New polio cases

The number of polio cases recorded this year continues to tick up, with the ninth and tenth cases confirmed this week. After several years of bouncing between double-digit caseloads and then coming within touching distance of eradication, Pakistan remains a concern for international bodies and donors — and many local experts — because despite the massive financial and logistical support for eradication efforts, security issues and parental refusal have combined to undermine all of the good work.

As recently as 2021, Pakistan had brought its annual caseload down to one, but whether it was because health authorities took their eyes off the ball, the deterioration of the situation in Pakistan, or increasing terrorism and militancy inside Pakistan, the infection numbers spiked the next year and have shown no sign of coming down to the "almost eradicated' level since then.

Despite largely successful campaigns to vaccinate millions of children, operational inconsistencies persist. While Punjab reports relatively higher coverage, provinces like Balochistan and K-P lag due to insecurity and logistical hurdles, with over 200,000 children missed in recent campaigns, creating fertile ground for outbreaks. It is also worth noting that the virus has been detected in sewage samples in Punjab, even though the province has been polio-free since 2020. Cross-border transmission with Afghanistan further complicates eradication.

But the single biggest hurdle towards polio eradication — and improving global health in general — is now US President Donald Trump and Elon Musk's decision to cut almost all USAID projects, including funding for vaccination and other health initiatives. A now-former top USAID official warned that in the worst-case scenario, the funding cuts could be responsible for up to 200,000 new polio cases per year around the world. In light of this, eradicating polio is less about decisions taken in Islamabad, and more about the White House.