By Imran Zakir
Sindh, once a beacon of success in Pakistan’s fight against polio, especially under the leadership of former EOC Sindh Coordinator Fayaz Hussain Abbasi when Sindh was optimizing a successful eradication of polio virus during 2020-2023, almost three years as the province was proudly being announced a polio free region then the incumbent EOC Coordinator was posted, if not a joke, intently damaged the entire course of polio eradication program through his ridiculously foolish ideas what he called them “My Innovations.” Can anyone ask him what his so-called ‘My innovations” are doing when Sindh being bumped by the continuous surfacing of polio virus which is not a joke but truly making innocent children’s life miserable as recently five new cases reported across Sindh, two each from Karachi and Hyderabad, and one from Shikarpur.
The situation represents a sharp reversal in the once-promising eradication efforts. Health experts have pointed to a combination of administrative missteps, operational failings, and security threats that are now hampering the fight against this preventable disease. At the core of these issues lie deeper problems of mismanagement, nepotism, and lack of accountability. The competent authority should have taken a note what being done under the rhetoric of “All is Well” though recently learnt from honorable Chief Minister Sindh Syed Murad Ali Shah, when he was innocently pilling all blames of the polio resurgence on the parents’ shoulders and otherwise supporting the rhetoric of “All is Well.” There is no doubt that the polio program has been blessed by some true professionals and they do know how to do their work but imposing a mere 18-grade bureaucrat with arrogance on such highly trained and widely experienced individuals, is certainly devastating.
Nepotism and the erosion of expertise
A key issue at the heart of Sindh’s polio crisis is the alleged hiring of non-technical staff for critical positions. These appointments have drawn widespread criticism, particularly in cases where inexperienced individuals have replaced experienced professionals who were instrumental in the province’s previous successes. Reports suggest that individuals without the requisite skills, have been appointed to essential roles like Union Council Medical Officers (UCMOs), positions that are pivotal for overseeing polio vaccination campaigns. Such practices have eroded the competence of field teams, with many experienced workers either dismissed or sidelined. While last but not least most of the senior staff having say in hiring process inducted their kins and immediate relatives, who interestingly do not bother to come as any of their relatives signs or makes their attendance.
In districts like Hyderabad, where two new cases have been reported, the consequences of this neglect are evident. The refusal by the Emergency Operations Center (EOC) Sindh to reinstate these skilled workers, despite requests from local authorities, highlighted the lack of transparency in the hiring process and the disregard for merit. Without a meritocratic and transparent system, polio eradication efforts remain vulnerable to inefficiency and failure. The repercussions of these practices extend beyond individual appointments. The endemic culture of political interference in the appointment of District Health Officers (DHOs), which is often driven by connections rather than competence, has significantly undermined the credibility of the program. Investigations into malpractice, such as the ongoing probe into Karachi Central’s Typhoid Conjugate Vaccine (TCV) campaign, are emblematic of a system plagued by delays and influenced by political pressures. These unresolved inquiries serve as a sobering reminder of the dysfunction within the public health sector.
Ghost teams and fake reporting
Compounding the mismanagement are reports of ghost teams—nonexistent workers listed in official records, contributing to false reports of vaccination coverage. These fabricated records paint a misleading picture of progress, while leaving vast segments of the population, particularly vulnerable children, unvaccinated. Without comprehensive coverage, herd immunity cannot be achieved, and the virus continues to find pockets in which to thrive. The problem of fake reporting is yet another manifestation of a system riddled with corruption, with those responsible seemingly shielded from accountability.
Security failures and worker vulnerability
The security of polio workers has long been a concern in Pakistan, but the recent gang rape of a female worker in Jacobabad has brought the issue to the fore. Despite some arrests, reports suggest that the true perpetrators—protected by their political connections—remain at large, underscoring the failure of law enforcement to deliver justice. The case is a harrowing reminder of the dangers faced by frontline workers, many of whom now fear for their safety and prestige. Low morale and a reluctance to work in high-risk areas have further jeopardized the anti-polio drives in future. The Sindh government has responded by removing the Deputy Commissioner, Senior Superintendent of Police, and District Health Officer of Jacobabad, but such steps are mere makeshifts in a system, where impunity reigns. Until polio workers are provided with robust security and genuine protection, these incidents will continue to weaken the resolve of those essential to the fight against the virus.
A crisis of governance and oversight
Poor coordination between field teams and central authorities has exacerbated the crisis. In the past, stronger supervision ensured timely interventions, but current gaps in communication have resulted in operational inefficiencies. Without real-time oversight and robust reporting mechanisms, public health infrastructure remains weak, allowing the virus to spread unchecked. It is crucial to acknowledge that the resurgence of polio in Sindh is not merely a health issue; it is a symptom of broader governance failures. The lack of transparency in the recruitment process, political interference in appointments, and the absence of accountability in both security and operational matters have brought the polio eradication campaign to the brink of collapse.
The path forward
Reversing the current trajectory requires urgent and decisive action. The provincial and federal governments must prioritize the appointment of qualified and committed personnel, free from political interference. The process of hiring and firing polio workers should be fully transparent, with merit and competence as the sole criteria. Field-level supervision needs to be strengthened, with mechanisms put in place to ensure real-time problem-solving and swift resolution of operational challenges. The international community, particularly donors such as the World Health Organization (WHO) and UNICEF, also bears responsibility. Periodic forensic audits of polio program funds should be conducted to prevent misuse and ensure accountability. These measures are not just technical fixes but essential steps to restoring public trust in the campaign.
Ultimately, Sindh’s polio resurgence is a stark reminder of the consequences of complacency and corruption. Without concerted efforts to address these issues, the province risks not only a public health disaster but also the further erosion of its governance institutions. The safety of children, the integrity of the health system, and the future of Pakistan’s polio-free status all hang in the balance. The time for action is now.
