KARACHI // Taliban militants have long been the scourge of Pakistan’s polio vaccination campaign, attacking aid workers and the police who protect them as they distribute doses to children.
But experts say there is another reason for the sharp spike in cases of the crippling disease in Pakistan this year – government mismanagement.
“Pakistan’s polio programme is a disaster. It continues to flounder hopelessly, as its virus flourishes,” the Independent Monitoring Board (IMB), which advises agencies fighting polio, will say in a report to be released this week.
The prime minister's polio cell was disbanded during 2013 elections, the new government delayed reconstituting it, and in recent months the prime minister has been consumed with protests in the capital that have only just ended.
“Eradicating polio is not rocket science,” said Elias Durry, head of the World Health Organisation polio campaign in Pakistan.
“If we could have three to five months to have really good campaigns, then we could get rid of this disease,” he said.
“We have been doing half-baked campaigns in high risk areas.”
Polio was meant be a thing of the past. A global campaign came tantalisingly close to wiping out the disease altogether.
Now polio, which can kill or paralyse a child in hours, is endemic only in Pakistan, Afghanistan and Nigeria.
So far this year, Pakistan has had 217 polio cases, a 14-year high accounting for 85 per cent of instances around the world.
The disease spreads easily from person to person, and Pakistan has already exported the virus to Syria, China, Israel and Egypt. Experts say complacency is not an option and the government has called the situation an “emergency”.
Yet as the latest vaccination campaign started this week in Karachi, vaccination workers said they had not received stipends from the provincial government for months.
Some have dropped out of the campaign in Karachi, a teeming city of 18 million people where the disease is entrenched.
As teams prepared to venture out on vaccination missions into some of Karachi’s most dangerous streets, police deployed to protect them showed up late.
Vaccinators must wait, which means they miss children. Sometimes only a third of children in an area are vaccinated, the WHO said, and low coverage fuels new outbreaks.
Pakistani prime minister Nawaz Sharif took six months to appoint an official responsible for polio, and the government approved a funding plan only last month.
“We had a loss of about nine to 10 months, which is a very big setback,” Mr Ali said.
Ayesha Farooq, the prime minister’s appointee on polio, admitted there were problems.
Most new cases were in areas where security was poor so children had not been vaccinated, she said, and denied that Mr Sharif was not taking the issue seriously.
Emergency operations centres, meant to be operational by July, will not be ready until the end of November, she said. The IMB report said the delay “speaks volumes about the inertia of the programme in Pakistan”.
For frontline polio workers, late pay is less worrying than lack of protection. Sixty-four people have been killed in attacks on polio teams and their security escorts since 2012, when the Taliban banned vaccinations.
Their targets are women like 19-year-old medical student Asma Nizam, who received a death threat for taking part in the programme.
“A man came on a motorbike and said, ‘if you want to save your life, you should go from here’,” she said.
The next day, militants killed five of her colleagues.
Last Monday, police sent to protect Ms Nizam were three hours late.
Pakistan’s police are thinly spread, especially in crime-ridden Karachi where only 26,000 police watch over the city. Some are seconded as bodyguards for politicians.
“I have seen six police taking a VIP’s teenager to the salon but they cannot spare any officers to protect the poor children of Pakistan,” one health official burst out in exasperation.
Karachi police spokesman Atiq Shaikh said the force was severely understaffed.
A further hurdle is caution among families offered the treatment. Some believe Taliban propaganda that says vaccinations are a Western plot to sterilise children.
Aiding polio’s spread has been this year’s military offensive in the tribal region of North Waziristan, which drove nearly a million people out of the conflict zone.
The mass movement allowed workers to vaccinate children previously unreachable. But families also moved to areas where vaccination coverage was patchy, allowing polio to reestablish itself in cities where it had been eradicated, experts say.
Children may need the oral vaccine up to 10 times for it to be effective. Many Pakistani children are malnourished or have diarrhoea so the vaccine is not absorbed.
The unlucky ones may end up like two-year-old Rafia. Her legs were partially paralysed after contracting polio this summer.
“She was vaccinated whenever they came,” said her father Ghulam Isaq. He massaged her tiny toes as a group of polio vaccinators looked on.
“We need help even if we are poor,” Mr Isaq said. “We are Pakistanis too.”
* Reuters
Leap of Faith
Michael J Mazarr
Public Affairs
Dh67
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
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Villains
Queens of the Stone Age
Matador
UAE currency: the story behind the money in your pockets
Pakistan squad
Sarfraz (c), Zaman, Imam, Masood, Azam, Malik, Asif, Sohail, Shadab, Nawaz, Ashraf, Hasan, Amir, Junaid, Shinwari and Afridi
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MATCH INFO
Manchester City 1 (Gundogan 56')
Shakhtar Donetsk 1 (Solomon 69')
Short-term let permits explained
Homeowners and tenants are allowed to list their properties for rental by registering through the Dubai Tourism website to obtain a permit.
Tenants also require a letter of no objection from their landlord before being allowed to list the property.
There is a cost of Dh1,590 before starting the process, with an additional licence fee of Dh300 per bedroom being rented in your home for the duration of the rental, which ranges from three months to a year.
Anyone hoping to list a property for rental must also provide a copy of their title deeds and Ejari, as well as their Emirates ID.