ALTHOUGH Pakistan recently announced its first National Vaccine Policy, it will take time before the immunity gap can be plugged. After clinical and epidemiological data exposed the country’s “catastrophically high volume of zero-dose children” in the WHO’s Eastern Mediterranean Region, with immunisation systems bypassing 651,000 infants, the Pakistan Medical Association has declared a national public health emergency, warning against the large-scale resurgence of preventable childhood mortality. Wild outbreaks now threaten the region as the inoculation interruption has breached the threshold needed to preserve herd immunity. New WHO data says Sudan, Yemen, Afghanistan, Pakistan and Somalia hold 90pc of all unvaccinated children. While Sudan, Yemen and Somalia are war-ravaged, the deep rot in Pakistan’s health infrastructure, and the government’s failure to reach every child, drive its presence on this list.

The immunisation crisis carries great economic costs for both families and the fragile healthcare system. A patchy strategy has undermined efficiency, leaving supervision, procurement and distribution to operate in a vacuum. Children go without doses due to poor outreach and information, delivery lapses, weak follow-up, and more critically, no information, or worse, misinformation. The government is responsible for thousands of children not receiving even the first dose of the diphtheria-tetanus-pertussis vaccine. Corruption, a weakened Expanded Programme on Immunisation, the inability to reach rural recesses, and the persistent failure to battle vaccine hesitancy are at the core of this emergency. Routine vaccination needs to be treated as a non-negotiable national concern achieved through GIS-mapped demographics so that no child misses a shot. Admittedly, climate events, population growth and displacement hinder vaccination efforts, particularly for children in crisis-affected zones. While transparency and accountability play a crucial role in preventing duplication and delays, only robust routine systems can reduce the risk.

Published in Dawn, July 20th, 2026