeave a commentTags ,

Precision Public Health: Using Malawi Population-Based Impact Assessment (MPHIA) Data to Reach HIV Epidemic Control in Malawi

The Malawi Population-Based HIV Impact Assessment (MPHIA) is Malawi’s first nationally representative HIV survey that measures national HIV incidence, pediatric HIV prevalence, and viral load suppression. MPHIA has provided detailed information on the current status of the HIV epidemic and the uptake of HIV prevention, care, and treatment services in Malawi. In his remarks during Read More >

Posted on by Nellie Wadonda-Kabondo and Danielle PayneLeave a commentTags , , , ,

Looking Ahead to a Measles and Rubella Free World

Robert Linkins, MPH, PhD

Vaccines fight diseases and save lives. Think of achievements like smallpox eradication, a polio-free world close at hand, and 2-3 million deaths prevented each year through routine immunizations. Yet despite a safe and effective vaccine against measles and rubella, these deadly viruses continue to steal the health and lives of children all over the world. Read More >

Posted on by Robert Linkins, MPH, PhDLeave a comment

Optimistic in the Face of Ongoing Tragedy: Progress toward a World Free of Human Rabies

During her presentation at 2017 PARACON meeting on how to plan and budget for a mass dog vaccination campaign, Emily Pieracci asked who was committed to ending rabies.

Rabies is a fatal disease that kills an estimated 59,000 people each year, almost half of whom are children. The majority of deaths occur in Africa and Asia. All of these deaths are vaccine-preventable with timely administration of post-exposure prophylaxis (PEP), the shots needed to prevent rabies from developing in bite victims. So why is Read More >

Posted on by Emily PieracciLeave a comment

CDC Global Rapid Response Team Pilots Workshop for Senegal and Burkina Faso

Global Rapid Response Team

Participants to the Rapid Response Team Management workshop, Dakar, Senegal, August 7-11 The 2014-2016 Ebola epidemic clearly demonstrated the need for trained scientists who can deploy quickly to confront health threats and ensure global health security. While we often think about the emergency response itself, we typically don’t think about the work that happens behind Read More >

Posted on by Global Rapid Response TeamLeave a comment

Making some noise about noncommunicable diseases in Rwanda

We weren’t sure what to expect when the Rwanda Biomedical Center requested a training for their noncommunicable disease (NCD) program managers. We had never delivered this particular curriculum before, but after three months of preparation, our journey from Atlanta began. After landing in the capital Kigali, we faced a bumpy three-hour drive into the mountains Read More >

Posted on by Kristy Joseph, MA, CDC Global NCD BranchLeave a comment

Parasitologist for the People

LT Knipes chats with school children who have been enrolled and are waiting to be tested for lymphatic filariasis and malaria in Nord Est Department, Haiti.

Global health emergencies are a constant in today’s world. In recent years, we have seen the impact of natural disasters, mass migrations, famines, conflicts, and more. When there are large population movements, we see rapid spread of infectious disease. When there is famine, those affected have a compromised immune system, allowing them to contract illnesses easier. For these reasons it is vital that public health staff from the Centers for Disease Control and Prevention (CDC) is on the scene. Read More >

Posted on by Adrienne Lefevre, MPH, CHESLeave a commentTags , , , ,

Are Ebola response investments making an impact? CDC Epidemiologist reflects on West Africa then and now

The first time I deployed to West Africa was in September 2014, at the height of the Ebola epidemic in Sierra Leone. I have witnessed many disease outbreaks in my public health career, but this one was more devastating than I could ever have imagined. It eventually took more than 11,000 lives. What was happening Read More >

Posted on by John T, Redd, MD, MPH, FACP, CAPT, US Public Health Services, CDCLeave a commentTags , , , ,

Vaccination remains the most cost-effective strategy to get on track with hepatitis B elimination in resource-limited settings

Midwife providing the 5-in-1 pentavalent vaccine (diphtheria-tetanus-pertussis [DTP], hepatitis B, and Haemophilus influenzae type b) during a routine vaccination session in Myanmar In the 1990s, the Western Pacific Region had one of the highest prevalence rates of chronic hepatitis B infection in the world (>8%). As a result, in 2005, it was the first World Read More >

Posted on by Dr. Rania Tohme, Team Lead, Global Immunization DivisionLeave a commentTags , , , ,

Training the Future Public Health Workforce in Malawi: Field Epidemiology Training Program (FETP)

8. Malawi FETP-Frontline Cohort 2 trainees with mentors and guests during graduation ceremony: Photo courtesy: Kiran Bhurtyal, CDC

At 4:00 PM on July 12, 2016, I received an urgent email from the CDC Malawi office asking if I had any information on a typhoid outbreak in Malosa in southern Malawi. The U.S. Embassy in Malawi was planning a visit to Malosa by the Second Lady of the United States, and they had received reports of an unusually high number of typhoid cases there. Fortunately for me, one of our trainees from the Field Epidemiology Training Program (FETP) had presented on the same outbreak earlier that day during the FETP graduation ceremony.  Read More >

Posted on by Kiran Bhurtyal, CDC MalawiLeave a commentTags ,