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, which has donated millions to Pakistan’s polio eradication programme, was later informed of the new cases.

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 vaccine-derived form of the disease .

“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.”

• Since publication, the Pakistan government has denied any cover-up. It said it had waited until the strain had been formally identified before announcing it. Babar Bin Atta has dismissed the allegations reported as baseless.

• This story was amended on 11 November 2019 to clarify when DfID was informed of polio cases.





