By:Abdul Karim
Pakistan’s fight against polio has entered its fourth decade, yet the virus continues to circulate despite repeated vaccination campaigns and extensive international support.
According to the World Health Organization (WHO), Pakistan reported 31 wild poliovirus type 1 (WPV1) cases in 2025 and one case in 2026 as of August 25. The country also recorded 57 positive WPV1 environmental samples in 2026, indicating continued circulation of the virus.
Every year, thousands of vaccination workers, many of them women, visit millions of homes. In difficult areas of Khyber Pakhtunkhwa and Balochistan, teams travel through mountainous terrain, cross rivers and streams, and sometimes use boats. Security personnel accompany teams in high-risk areas.
But Pakistan’s polio problem is no longer simply a vaccination issue. Insecurity, vaccine refusal, misinformation, poverty, poor sanitation, unsafe drinking water and population movement continue to create obstacles. Children and families also move across districts and the Pakistan-Afghanistan border, allowing the virus to spread.
Security and Access
The danger faced by vaccination teams is real. On May 18, 2026, two police officers protecting polio teams were killed in separate attacks in Bajaur. According to an Associated Press report published by The Washington Post, more than 200 polio workers and security personnel assigned to protect them have been killed in Pakistan since the 1990s.
The WHO says sustained transmission remains concentrated in southern Afghanistan, southern Khyber Pakhtunkhwa and Karachi, while the southern Afghanistan-Quetta Block and northwest Pakistan-southern KP-southeast Afghanistan corridors remain important cross-border transmission areas.
Security and access restrictions in southern KP have reportedly left thousands of children unreached.
The Sanitation and Trust Challenge
Poliovirus mainly spreads through the fecal-oral route, making clean water, sanitation and hygiene important to eradication. WHO uses environmental surveillance, including sewage testing, to identify areas where the virus is circulating.
Vaccination remains essential, but repeatedly positive environmental samples also raise questions about drainage, sewage systems and access to safe drinking water.
Misinformation and mistrust are another major challenge. False claims that polio vaccines cause infertility or are part of foreign conspiracies continue to influence some communities, despite the lack of scientific evidence supporting such claims.
UNICEF says community-based vaccinators, religious leaders, health-care providers and tribal elders can play an important role in building public trust.
Protecting the Frontline Workers
Female vaccinators are particularly important because they can reach families inside homes and engage directly with mothers and children. UNICEF has documented efforts by female vaccination workers to reach previously missed children in high-risk areas, including Quetta and Balochistan.
These workers need adequate training, compensation, transportation, insurance, supervision and security if Pakistan expects them to reach every child.
International Support
Pakistan’s eradication programme has received major international assistance. The Global Polio Eradication Initiative (GPEI) reported in 2024 that Rotary International had invested almost $427 million in Pakistan’s polio eradication efforts.
UNICEF reported in March 2026 that a partnership with the King Salman Humanitarian Aid and Relief Centre helped vaccinate 2.8 million children against polio and strengthen immunization systems.
The scale of international support also highlights the importance of transparency and accountability in tracking funding, campaign performance, missed children, vaccine refusals, security costs and surveillance results.
What Pakistan Needs to Do
Experts and public-health officials face a challenge that cannot be solved by vaccination campaigns alone. Pakistan needs to:
* Identify and reach every zero-dose and repeatedly missed child.
* Improve coordination between health and security authorities in high-risk areas.
* Strengthen clean water, sewage and sanitation systems.
* Involve religious scholars, teachers, doctors, tribal elders, women and other trusted community figures.
* Respond rapidly to vaccine misinformation in local languages.
* Provide vaccination workers with proper training, pay, insurance, transportation and protection.
* Maintain close cooperation with Afghanistan on surveillance, vaccination and mobile populations.
The Final Mile
The GPEI says the global effort has reduced polio by more than 99 percent since 1988, demonstrating that eradication is possible.
Pakistan has made significant progress, but the continued detection of WPV1 in children and environmental samples shows that the virus has not been eliminated.
The question is no longer whether Pakistan knows how to vaccinate children. It does.
The real challenge is whether the country can build a system capable of reaching every child, protecting every frontline worker and addressing the sanitation, security, misinformation and population-movement problems that allow poliovirus to survive.
After nearly four decades, Pakistan needs more than another vaccination campaign. It needs a sustained, accountable national strategy to eradicate polio once and for all.
