The extremely rare poliovirus (vaccine-induced) case discovered by authorities in New York (the first in nearly a decade) has sent alarm bells ringing as health officials jolt to action with pop-up vaccination centres and calls for an urgent vaccination. Given nearly 93 per cent of children are vaccinated before the age of two, most Americans have nothing to worry about. But halfway across the world, reports of an 18-month-old being crippled by this highly infectious disease in Khyber Pakhtunkhwa raises the tally to 13 this year; dampening hopes of Pakistan ever shutting its doors on the polio outbreak. As nearly all of the cases reported at home have been of wild poliovirus, the explosion speaks more to the access to clean water and bears no relevance whatsoever to the detection in Rockland County. Nonetheless, the authorities would do better than to let the cluster slide by in a region already notorious for its reluctance to vaccination. The widespread refusal stems from much-talked-about conspiracy theories that touch upon a little bit of everything (from Western-led sterilisation campaigns to terrorists’ witchhunt to the installation of tracking chips). Continued attacks on polio vaccination teams, as if the very effective slander drive were not enough deterrents, have long been a question mark on the government’s willingness to move heavens to ensure crossing its inoculation milestone. However, far more dangerous has been the rather new phenomenon of deceitful refusals. Of the cases found in North Waziristan, two boys had fake markers on their fingers, implying that their families did not hold any punches in registering their preferences. That nothing much can be done for the hapless victims now because polio is a disease that spreads rather aggressively is a different tale altogether. Only a comprehensive investigation would reveal whether these markers ensued as a result of any dirty collusion with the health workers and if so, should the entire district’s schedule be reviewed. In the meantime, engaging the ulema and local administration to dispel nefarious rumours (for the millionth time) and reminding the people that Pakistan, along with Afghanistan, is the “final frontier” in this global war remains the only reasonable step. We may have been lucky in New York and London but the 2019 outbreak in Malawai was traced back to our waters. The world is clearly not in the mood to let our negligence torpedo its eradication goals. *