World
Will Pakistan ever be able to eradicate polio?
Health workers have begun a campaign to vaccinate 9.5 million children against polio in 41 districts in Pakistan this week. This latest round of a national vaccination drive will include Islamabad and focus particularly on areas where polio-positive sewage samples have been found.
The anti-polio drive will be launched in 16 districts of Balochistan, 11 districts of Khyber Pakhtunkhwa, eight districts of Sindh, and five districts of Punjab, according to local media.
Despite major efforts to eradicate the disease in Pakistan, six cases of the highly infectious virus have already been reported this year. Further hampering the drive, vaccination teams and medical professionals have faced harassment and even physical attacks in some parts of Pakistan.
Pakistan’s PM Shehbaz Sharif, however, said the government “remains steadfast” in its aim to eradicate polio after a meeting with American billionaire philanthropist Bill Gates in Islamabad last week.
How serious a problem is polio in Pakistan?
Pakistan is one of only two countries in the world where polio is still endemic, the other being neighbouring Afghanistan, according to the World Health Organization (WHO).
The highly contagious viral disease largely affects children under the age of five. Children infected by poliovirus can suffer paralysis and in some cases death.
The South Asian nation launched a vaccination programme as part of its Polio Eradication Programme in 1994. Officials say the country used to report more than 20,000 cases annually.
Despite administering more than 300 million doses of the oral vaccine annually and spending billions of dollars, the disease is still rife across Pakistan.
This year, four vaccination campaigns targeting more than 43 million children have already been undertaken as authorities claim they are in the “last mile” of their fight against polio in the country of 235 million people.
How many cases have been reported in Pakistan?
Since 2015, Pakistan has reported 357 polio cases, including six this year. One of the victims, a two-year-old boy, died in May.
Officials said all of this year’s cases belong to the YB3A cluster, which they said originated in Afghanistan, where four cases have been reported this year.
In addition to human cases, wild poliovirus type 1 (WPV1) has frequently been detected in environmental samples taken across the country. This year, WPV1 has been found in 45 of Pakistan’s 166 districts.
How does Pakistan run its polio immunisation campaigns?
Nationwide immunisation campaigns involving more than 350,000 health workers are run in phases with vaccine desks set up at health centres and health workers going door to door. The campaigns are organised by the government-run National Emergencies Operation Center (NEOC), which has been tasked with running Pakistan’s Polio Eradication Programme.
Field workers go door to door over the course of a specified number of days, vaccinating children under the age of five.
Vaccines are also administered at land and air borders, including to adults, and on motorways connecting major cities across the country.
What are the issues facing the polio campaign?
Resistance to the polio immunisation drive grew in Pakistan after the CIA, a United States spy agency, organised a fake hepatitis vaccination drive to track al-Qaeda leader Osama bin Laden, who was killed in 2011 in Pakistan by US special forces.
Misinformation linked to religious beliefs has also been spread, claiming that the vaccine contains traces of pork and alcohol, which are forbidden in Islam.
Disinformation, agenda-driven campaigns, myths, community boycotts and mistrust in the government have also been factors behind refusals. But officials said government campaigns are helping change bad perceptions.
Health authorities in Pakistan have listed seven districts where polio is “endemic”. All seven are in the northwest, in Khyber-Pakhtunkhwa province. Officials said the security situation has been the biggest obstacle in reaching the target population in the province bordering Afghanistan.
In addition to the security situation, health officials say a target population that moves from one place to another, which may be carrying the YB3A variant, has proven to be a challenge.
Why have health workers and security officials been targeted?
Health workers and security officials accompanying them have been harassed, ridiculed, taunted, threatened and even targeted physically.
At least 102 polio field workers, officials and security personnel have been killed, including at least six in campaigns carried out this year.
In recent years, the Pakistan Taliban has killed dozens of health workers and members of the security forces involved in polio campaigns. But officials believe the reason for the violence is not the polio programme alone.
“Over the last few years, it is not the polio programme that is targeted, but unfortunately, the targets are the security personnel guarding the teams because, given the security situation in some parts of the country, they become soft targets when they are in the community,” Dr Hamid Jafari, the WHO’s director of polio eradication, told Al Jazeera.
What other issues affect the health workers?
Low pay, salary delays, lack of assistance and compassion, and tough working conditions are some of the other issues facing the field workers.
Some health workers told Al Jazeera they get paid as little as 1,360 rupees per day (about $5) for at least eight hours of work. Catch-up days when they go out in the field after the end of the campaign to vaccinate children who were missed are not paid, they said.
In addition, some polio survivors now working on the campaign do not receive help with transport or health benefits despite their conditions, leaving them to walk in poor weather and tough terrain to carry out their work.
Some staff lamented the lack of pay parity, saying people working with international organisations involved in the campaign are paid much more.
What is the outlook for the polio eradication campaign?
Dr Shahzad Baig, who was the NEOC chief until May, told Al Jazeera that the aim was to make Pakistan polio-free by 2026.
“That is our target at the moment,” he said before he was replaced.
However, after a Technical Advisory Group meeting organised by the WHO that took place in Qatar in May, there are increasing concerns over the “deteriorating situation of the disease” in the country, according to a report by Pakistan’s Dawn newspaper.
A Pakistani official quoted in the report said that at the meeting, “We faced an embarrassing situation as all the gains made by Pakistan in 2021 have been lost and the virus has re-emerged in three blocks.”
Health officials, however, remain hopeful, given that the number of positive cases has decreased significantly over the past five years – from 147 in 2019 to six so far this year.
“The programmes in Pakistan and Afghanistan are very mature and have learned a lot,” Jafari said.
“Despite changes in government and security situations, these programmes have evolved, adapted and adjusted. And that’s why they have a level of population immunity that you’re not seeing outbreaks of paralytic polio cases.
“It’s not a widespread problem across Pakistan. It’s not even a widespread geographic problem. It is now a matter of getting to these final, hard-to-reach populations. When you start reaching these populations, progress happens very fast.”
World
Live updates: Tracking Venezuela oil tankers as US seizes Russian-flagged vessel
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World
Iranian protesters rename Tehran street after Trump, plead ‘don’t let them kill us’ amid crackdown
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Iranian protesters intensified nationwide demonstrations over the past 24 hours, directly appealing to President Donald Trump while chanting anti-regime slogans. Footage published Wednesday showed a protester in Tehran symbolically renaming a street after Trump, while other videos captured handwritten appeals reading, “Don’t let them kill us,” Iran International reported.
Holly Dagres, a senior fellow at the Washington Institute, posted the video on X stating, “Since Trump’s comments about the Iran protests, I’ve seen numbers videos of Iranian protesters either thanking him or, in this case, renaming streets after the US president.”
The appeals came as demonstrators faced a widening security crackdown, including the deployment of armed units and tear gas near major civilian sites in Tehran.
TRUMP SIGNS ‘MAKE IRAN GREAT AGAIN’ HAT ALONGSIDE LINDSEY GRAHAM
Exiled Iranian opposition leader Reza Pahlavi said the current unrest represents a historic opportunity to end Iran’s Islamic Republic.
“In all these years, I’ve never seen an opportunity as we see today in Iran,” Pahlavi said in an interview aired Tuesday on “Hannity.”
“Iranian people are more than ever committed to bringing an end to this regime, as the world has witnessed in the last few days, the level of demonstrations is unprecedented in Iran,” he said.
Pahlavi said protests have spread to more than 100 cities and emphasized the role of Iran’s traditional merchant class, describing developments inside the country’s bazaars as a turning point. “We are beginning to see more and more defections,” Pahlavi said, adding that “Either way, the regime is crumbling and is very close to collapsing.”
IRAN ON THE BRINK AS PROTESTERS MOVE TO TAKE TWO CITIES, APPEAL TO TRUMP
Sen. Lindsey Graham, R-S.C., posted a photo of himself posing with President Donald Trump, who is holding a signed “Make Iran Great Again” hat. (Lindsey Graham / X)
Over the past 24 hours, Iran International reported continued protests and strikes across the country, including in Tehran, Tabriz, Qazvin, Kermanshah, Kerman, Shiraz, Falavarjan and Bandar Abbas. Tehran’s Grand Bazaar remained a focal point of unrest, with large crowds chanting against Iran’s leadership as authorities responded with tear gas and armed deployments.
Security operations expanded into sensitive civilian locations. Videos published by Iran International showed tear gas used near or inside Tehran’s Sina Hospital and the Plasco Shopping Center.
Protesters hold signs during a demonstration in Iran amid ongoing unrest, according to images released by the Iranian opposition group National Council of Resistance of Iran. (NCRI )
Casualty and arrest figures continued to rise. The Human Rights Activists News Agency, cited by Iran International on Wednesday, reported at least 36 people killed since protests began, including 34 protesters and two members of Iran’s security forces, with more than 2,000 arrests nationwide. Iranian authorities have not released updated official figures.
New footage from the past day showed demonstrators lighting fires in the streets of Shiraz and chanting “Death to Khamenei,” referring to Supreme Leader Ali Khamenei. In Qazvin, protesters were heard chanting, “Law enforcement, return to the side of the nation.”
Iranian protesters try to take control of two cities in western Iran as nationwide unrest continues, with demonstrators chanting ‘Death to Khamenei’ in the streets. (Getty)
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Workers also joined the unrest, with strikes reported at the South Pars gas refinery and widespread shop closures at major markets in Tehran and Tabriz.
World
How Ukraine is shaping Europe’s response to Trump’s Greenland threats
For the past year, staying in Donald Trump’s good graces has become a top priority for European leaders, who have gone the extra mile to appease the mercurial US president, rein in his most radical impulses and keep him firmly engaged in what is their be-all and end-all: Russia’s war on Ukraine.
Though Europe is by far the largest donor to Kyiv, nobody on the continent is under the illusion that the invasion can be resisted without US-made weapons and come to an eventual end without Washington at the negotiating table.
In practice, the strategic calculus has translated into painful sacrifices, most notably the punitive tariffs that Trump forced Europeans to endure.
“It’s not only about the trade. It’s about security. It is about Ukraine. It is about current geopolitical volatility,” Maroš Šefčovič, the European Commissioner for Trade, said in June as he defended the trade deal that imposed a sweeping 15% tariff on EU goods.
The same thinking is now being replicated in the saga over Greenland’s future.
As the White House ramps up its threats to seize the vast semi-autonomous island, including, if necessary, by military force, Europeans are walking an impossibly thin line between their moral imperative to defend Denmark’s territorial integrity and their deep-rooted fear of risking Trump’s wrath.
The precarity of the situation was laid bare at this week’s meeting of the “Coalition of the Willing” in Paris, which French President Emmanuel Macron convened to advance the work on security guarantees for Ukraine.
The high-profile gathering was notable because of the first-ever in-person participation of Steve Witkoff and Jared Kushner, the chief negotiators appointed by Trump.
At the end of the meeting, Macron hailed the “operational convergence” achieved between Europe and the US regarding peace in Ukraine. By his side, British Prime Minister Keir Starmer was equally sanguine, speaking of “excellent progress”.
But it did not take long for the elephant in the room to make an appearance.
Hard pivot
The first journalist who took the floor asked Macron whether Europe could “still trust” America in light of the threats against Greenland. In response, the French president quickly highlighted the US’s participation in the security guarantees.
“I have no reason to doubt the sincerity of that commitment,” Macron said. “As a signatory of the UN charter and a member of NATO, the United States is here as an ally of Europe, and it is, as such, that it has worked alongside us in recent weeks.”
Starmer was also put on the spot when a reporter asked him about the value of drafting security guarantees for a country at war “on the very day” that Washington was openly talking about seizing land from a political ally.
Like Macron, Starmer chose to look at the bright side of things.
“The relationship between the UK and the US is one of our closest relationships, particularly on issues of defence, security and intelligence,” the British premier said. “And we work with the US 24/7 on those issues.”
Starmer briefly referred to a statement published earlier on Tuesday by the leaders of France, Germany, Italy, Poland, Spain, the UK and Denmark in defence of Greenland.
The statement obliquely reminded the US to uphold “the principles of sovereignty, territorial integrity and the inviolability of borders” enshrined in the UN Charter – precisely the same tenets that Moscow is violating at large in Ukraine.
The text did not contain any explicit condemnation of the goal to forcefully annex Greenland and did not spell out any potential European retaliation.
“Greenland belongs to its people. It is for Denmark and Greenland, and them only, to decide on matters concerning Denmark and Greenland,” its closing paragraph read.
Conspicuous silence
The lack of censure was reminiscent of the European response to the US operation that just a few days earlier removed Nicolás Maduro from power in Venezuela.
Besides Spain, which broke ranks to denounce the intervention as a blatant breach of international law, Europeans were conspicuously silent on legal matters. Rather than condemn, they focused on Venezuela’s democratic transition.
Privately, officials and diplomats concede that picking up a fight with Trump over Maduro’s removal, a hostile dictator, would have been counterproductive and irresponsible in the midst of the work to advance security guarantees for Ukraine.
The walking-on-eggs approach, however, is doomed to fail when it comes to Greenland, a territory that belongs to a member of both the EU and NATO.
Danish Prime Minister Mette Frederiksen has warned that the entire security architecture forged at the end of World War II, which allies have repeatedly invoked to stand up to the Kremlin’s neo-imperialism, would collapse overnight in the event of an annexation. The worry is that trying to stay in Trump’s good graces at all costs might come at an unthinkable price.
“Europeans are clearly in a ‘double-bind’: Since they are in desperate need of US support in Ukraine, their responses to US actions – whether on Venezuela or Trump threatening Denmark to annex Greenland – are weak or even muted,” said Markus Ziener, a senior fellow at the German Marshall Fund.
“Europeans are afraid that criticising Trump could provide a pretext for the US president to conclude a peace deal at Ukraine’s and Europe’s expense. Is this creating a credibility gap on the part of the EU? Of course. But confronted with a purely transactional US president, there seems to be no other way.”
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