THE federal health minister’s assertion of a 99pc reduction in polio cases in Pakistan, while impressive on the surface, invites closer scrutiny. At a recent meeting of the Gavi Board and the Polio Oversight Board, he attributed this decline to a coordinated national strategy, effective field monitoring and the commitment of front-line workers. But only a day after this claim was publicised, the national polio programme confirmed the year’s 12th case — this time from district Bannu in KP. Six of the cases this year have emerged from KP alone, underlining that not only does eradication remain an unfinished task, but that the province poses a serious challenge. To be fair, a broader view does place the minister’s claim in context. When the national polio campaigns began in 1994, the country recorded an average of 20,000 cases annually. The reduction to double digits indeed shows decades of effort. Yet, this hard-won progress cannot afford complacency. The virus is entrenched in regions like southern KP, where access challenges and local resistance continue to obstruct vaccination drives. The area’s rugged terrain, security concerns and low numbers of female vaccinators means that thousands of children are missed.

These missed children are potential carriers of a crippling disease that, if left unchecked, could resurge and undo years of progress. The latest case from Bannu is a reminder that even a few missed areas can keep the virus alive. To overcome these hurdles, the government must urgently invest in expanding the cadre of female vaccinators, especially in conservative areas where male workers face cultural barriers. Community engagement should be deepened through sustained dialogue with local leaders and religious scholars. House-to-house access needs to be improved by working with local security personnel to create safer conditions for vaccination teams. Coordination between polio and routine immunisation efforts should be boosted to ensure all children are reached. The government must also consider introducing hardship allowances for vaccinators, deploying digital map-based microplanning, integrating nutrition packets to foster acceptance, incentivising local mothers as ‘polio champions’, and instituting independent audits to track every unvaccinated child. Pakistan may be close to eradicating polio. But the final steps are the hardest. A more realistic assessment of the challenges and a targeted strategy for vulnerable areas are key to eradicating polio.

Published in Dawn, June 23rd, 2025