Making Polio Vaccination Accessible to All—Policy Options

Policy Question: What actions, if any, Government of Pakistan should take to make polio vaccination accessible to everyone in the country?

Client: Prime Minister of Pakistan.

Policy Options

Following are policy options:

1.     Maintain the status quo, i.e., continue with current policy. Current policy has strengths in the sense that it has Government backing, strong support from international organizations such as WHO and UNICEF, strong support from administrative and political institutions, and frameworks for monitoring policy implementation and taking corrective actions whenever necessary.  The policy has been successful in the past, however, more recently starting the year 2012, polio cases have started appearing again. Continuing with this policy will definitely be helpful, as it would not let polio spread at wider scale in the country.

2.     Build confidence of the local people in usefulness of the polio vaccination program by involving them in program implementation at grass root level. Due to some negative propaganda and lack of awareness, many people in some regions of Pakistan have started assuming that there is some political, instead of health, agenda behind polio vaccination programs. Underlying motivation for this policy alternative is that when people who are being affected most by polio become part of the program implementation, their overall confidence in usefulness of the program will be increased and they will stand themselves in favor of the polio program in particular and similar other health programs in general.  Moreover, this will not require government advocate the usefulness of such programs all the time. This differs from the status quo in the sense that current policy has been implemented by government using top-down administrative organizations and this alternative suggests building bottom-up infrastructure as well that complements existing top-down infrastructure.
3.     Keep political and religious conflicts separate from public health by engaging a third party that can mediate between Government and influential non-state actors who have banned administration of polio vaccination in areas under their control. In quite a few regions in the country, government and some non-state actors are at war with each other due to apparently political and religious differences and, therefore, non-state actors resist implementation of government policies, even if the policies are related to public health in general. Underlying motivation for this policy alternative is that public health should be considered separately from political or religious conflicts among organizations. This policy differs from status quo in the sense that government and non-state actors, who are at conflicts with each other in some domains, will not interfere with each other in health sphere, resulting in better public health irrespective of who is politically or religiously influential in certain regions.