Pakistan has active and widespread transmission of polio, and is the only country in Asia with confirmed Wild Polio Virus type 3 (WPV3) transmission, a strain on the verge of eradication in this continent. The majority of cases occur in three main areas: Balochistan (Killa Abdullah, Pishin and Quetta Districts); Sindh (Karachi and northern Sindh); and parts of the Federally Adminstered Tribal Areas (FATA) and Khyber Pakhtunkhwa (KP). In 2011, Pakistan was responsible for international spread to China, where it caused an outbreak in the western Xinjiang province. During SIAs, children are missed due to operational challenges due to poor management and inadequate commitment at district and union council level and, in some areas, due to security-related lack of access (notably some areas of FATA). Communication in Action: overview of community engagement
In Asia, persistent poliovirus transmission is highly localized in a few districts. The approach in Asia therefore focuses on district- and sub-district-specific plans to achieve exceptionally high coverage with very frequent supplementary immunization activities to boost population immunity to >95% – the threshold required to stop transmission in Asia. Engaging local political and administrative leaders to ensure the quality of supplementary immunization activities is also important.
Interrupting the remaining poliovirus transmission in Afghanistan has been declared an emergency by the World Health Assembly. In response, the National Polio Emergency Action Plan has been developed which recommends the following emergency approach.
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