Pakistan’s long war against polio appears, at last, to be approaching its decisive phase. The latest numbers offer cautious grounds for optimism – provided the authorities maintain focus and resist the familiar temptation of complacency.
In 2025, Pakistan recorded 30 confirmed wild poliovirus cases, down from 74 the year before. The first two months of 2026 have, however, produced only 39 positive environmental samples nationwide, while just one child in Sindh has developed paralysis linked to the virus. For a country that once reported hundreds of cases annually, these figures mark a remarkable decline.
This progress reflects years of relentless vaccination campaigns involving an extraordinary national effort. Roughly 400,000 vaccinators fan out across the country each year to reach more than 45 million children, an operation that has reduced Pakistan’s polio burden by about 99.7 per cent since the 1990s.
Despite impressive campaign coverage, around one million children were still missed last year. In Karachi’s densely packed informal settlements, refusals accounted for more than half of all missed children, reflecting persistent mistrust and misinformation.
Security threats also remain an enduring challenge. Over the past decade, dozens of polio workers and their security escorts have been killed by militants, turning a public health mission into a dangerous frontline assignment.
Too often, however, the persistence of polio is framed narrowly as a problem of public resistance. The reality is far more complex and far more uncomfortable. Pakistan’s struggle with polio is inseparable from broader failures in healthcare, sanitation and governance.
Communities lacking clean drinking water, functioning clinics, and reliable schools naturally question why the state appears primarily at their doorstep only to administer a vaccine.
Equally troubling is the treatment of the frontline workforce. Polio vaccinators–most of them poorly paid women–undertake exhausting and sometimes dangerous work. Many have survived harassment and violence, only to find their efforts undermined by conspiracy theories portraying vaccination campaigns as foreign plots. Such narratives corrode trust and weaken the programme’s credibility.
At the end of the day, polio cannot be understood purely as a medical issue. It is entangled with Pakistan’s social and political landscape, where poverty, inequality and state neglect concentrate risk in the most marginalised communities. Unless these structural inequities are addressed (through investment in primary healthcare, improved sanitation, and sustained engagement with religious and civic leaders), vaccination campaigns alone will struggle to eliminate the virus entirely.
The stakes could not be higher. Pakistan and Afghanistan remain the only two countries where wild poliovirus is still endemic. The global health community is watching closely, aware that failure here could unravel decades of painstaking eradication efforts worldwide.
To finish the job, Pakistan must close every remaining gap: tracking missed children, rebuilding community trust, ensuring the safety and dignity of vaccinators, and maintaining relentless vigilance in high-risk zones before the next transmission season begins. Anything less would not merely be a policy failure. It would be a profound betrayal of the millions of children whose future depends on a polio-free Pakistan. *