Polio: no sign of abating

The confirmation of Pakistan's 12th polio case in 2025 — a boy from Bannu just short of his third birthday — marks another grim milestone in a worsening public health crisis. This year's cases, spanning six districts in K-P, four in Sindh, and one each in Punjab and Gilgit-Baltistan, reveal a concerning trend. Despite decades of effort, the virus is regaining footholds in large cities, most notably Karachi. While we are still doing better statistically than last year, the only reason is that the 74 cases in 2024 represented a 12-fold surge from 2023, shattering earlier optimism and underscoring systemic vulnerabilities.

Several interrelated crises drive this setback, including operational gaps, misinformation, militancy and security, and border-related issues. Several inaccessible areas in K-P and Balochistan have not seen comprehensive vaccination efforts for several months, and even years, because of security challenges, staff shortages and logistical difficulties. Anti-vaccine propaganda and outright threats from extremist groups further complicate the issue.

Finally, the Afghan border was already a cause for concern for health authorities due to low vaccination rates across the border and among refugees, and security threats. This could worsen significantly if Israel's vicious campaign against Tehran leads to a large number of Iranians fleeing to Pakistan.

The evolving nature of the challenges means there is no single solution for any part of the country. While ongoing vaccination efforts are laudable, creative solutions are required to fill lingering coverage gaps, particularly in high-risk zones where door-to-door campaigns were replaced with site-to-site efforts which, though safer, have been much less effective.

We must also bridge the trust deficit between parents and the government. Political leaders, health bodies and local influencers must unite to dispel myths, ensure the safety of vaccinators and guarantee every dose reaches every child. Polio eradication is still possible within a few years, but only if we act with unprecedented urgency and cohesion.