TWO more children have been paralysed by poliovirus in Tank and North Waziristan, bringing Pakistan’s cases this year to 23. Of these, 15 are from KP. This concentration means that the province has become the epicentre of the crisis and that routine responses are failing to turn the tide. With the country in such dire straits, it beggars belief that just a few weeks ago, the federal health minister boasted before international partners of a 99pc decline in cases. This kind of premature celebration shows that the state continues to measure success in tallies and targets, while failing to confront the structural weaknesses that allow polio to persist.

Countering polio’s unrelenting grip, especially in KP, is not just a health challenge but a governance one. Decades of neglect, followed by the troubled merger of former Fata, have left communities with a deep mistrust of state institutions. Families who see little evidence of schools, clinics, clean water or sanitation in their daily lives view vaccination drives with suspicion. In their eyes, the state arrives only to deliver polio drops, not to address their broader needs. With the latest drive set to commence on Sept 1, and in southern KP on Sept 15, the government must realise that such a model is no longer sustainable. Polio campaigns must be integrated into a more credible package of primary healthcare. If vaccinators also provide routine immunisation, nutritional supplements or maternal care, families are more likely to open their doors. Linking the effort to clean water projects and basic sanitation would further build confidence. Moreover, campaigns too often rely on outsiders who have little standing in the community. In places like Tank and Waziristan, trusted ulema could make the decisive difference in countering rumours and ensuring acceptance. Front-line workers will continue to risk their lives, but unless governance failures are addressed alongside vaccination, Pakistan may find itself the very last frontier of polio.

Published in Dawn, August 29th, 2025