The crippling polio virus is no longer an endemic in all countries of the world except in two — Pakistan and Afghanistan — where 13 and six polio cases have been reported this year respectively. Even after achieving considerable reduction in polio cases, Pakistan still houses 69 percent of the global polio cases, which is a critical situation for children worldwide, and a colossal challenge for our government. It is a fact that government and health authorities are making all-out efforts by launching polio immunisation campaigns to vaccinate children. Polio workers, especially women, carrying out vaccination drives in far-flung and high-risk areas in their aim to protect children from lifelong disability perform precarious work and make heroic efforts. World Health Organisation (WHO) workers report that going into the field is like going into a war zone. Several polio workers and security personnel have lost their lives while vaccinating children in tribal areas and in other places. In spite of all this, workers and volunteers still risk their lives going from door to door in their attempts to rid Pakistan of the disease. No doubt, the sacrifices of brave polio volunteers and security personnel are unforgettable. Despite the fact that polio is a curable disease children in Pakistan are still in danger of suffering the lifelong debilitating consequences of the virus. The number of children affected was 199 in 2001, and 198 in 2011; a sharp decline was witnessed in 2012 and 2013 when only 58 and 93 respectively cases were reported. But in 2014, the country broke its own 14-year-old record as 296 cases were reported, the highest number to date. Health authorities applaud the progress Pakistan has made against existence of poliomyelitis, reducing the cases to 13 reported this year. However, according to the WHO as long as even a single child remains infected, children in all countries are at risk of contracting polio. Since 1988 a global campaign initiated with the objective to eradicate polio virus from the world has been in operation, and with the committed efforts of all states, the crippling virus has been wiped out globally except in Pakistan and Afghanistan — the only impediment in exterminating the virus completely. Even the poorest and most war-torn states have succeeded in stamping out the virus completely. Amidst others, our culture is the main reason of polio’s persistence in Pakistan. Our society, based on patriarchal family structure, giving male members a dominant position, authorises them to make all decisions, and most women have no say in decision-making. Women and children’s medical treatment is restricted by fathers, fathers in rural areas are reluctant to get polio drops administered to their children as some Muslim extremist clerics and militants, operating in the country, have brainwashed them, fuelling a misconception that children who are vaccinated would be sterilised. The only objective of spreading this misconception is to reinforce their traditional authority over the people. In fact, it is insanity to endanger the lives of children by stopping workers from administering anti-polio drops to them. There are a great number of chronic cases involving parents refusing to have their children vaccinated against this crippling disease. The Khyber Pakhtunkhwa province has a large number of people who refuse to vaccinate their children with anti-polio vaccines during an immunisation drive. The refusal to vaccinate children against polio virus is incomprehensible; however, the vaccination has no detrimental side effects, but on the contrary, the refusal for vaccination itself is harmful for children. The tragedy lies in the fact that reports show that even educated parents are reluctant to administer anti-polio vaccines to their children. Another reason for the existence of polio is the security concern. Of the four cases reported this year from Sindh, two are from a union council of district Shikarpur, and one is from Jacobabad, areas that have remained the hub of tribal clashes for years. A large number of villages in the districts were made no-go areas for outsiders including polio workers. This deprived children of being vaccinated against polio virus, whereas the factor of refusal to vaccination does not exists in interior Sindh. Emergency Operations Centre (EOC) — a collaboration of various stakeholders including WHO, UN, federal and provincial governments and volunteer organisation, the Rotary Club — is making integrated efforts for the eradication of polio virus, and it warns that the world is watching Pakistan, the state that still has 69 percent of the worldwide polio cases. We as a nation are under a colossal pressure to stamp out this crippling virus instantaneously. In case of failure, we will be suffering dire consequences, most likely leading us to be disconnected from the world when travel bans to and from Pakistan will be imposed. To attain the status of a polio-free state is imperative for Pakistan. In this perspective, the country has to take concrete, fool-proof and result-oriented initiatives, keeping in view the international state of play, pressures and warnings. The change of mindset of people along with the removal of lingering misconceptions about polio vaccines’ efficacy, and implementation of an effective mobilisation mechanism is strongly needed in order to administer polio drops to vulnerable children. High-risk areas or sensitive localities, where both security concerns and parental refusals exist, are to be conscientiously focused on. To make the vaccination drive successful, services of expert female social mobilisers, like Bibi Khalida Nasreen — a supervisor of the polio team — who with her hard-work and commitment made it possible to vaccinate children in the Mehsud neighborhood in Karachi’s Orangi Town where majority of the residents are from tribal areas and refuse polio vaccinations to their children are to be availed essentially. They must be charged with the task of enlightening mothers about the efficacy of vaccination and ramifications of the refusal of polio vaccination. Besides, services of broad-minded religious scholars, political leaders and local dignitaries who have ingrained their influence in sensitive areas should be availed. Civil society organisations, social activists, and mainstream media highlighting awareness campaign can also play a crucial part. The writer is an academic, and can be reached on Twitter @ARShykh