Three hundred thousand children missed in Pakistan’s second nationwide polio campaign should not and cannot be dressed up as a manageable shortfall. The campaign set out to reach more than 45 million children and fell short at 44.7 million, leaving a gap that officials say stems from refusals, mobility and access.
It is lower than the nearly one million missed in the February drive, yes, but that is hardly a standard fit for a country still carrying one of the world’s last reservoirs of wild poliovirus. Pakistan recorded 31 cases last year and has already confirmed another this year. The virus is still showing up in sewage, still moving through Karachi, still entrenched in South Khyber Pakhtunkhwa, still waiting for the state to blink.
That is the point these pages have time and again called on the authorities to realise: a single missed child is the real unit of failure. Once eradication reaches this stage, we can no longer hide behind budget discussions and feel-good slogans. One unvaccinated child sustains the chain. One cluster resets months of work.
Pakistan has reason to defend its campaign workers–more than 400,000 of them were mobilised this year, many crossing mountains, crowded alleys and insecure neighbourhoods to reach families. Some do this under armed escort. Some do it after colleagues have been buried. Attacks this month targeted police assigned to protect vaccination teams in Khyber Pakhtunkhwa, killing an officer and injuring others. Over the decades, more than 200 workers and escorts have been killed.
However, the social wound is deeper than militancy. In high-risk urban pockets, missed children often come from the same places that have bad drains, crowded rooms, poor routine immunisation and a long memory of official neglect. Refusal grows there because the people feel state representatives disappear when they need clinics, water, nutrition or treatment for fever. The answer, therefore, cannot be sentimental outreach alone, nor can it be a lazy parade of arrests. Similarly, routine immunisation has to stop trailing behind emergency campaigns. Religious leaders, school systems, local elected representatives and urban employers need to be folded into a single chain of responsibility; all convincing a parent to realise their ultimate duty to protect their children.
Pakistan has reduced cases dramatically over the past three decades. Good. Now it must finish the work, which requires closing the last gaps with services that outlast a campaign cycle. *