LAHORE/PESHAWAR: For Kaleem Ullah Khan, a polio health worker in Pakistan’s northern city of Peshawar, the rise of new myths about the virus immunization drive have made his job harder. There are the usual suspects, like the prevalent misconception that the polio campaign is a foreign ploy to sterilize Muslim children. But with the latest surge in Pakistan’s polio rates, health workers like Khan fear greater resistance at work.

In a major setback to the global campaign to eradicate polio, Pakistan has reported 69 cases this year (till September), the highest in the world. In comparison, it reported only 12 in 2018, and seemed to be on the brink of wiping out the deadly virus- an incurable and highly contagious disease that leads to paralysis in young children. Pakistan, neighboring Afghanistan and Nigeria, are the only three countries in the world that have failed to eliminate the crippling disease.

“Nowadays, there is a new trend,” Khan told Arab News. “Parents use the high-profile (polio) drive as a bargaining chip. They ask for jobs and utilities in exchange and refuse to have their children administered drops till their demands are met.” Even turning to local elders, he said, was often unsuccessful.

“This one time, I kept going back to a woman’s house to convince her. Every time she said the drops gave her grandson a stomach ache. After a month, I gave up.”

In its review, the Independent Monitoring Board (IMB), which oversees the global polio eradication effort, declared Pakistan’s polio program a ‘disaster.’

“It is now clear that there is something seriously wrong with the program,” it noted last October. “Some would say that the polio program is fooling itself into thinking that it has made any progress at all since 2017.”

Babar Bin Atta, who was appointed the Prime Minister’s focal person for polio eradication a few days before the Board’s scathing review, said the hysteria surrounding the campaign came primarily from a trust deficit.

“There is only one reason for the resurgence: mistrust,” Atta told Arab News. “Nearly 70 percent of the cases are coming from the district of Bannu in the Khyber Pakhtunkhwa province.”

When Atta and his team visited the district to talk to health workers and reluctant parents, they were surprised to note that the number of refusals were 60 times higher than reported.

The people of Bannu had lost trust in the vaccination campaign as local administration used force and threatened to register police complaints against unwilling parents. Other parents, in cahoots with health workers under pressure not to report non-compliance, had acquired the special pens used to mark a vaccinated child’s finger.

“This led to data manipulation by the field staff, since their performance depended on the number of children they reached,” Atta said.

Aside from Bannu, in Pakistan, the most high-risk areas have remained its urban centers- Karachi, Quetta and Peshawar- which have continued to show transmission of the disease. Troublingly, this year, Pakistan saw a resurgence of the polio virus in the Punjab province, which was declared polio-free in 2018.

One overlooked dimension to the resurgence of polio numbers, officials say, could be Pakistan’s general elections.

Health workers insist that national polls disrupt the immunization drives, leading to a spike in the deadly disease every five years.

“Whenever a new government comes in, the bureaucracy overlooking the health campaigns is transferred, posted or changed,” Atta said. “The country has historically reported higher polio cases a year after elections.”

There may be some truth to this pattern. In 2013, when Pakistan went to the ballot, the tally of polio cases was 93. The next year, these shot up to 306. Then again, the year of the 2018 elections, a total of 12 cases were reported from across the country. Now, the newly-elected Pakistan Tehreek-e-Insaf (PTI) government is grappling with 69 cases.

“Pakistan now accounts for 80 percent of all wild polio cases globally,” the Bill and Melinda Gates Foundation’s media team told Arab News via email. “The importance of Pakistan to the success of the global eradication, therefore, cannot be understated.”

The Bill and Melinda Gates Foundation, World Health Organization (WHO), Rotary International and UNICEF are the international partners and donors of the country’s polio eradication initiative.

A concocted video circulated widely on social media in April showed children falling sick after taking anti-polio drops in Peshawar. Later, a right-wing televangelist called the immunization drive “dangerous” on his weekly TV show.

The rumors stuck. Mobs rioted in KP province and three polio workers were killed.

“After the fake video, the situation on ground became terrible,” Saba Gul, a health worker in Peshawar told Arab News. “No one would want to listen to us or let us in their homes.”

Though the men behind the April scam were arrested and videos of the televangelist were taken down, the damage had been done. From July to date, over 1,000 Facebook and Twitter accounts have been suspended over harmful polio-related content.

Officials at WHO working in tandem with local administration said the program had the ‘highest level’ of political commitment with the full support of the government and Pakistan army.

“We knew that the last few steps in polio eradication would be the hardest,” Dr. Palitha Mahipala, the WHO representative in Pakistan, told Arab News.

Settled in, the new government has now promised to restructure the polio campaign, including running a high-profile media campaign starting next month.

By 2022, Babar Atta, said he was confident his team would eliminate polio.

“Pakistan is the last and final battleground of the virus,” he said.