Health experts have raised alarms over the increasing number of wild poliovirus cases in Pakistan, with projections indicating that the total could reach 55 to 65 by the end of 2024. As of now, the country has recorded 28 cases, with Balochistan leading the count at 16, followed by Sindh with seven, Khyber Pakhtunkhwa with three, and one each in Punjab and Islamabad.
A report from the Institute for Disease Modeling (IMD) emphasizes that missed vaccinations and refusals are significant obstacles hindering eradication efforts. The ongoing issues within the national polio eradication program, particularly in high-risk areas such as Peshawar and parts of Karachi, have resulted in a troubling surge of vaccine refusals due to misinformation and mistrust.
Anwar-ul-Haq, National Coordinator for the Emergency Operations Centre (EOC), highlighted Karachi, Quetta, and Peshawar as core reservoirs of polio transmission, where the virus has circulated for over 16 months in some areas. He noted that many children in these regions remain unvaccinated, despite intensified vaccination efforts.
Immunity gaps have emerged as a critical challenge, with estimates suggesting that 2-3% of children have consistently been missed during vaccination campaigns across various districts. This percentage, while seemingly small, represents hundreds of thousands of vulnerable children, particularly in densely populated and underserved areas like Karachi East and Quetta Block. The report underscores that poor sanitation conditions in these regions further exacerbate the spread of the virus.
In light of these challenges, the IMD report stresses the importance of conducting high-quality vaccination campaigns in high-transmission zones to prevent a surge in polio cases. Moreover, a senior government official noted that the program has faced systemic issues since 2021, when a non-government accountable coordinator was placed in charge, leading to fragmented operations and poor communication with implementing partners like WHO and UNICEF.
Despite these challenges, the current leadership in Pakistan’s polio eradication initiative has adopted a more transparent approach than in previous years. Officials are openly acknowledging systemic problems and have implemented internal accountability measures, dismissing hundreds of personnel for irregularities such as data manipulation.
The program is cautiously optimistic about the future, with plans for a “2-4-6” strategy aimed at conducting high-quality vaccination campaigns in the coming months. However, the detection of poliovirus in environmental samples from previously unaffected areas complicates efforts.
International organizations, including the Global Polio Eradication Initiative (GPEI), are urging Pakistan to address its immunity gaps and logistical challenges urgently. Officials warn that the next few months are critical; failure to control the virus could jeopardize global eradication efforts and risk wider transmission across borders. Immediate action is essential to prevent a significant rise in polio cases by the end of 2024, which would deal a severe blow to the country and the global fight against polio.
