PAKISTAN’S long battle against polio has recently produced encouraging signs. Data from the national eradication programme shows a considerable drop in the virus detected in environmental samples during the first two months of 2026. Out of 126 sewage samples collected nationwide in February, 111 tested negative. More broadly, only 39 positive environmental samples were reported during January and February this year, compared with 144 during the same period in 2025. What is more heartening is the decline in paralytic cases: only one child has been infected so far this year, compared with six at the same stage last year. These figures suggest that vaccination campaigns and surveillance measures have begun to yield results. The improvement is visible across provinces. In Balochistan, the number of positive environmental samples has fallen from 38 last year to 11 this year. Punjab has reported only one positive sample so far in 2026 compared with 27 during the same period last year. KP has seen a similar trend, with six positive samples compared with 26 previously, while Sindh has recorded 27 positives this year against 50 in early 2025. Such numbers point to stronger immunisation coverage and better monitoring systems. Sewage surveillance, which allows authorities to detect the virus even before clinical cases emerge, has become one of the most valuable tools in the eradication campaign.

Yet, several factors threaten the fragile gains. Foremost among these are the tensions between Pakistan and Afghanistan — the world’s last two reservoirs of wild poliovirus; population movement across their porous border allows the pathogen to circulate easily between communities. If tensions disrupt vaccination drives, the virus could regain ground. Security constraints already pose a serious challenge. In southern KP alone, around 120,000 children are reportedly being missed during immunisation campaigns due to safety concerns. Such gaps allow the virus to persist. Even a small pocket of unvaccinated children can sustain transmission and trigger wider outbreaks. The upcoming high-transmission season, which typically begins in late April or early May and continues through September, makes the situation even more delicate. Infrastructure weaknesses also complicate surveillance. In some areas, the absence of proper drainage systems prevents the collection of sewage samples, allowing the virus to circulate unnoticed. Without reliable environmental monitoring, an effective early-warning system may be lost.

Pakistan’s progress against polio is, therefore, real but precarious. The latest figures show that eradication is within reach if momentum is maintained. But success will require sustained vaccination coverage, improved surveillance, and above all, uninterrupted cooperation across borders. Polio thrives in the cracks created by conflict, insecurity and neglect. Holding the line and closing those gaps is now Pakistan’s most urgent public health task.

Published in Dawn, March 16th, 2026