Yet another campaign

This week's launch of yet another nationwide polio vaccination campaign in Pakistan - targeting some 45 million children under five across 159 districts - is another reminder of both ambition and frustration in the country's struggle to eradicate the disease. While door-to-door teams of more than 400,000 workers will be dispatched, the fact that roughly 830,000 children are still missed in each campaign is a troubling statistic that underlines an endemic weakness in implementation. It is not enough to repeat mass drives, hoping for incremental gains. The persistence of polio, even in tiny pockets, suggests that the strategy has reached diminishing returns. Environmental detection of poliovirus in multiple districts and confirmed new human cases signal that we are not closing the gaps fast enough.

Rather than simply conducting more campaigns, the polio programme needs a serious strategic re-orientation. First, the surveillance system must be strengthened: environmental sampling, community reporting and mapping of zero-dose children must become more refined and timely. Second, campaigns should be complemented by reinforcing routine immunisation, especially in the most neglected areas, so that every child receives full, consistent protection outside the blitz periods. Third, social mobilisation must be localised - tapping local leaders, religious scholars, teachers and trusted community voices to counter misinformation, resistance and fatigue. Fourth, the programme needs flexibility: campaign designs should be adjusted mid-course based on real-time data about missed children, refusals, migration, conflict zones or flooding.

Above all, political will and accountability must match the rhetoric. It is not enough for the government to laud the campaign launch. Instead, they must invest in sustainable systems, account for missed targets and integrate polio work into broader health and sanitation interventions. Only when polio vaccination ceases to be an isolated drive and becomes woven into everyday public health infrastructure will the country finally make the decisive push toward eradication.