Poliomyelitis, commonly known as polio, remains a significant health threat in Pakistan, one of the only two countries in the world where the virus is still endemic. Despite ongoing efforts to eradicate the disease, recent reports indicate a resurgence, necessitating immediate and comprehensive action. Polio continues to be a public health concern in Pakistan. In 2019, the country reported 147 cases of wild poliovirus. This number declined to 84 in 2020 and drastically dropped to just one case in 2021. However, the trend reversed with 20 cases reported in 2022, six in 2023, and five in the early months of 2024. Most recently, two new cases were reported in the Balochistan province, specifically in the Chaman and Dera Bugti districts. Environmental surveillance also paints a concerning picture. In 2023, there were 125 positive samples for poliovirus detected in environmental samples. This figure has already reached 130 in 2024, with most cases emerging from Sindh and isolated incidents in Balochistan, Khyber Pakhtunkhwa, and Punjab. These statistics underscore the ongoing threat posed by polio and the urgent need for intensified efforts to eradicate it. Polio primarily affects young children, causing paralysis and, in severe cases, death. A recent incident in Quetta, Balochistan, saw a two-year-old child succumb to the virus. The health department confirmed that the virus was detected in stool samples from the child, who developed paralysis symptoms on May 21, 2024. This incident is part of a worrying trend, with most polio cases in Pakistan being reported in Balochistan. Addressing misconceptions about vaccines, overcoming logistical and security challenges, and enhancing surveillance are critical in the fight against polio. One of the most significant barriers to polio eradication in Pakistan is the widespread misconception about vaccines. Despite extensive vaccination campaigns, many parents remain sceptical about the safety and efficacy of polio vaccines. These misconceptions are often fueled by misinformation and distrust in the healthcare system. The health secretary emphasized that poliovirus predominantly attacks children with insufficient immunity to fight off the infection. Therefore, parents must understand the importance of vaccinating their children. Unfortunately, misconceptions and resistance to vaccination campaigns continue to hinder progress. Conducting vaccination campaigns in Pakistan is fraught with logistical and security challenges. Some regions, particularly in Balochistan and Khyber Pakhtunkhwa, are difficult to access due to rugged terrain and poor infrastructure. Additionally, these areas are often plagued by security concerns, making it dangerous for health workers to carry out vaccination drives. Health workers in Pakistan have faced numerous attacks while administering vaccines, further complicating efforts to reach vulnerable populations. These challenges necessitate innovative strategies and robust security measures to ensure the safety and effectiveness of vaccination campaigns. The Pakistani government, with support from international organizations, has been conducting extensive vaccination campaigns to combat polio. In recent years, two nationwide campaigns aimed to vaccinate over 45.4 million children under the age of five. These campaigns are crucial in maintaining high immunity levels among children and preventing the spread of the virus. In addition to vaccination drives, awareness and education programs are essential in addressing misconceptions about vaccines. These programs aim to inform parents about the safety and benefits of polio vaccines, dispelling myths and encouraging widespread participation in vaccination campaigns. Health officials have stressed the importance of community engagement and the role of local leaders in promoting vaccine acceptance. By involving religious and community leaders, these programs can effectively reach a broader audience and foster trust in the vaccination process. The fight against polio in Pakistan has garnered significant international support. Organizations such as the World Health Organization (WHO) and UNICEF have been instrumental in providing technical assistance, funding, and resources for polio eradication efforts. Collaborative initiatives have focused on enhancing surveillance systems, improving vaccine delivery, and ensuring that vaccination campaigns reach even the most remote and underserved communities. Robust surveillance systems are critical in identifying and responding to polio cases promptly. Enhancing environmental surveillance and ensuring comprehensive monitoring of polio cases can help in tracking the virus’s spread and implementing targeted interventions. This includes regular testing of sewage samples and increasing the frequency of field visits by health workers. To achieve polio eradication, it is essential to ensure high vaccine coverage across all regions of Pakistan. This involves not only increasing the number of vaccination campaigns but also improving their reach and effectiveness. Strategies such as mobile vaccination teams and community-based distribution can help in reaching children in hard-to-access areas. Combating misinformation about polio vaccines is crucial in increasing vaccine acceptance. This requires a multi-faceted approach, including mass media campaigns, community engagement, and partnerships with local leaders. By providing accurate information and addressing concerns, these efforts can build trust in the vaccination process and encourage more parents to vaccinate their children. The safety of health workers is paramount to the success of vaccination campaigns. Implementing robust security measures and providing adequate training and support to health workers can help mitigate risks and ensure that vaccination drives are carried out smoothly. This includes coordination with local law enforcement agencies and involving community leaders in ensuring the safety of health workers. The persistence of polio in Pakistan is a public health emergency that requires immediate and sustained action. Despite significant progress, the recent resurgence of cases highlights the challenges that remain in eradicating this debilitating disease. Addressing misconceptions about vaccines, overcoming logistical and security challenges, and enhancing surveillance and vaccination efforts are critical in the fight against polio. The Pakistani government, in collaboration with international organizations and local communities, must intensify efforts to eradicate polio. By prioritizing vaccination campaigns, improving awareness, and ensuring the safety of health workers, Pakistan can move closer to achieving a polio-free future. The stakes are high, and the time to act is now. The writer is a freelance columnist.