Pakistan is taking oral vaccination tips from India, which has been polio-free for over two years, and wants to replicate its success story, the head of the neighbouring country's polio programme says.
"But what hinders Pakistan in containing the dreaded virus is insurgency, violence and illiteracy," Pakistan National Polio Plus Committee Chairman Aziz Memon said in an interview during a visit here.
Earlier this week, Pakistan's polio campaign suffered a major setback when a volunteer in the vaccination campaign was killed and her colleague wounded in a militant attack near Peshawar. The attack came soon after nation wide polio campaign started May 28.
Memon said Pakistan is taking lessons from India for the way it reached out to its population.
"We are taking lessons from India. Our teams visited Bihar and Uttar Pradesh to see the way they vaccinated children," Memon said.
Both Uttar Pradesh and Bihar were the hotbed of the paralytic disease in India. Some members of the Muslim community in the two states resisted polio drops being given to their children as they feared that it could make them children impotent.
After 741 polio cases surfaced in 2009, India started using bivalent vaccines (targetting Polio 1 and Polio 3 viruses) in its national vaccination programme from 2010 January. This showed dramatic effects and India moved out of WHO's list of endemic countries in 2011.
"We picked many tips (from our visit). We learned how to involve hundreds of volunteers (involved in the campaign), how to handle the resource center and how to immunize children at the transit check posts," he said.
As India remains free from polio for the past two years, Pakistan, Afghanistan and Nigeria are the only three countries in the world now where the highly infectious, crippling disease still remains endemic.
Menon said that in some areas in Pakistan they have been able to vaccinate children, but some areas still remain out of bounds due to various reasons, including violence.
"The situation of our polio programme is good. One of the main reserves of polio is the Gadap Town slum area in Karachi. Now, it is very much in control there," Memon said.
Gadap Town is the largest slum of Karachi, which has concentration of migrant Pashtun speaking population of Khyber Pakhhtunkhwa province and the tribal areas, which have high incidents of polio, increasing the risk of the virus being imported.
However, Memon said that the issue of insurgency and violence in certain areas was a "major setback" to the programme.
"The area around Peshawar is another focus... Insurgency and law and order is the problem there," Memon said.
After the May 28 attack, the Pakistani authorities suspended the four-day polio vaccination programme.
Memon said that the tribal region of the northwest was another dark area, with the Taliban's rejection of the oral vaccination programme.
While the Taliban in Afghanistan recently announced its support for polio vaccination, the Pakistani Taliban continues to oppose this.
"The Afghan Taliban has announced support for polio vaccination, but the Taliban in Pakistan is different. The Afghan Taliban's support had no effect on the Pakistani Taliban," Memon said.
"In Pakistan, Taliban leaders change every 30 miles. They are against polio vaccination," he added.
The Pakistani Taliban has banned polio vaccination, saying that it is a cover for espionage.
"Working in that area (the northwest) is not so easy. There are many issues. Children are trapped there, though we have vaccinated some children with the army's help," Memon said.
Media reports, two children have been detected with polio in the last 36 months in the North Waziristan area of the Federally Administered Tribal Agencies (FATA).
FATA is a semi-autonomous tribal region in the northwest, lying between Afghanistan to the west and north, Khyber Pakhtunkhwa to the east and Balochistan to the south.
As per WHO data, during the last polio vaccination campaign in Pakistan, some 1.83 million children missed polio drops across the country owing to various reasons, including security threats.
About 763,714 children were missed in Khyber Pakhtunkhawa alone, 621,724 in other areas of FATA, including 260,000 from North and South Waziristan, and 396, 925 in Balochistan.
In 2013, eight cases have so far been reported in Pakistan.