THIS year’s likely tally of new polio cases reported across the country may be lower than corresponding periods before, but Pakistan has no reason to be sanguine.

The ugly reality of this crippling illness here is thrown into even starker relief when it is considered that globally, the number of cases reported over the course of 2015 is at its lowest in history, according to a report released earlier last month by the Global Polio Eradication Initiative.

Sadly enough, the two countries still considered polio-endemic that stand in the path of success are Pakistan and Afghanistan; Nigeria, until recently the third country thus classified, was taken off the list in September.

Also read: Vaccine refusal: another polio case surfaces in Quetta

On Wednesday, came further bad news. Two children in Karachi were confirmed as having contracted the poliovirus, bringing the number of new cases to four in just three days in the city. Significantly, both these children are said to have been administered the OPV. This is not for the first time that such failure of the vaccine has been reported.

The difficulty in reaching every child is well known, as are the problems of misconceptions about the vaccination, refusals and the ever-present security threat. More focus is needed, though, on the apparent failure of the vaccine to immunise a child.

One reason is the interruptions in the cold-chain storage process, which render the vaccine ineffective. On a few instances, vials have also been found to be past their expiry date.

An official of the emergency operations centre for polio in Sindh threw up another possibility about the two most recent Karachi cases: that the children may have compromised immune systems, which may have “assist[ed] the vaccine”. It is true that vaccine-associated paralytic polio is a reality, though the incidence is fractional.

This possibility can be put to test in a lab. Yet addressing these issues still leaves the big question unanswered: how will Pakistan find the commitment to take meaningful strides towards tackling polio effectively and eliminating it?

Published in Dawn, December 4th, 2015