MARDAN: Bathed in crisp morning light, Sidra Hussain grips a cooler stacked with glistening vials of polio vaccine in a northwestern area of Pakistan.

Watching over Hussain and her partner, a policeman unslings his rifle and eyes the horizon.

In concert they begin their task — going door-to-door on the outskirts of Mardan city, dripping bitter doses of rose-coloured medicine into infants’ mouths on the eve of a major milestone for the nation’s anti-polio drive.

The last infection of the wild poliovirus was recorded on January 27, 2021, according to officials, and Friday marks the first time in the country’s history that a year has passed with no new cases.

To formally eradicate the disease, a nation must be polio-free for three consecutive years — but even 12 months is a long time in a country where vaccination teams are in the crosshairs of a simmering insurgency.

Since the Taliban takeover of Afghanistan, the Pakistan version of the movement has become emboldened and its fighters frequently target polio teams.

“Life or death is in God’s hands,” Hussain told AFP this week, amid a patchwork of high-walled compounds in Khyber Pakhtunkhwa province.

“We have to come,” she said defiantly. “We can’t just turn back because it’s difficult.”

Nigeria officially eradicated wild polio in 2020, leaving Pakistan and Afghanistan as the only two countries where the disease — which causes crippling paralysis — is still endemic.

Spread through faeces and saliva, the virus has historically thrived in the blurred borderlands between the South Asian nations, where state infrastructure is weak and the Tehreek-i-Taliban Pakistan (TTP) has carved out a home.

A separate group sharing common heritage with the Afghan Taliban, the TTP, was founded in 2007 and once held sway over large swathes of the tribal tracts of Pakistan.

In 2014, it was largely ousted by an army offensive, its fighters retreating across the porous border with Afghanistan.

But last year overall militant attacks surged by 56 per cent, according to the Pakistan Institute for Conflict and Security Studies, reversing a six-year downward trend.

The largest number of assaults came in August, coinciding with the Taliban takeover of Kabul.

Pakistan’s newspapers are regularly peppered with stories of police slain as they guard polio teams — and just this week a constable was gunned down in Kohat.

The media has reported as many as 70 polio workers killed in Taliban attacks since 2012, mostly in Khyber Pakhtunkhwa.

Still, a TTP spokesman told AFP it “never attacked any polio workers”, and that security forces were their target.

“They will be targeted wherever they perform their duties,” he said.

Mardan Deputy Commissioner Habib Ullah Arif admits polio teams are “a very soft target”, but says the fight to eradicate the disease is entwined with the security threat.

“There is only one concept: we are going to defeat polio, we are going to defeat militancy,” he pledged.

Anti-polio drives have been runn­ing in the country since 1994, with up to 260,000 vaccinators staging regular waves of regional inoculation campaigns. But on the fringes of the country, the teams often face scepticism.

“In certain areas of Pakistan, it was considered as a Western conspiracy,” explained Shahzad Baig, head of the national polio eradication programme.

The theories ranged wildly: polio teams are spies, the vaccines cause infertility, or contain pig fat forbidden by Islam.

Published in Dawn, January 28th, 2022