Progress towards poliomyelitis eradication--Pakistan, January 2023-June 2024/Progres accomplis vers l'eradication de la poliomyelite--Pakistan, janvier 2023-juin 2024

Since its launch in 1988, the Global Polio Eradication Initiative (GPEI) has made substantial progress towards eradication of wild poliovirus (WPV), including eradicating 2 of the 3 serotypes and reducing the number of countries with ongoing endemic transmission of WPV type 1 (WPV1) to Afghanistan and Pakistan. The two countries are considered a single epidemiological block. Despite the occurrence of only a single confirmed WPV1 case during the first half of 2023, Pakistan experienced widespread circulation of WPV1 during the subsequent 12 months, specifically in the historical reservoirs of the cities of Quetta, Karachi and Peshawar. As of 30 June 2024, 8 WPV1 cases had been reported in Pakistan, as compared with 6 reported during all of 2023. These cases, and >300 WPV1-positive environmental surveillance (sewage) samples reported during 2023-2024, indicate that Pakistan is not on track to interrupt WPV1 transmission. The country's complex sociopolitical and security environment continues to pose formidable challenges to poliovirus elimination. To interrupt WPV1 transmission, sustained political commitment to polio eradication, including increased accountability at all levels is necessary. Systematic tracking and vaccination of children who are continually missed during polio vaccination activities should be enhanced by better addressing operational issues and the underlying reasons for community resistance to vaccination and vaccine hesitancy. Depuis le lancement de l'Initiative mondiale pour l'eradication de la poliomyelite (IMEP) en 1988, des progres substantiels ont ete accomplis vers l'eradication des poliovirus sauvage (PVS). Ainsi, 2 des 3 serotypes sont desormais eradiques et seuls l'Afghanistan et le Pakistan enregistrent encore une transmission endemique du PVS de type 1 (PVS1). Ces deux pays forment un bloc epidemiologique unique. Bien qu'ayant observe un seul cas confirme de poliomyelite due au PVS1 au premier semestre 2023, le Pakistan a connu une circulation a grande echelle du PVS1 au cours des 12 mois suivants, en particulier dans les villes de Quetta, Karachi et Peshawar, qui constituent des reservoirs traditionnels du virus. Au 30 juin 2024, 8 cas de PVS1 avaient ete signales au Pakistan depuis le debut de l'annee, contre 6 notifies sur l'ensemble de l'annee 2023. Ces cas, ainsi que les >300 echantillons de surveillance environnementale (eaux usees) positifs pour le PVS1 qui ont ete recenses en 20232024, indiquent que le Pakistan n'est pas en voie d'interrompre la transmission du PVS1. Le contexte sociopolitique et securitaire complexe du pays demeure un obstacle majeur a l'elimination des poliovirus. Pour interrompre la transmission du PVS1, un engagement politique durable en faveur de l'eradication de la poliomyelite, assorti d'une responsabilisation accrue a tous les niveaux, est indispensable. Des efforts plus soutenus doivent etre deployes pour suivre et vacciner de maniere systematique les enfants qui continuent d'echapper aux activites de vaccination antipoliomyelitique, ce qui implique d'apporter de meilleures solutions aux problemes operationnels existants, ainsi qu'aux facteurs qui sous-tendent la reticence a la vaccination et la resistance des communautes.
Introduction Although the GPEI has achieved substantial progress since its establishment in 1988, the goal of polio eradication has remained elusive. Indigenous WPV1 circulation has never been interrupted in Pakistan, [...]