As of November 2024, Pakistan has reported 50 confirmed polio cases, marking the highest number of infections this year. The latest case involves a 20-month-old girl from Tank district in Khyber Pakhtunkhwa (KP). Pakistan and neighboring Afghanistan are the only two countries where polio remains endemic.

In a statement issued on November 19, 2024, the National Emergency Operation Centre (NEOC), along with the Regional Reference Laboratory for Polio Eradication at Islamabad’s National Institutes of Health, highlighted that Tank remains one of the endemic districts of southern KP. The district has reported multiple positive environmental samples this year, alongside two confirmed cases, signaling that the poliovirus continues to pose a threat to children.

The 49th case was reported just last week from Jaffarabad in Balochistan, involving a 15-month-old male child. Earlier this month, health officials pointed out that unvaccinated children were hampering efforts to control the spread of polio, particularly in KP.

Despite administering over 300 million doses of oral polio vaccine annually in the past, Pakistan continues to face a polio crisis. Balochistan remains the hardest-hit province, with 24 cases, followed by Sindh with 13, KP with 11, and one case each from Punjab and Islamabad.

The persistent spread of polio in Pakistan is attributed to challenges such as insecurity, misinformation about vaccines, and community resistance. Pakistani authorities have struggled to adequately address the importance of vaccination campaigns, particularly in high-risk areas, and combat the spread of the virus.

International health organizations have expressed growing concern over the situation and have urged Pakistan to take urgent action. Representatives from these organizations are expected to visit Pakistan later this month to assess the situation and offer additional support for vaccination efforts.

Additionally, the World Bank reports that more than half of Pakistan’s children are born stunted, with a significant proportion suffering from malnutrition in their early years. These challenges, combined with the ongoing threat of polio, further disadvantage the country's future generations.

Despite significant financial investments in vaccination campaigns, polio remains a serious public health issue in Pakistan. Several factors contribute to the persistence of the disease.

Many Pakistanis believe that the polio vaccine is harmful or part of a conspiracy. The CIA's use of a fake hepatitis vaccination campaign to locate Osama bin Laden in 2011 has fueled distrust in vaccination efforts, particularly in rural areas.
  
In regions such as Khyber Pakhtunkhwa and Balochistan, insecurity and violence have made it difficult for vaccination teams to access and immunize children safely. Militant groups, including in KP and Balochistan, have targeted health workers and issued fatwas against the vaccine.

Some religious leaders and communities have opposed vaccination campaigns, claiming that the polio vaccine contains non-halal substances, such as pork or alcohol. Others falsely believe that it is part of a broader conspiracy to sterilize Muslim children. Although the Drug Regulatory Authority of Pakistan certified the vaccine as halal in 2015, these rumors continue to fuel resistance.

Polio remains one of the most contagious diseases in the world, with the potential to cause irreversible paralysis. The virus is primarily transmitted through contaminated food, water, or contact with an infected person’s fecal matter, and in rare cases, through oral secretions. Most people infected with the poliovirus do not exhibit symptoms, but the disease can cause paralysis and even death.

Vaccination is the most effective way to prevent polio, and if the virus continues to spread, international travel restrictions may be imposed. The failure to eradicate polio in Pakistan remains a critical issue, demanding immediate political commitment and action from the government.

Unfortunately, successive governments have failed to provide the necessary coordination and resources to combat the polio epidemic effectively. The hybrid government's failure to counter years of misinformation and to prioritize public health, particularly during a time of political instability, has contributed to the crisis. This represents a significant failure not only of the government but also of media, civil society, and all institutions responsible for safeguarding public health.

Pakistan must urgently address its complacency regarding vaccination and polio eradication, as the stakes are incredibly high for the nation's children and its future.