Pakistan’s poliovirus crisis is alive and kicking, ready to undo years of progress. Recent tests revealing the presence of the virus in environmental samples from 26 districts across all provinces serve as a stark reminder of the challenges we face. In a world that is increasingly making strides toward eradicating this debilitating disease, Pakistan’s ongoing crisis exposes deep-rooted systemic issues within our healthcare framework. Prime Minister Shahbaz Sharif’s announcement of the first nationwide polio vaccination campaign for 2025 is, indeed, a commendable initiative, signalling a renewed commitment to tackling this issue. It reflects a collaborative effort, particularly in extending vital support to neighbouring Afghanistan, which remains one of the last bastions of the disease. However, while this is a step forward, it underscores the urgent need for immediate, comprehensive action in light of the alarming rise in new cases. The emergence of over 70 polio cases in 2024 is a wake-up call that cannot be ignored. There’s more. This year’s campaign has already turned tragic as a police officer travelling to guard polio vaccinators was shot dead in Khyber Pakhtunkhwa on the very first day. Health officials and advocates appear increasingly worried, reading these frantic signs as part of the troubling puzzle. Each new incidence is a vital indicator of our communities’ vulnerabilities. The cycle of violence and distrust must be broken; we can no longer afford complacency as the erosion of our health standards continues. The hurdles in our fight against polio are as multifaceted as they are complex. Misinformation and cultural resistance significantly undermine vaccination initiatives, creating an environment where fear and doubt flourish. Only through education and transparent dialogue can we instil the confidence necessary to reach the most vulnerable populations, for which we need out-of-the-box, unprecedented support from local leaders, health workers and government representatives. Moreover, as we redesign the evolution of health campaigns, we must recognise that pandemic fatigue has weakened public health messaging. The urgency once palpable in polio eradication efforts now risks being diluted. We must rediscover and convey the tangible benefits of a polio-free Pakistan: improved health outcomes, economic stability, and an elevated global standing. Pressure from other countries mandating demanding proof of vaccination should have been enough to make all of us realise how polio is not just a health issue but a national priority. No time for wishful thinking! *