Daily Times

Wild poliovirus strains continue to be detected in Khyber Pakhtunkhwa where traces of the virus have recently been found in sewage-a major setback for a country that has witnessed a marked increase in polio cases this year. As of the year 2023, Pakistan remains one of the only two countries where polio is endemic, the other being its neighbour Afghanistan. We have come close to eradicating polio many times but long-standing propaganda campaigns against vaccination initiatives continue to maintain their chokehold over many people in the country, particularly in violence-hit North Waziristan on the Afghan border.

It doesn’t help that those conducting vaccination campaigns have faced unprecedented resistance in a difficult, and often, deadly working environment. Just last year, gunmen attacked a polio vaccination team in the northwest, the latest deaths spurred by anti-vaccination sentiment in the country. With violence in the mountainous northwest on the rise due to the Taliban’s resurgence in the region, polio eradication efforts have been seriously hampered.

What is often overlooked, however, is that polio eradication efforts are still largely seen as a foreign initiative rather than one backed by local policymakers. In their absence, foreign technical staff are most visible to communities being vaccinated. When we venture beyond the streets and into polio vaccination offices, there is hardly any evidence of local involvement at all, with international staff developing strategies and supervising implementation.

Local problems require local solutions-without input on how to navigate the complexities of Pakistan’s cultural climate, the scope of polio eradication efforts will remain tragically limited. It is crucial to fund research in targeted locations with a higher number of vaccine refusals and confirmed cases to analyse how to best communicate pro-vaccine messaging to people who are reluctant to take them.

Many have proposed official legislation criminalising the refusal of vaccines but laws alone cannot remedy a problem that is rooted in the collective psyche of many communities across Pakistan. What we need more than ever before is a context-based approach that accounts for cultural sensitivities and recognises that each vaccine refusal must be dealt with differently. *