POLIO ERADICATION Security and Access for Vaccination Teams Strictly Confidential: Update Polio Pakistan 19 August 2014 Overview • As of August 13th 2014, 139 cases of polio have been reported worldwide in 2014 compared to 181 cases in the same period of 2013 (a decline of 24%) • Out of 139 cases, 108 (78%) were reported from Pakistan, 8 (6%) from Afghanistan, 5 (4%) from Nigeria, 4 (3%) from Somalia and 14 (10%) from other countries (Equatorial Guinea, Iraq, Syria, Cameroon, Ethiopia) Pakistan Focus • The majority of cases in Pakistan were reported from the federally administered tribal areas (FATA), particularly from North Waziristan. • After the Karachi Airport attack by IMU fighters of Uzbek origin closely linked to the Tehrik-l-Taliban (UP), the Pakistani military launched an air and ground offensive in North Waziristan targeting militant hideouts. • The military's ground offensive displaced ca. 800'000 tribesmen including ca. 450'000 children who had to flee rpuisishr '—'111•010•04 tribnau to unsafe areas. --t,wsdc IMSW•01 rear P“Mne• • For the first time since June 2012, the majority of children from North Waziristan were vaccinated, as all internally displaced people (IDPs) had to register to receive food, aid, cash, etc. which allowed the 25 polio teams to reach the people. IPI value add and outcome • IPI approached very senior Army officials in connection with security and other direct support for polio vaccination teams. • IPI established direct contact (field visit Nov/Dec 2013), and followed through with discreet, confidential requests and negotiations (field visit in Mar/April 2014), plus continuing contact. • Consequently, the Pak Army provided security for polio-vaccination teams and enabled the successful vaccination of previously unreached children after tribesmen fled from inaccessible areas to settled areas during the May-July military operation. • As a result of IPIs continuing work in the field, th