Why Pakistan still can’t contain polio

2026-03-05 - 21:53

ACCORDING to Daily Dawn, nearly one million children were missed and about 53,000 families refused vaccination during Pakistan’s latest nationwide polio campaign. Although officials say more than 44 million children were vaccinated and coverage reached 98 percent, the remaining 2 percent is still a serious concern. Pakistan is one of the last countries where poliovirus still exists, and even a small gap leaves thousands of children at risk. Polio is a dangerous disease that mainly affects children under five and can cause lifelong paralysis or even death. The fact that 670,000 children were recorded as “not available at home” defies operational logic. A child absent from one doorstep is not absent from the city; they are in schools, markets, parks or with relatives. Yet vaccination teams continue to rely on door-to-door visits alone, allowing hundreds of thousands of children to slip through the cracks. Missed children should not be a routine statistic in official briefings; they represent a systemic failure. The problem is especially acute in Karachi, which accounted for 31,000 refusals, 58 percent of all refusals nationwide. This raises urgent questions about why Pakistan’s largest and most resourced city remains the epicentre of resistance. Whether driven by misinformation, weak microplanning, poor local administration or political indifference, Karachi’s crisis demands targeted neighbourhood-level strategies and stronger engagement with community leaders. Several factors have contributed to the persistence of polio in Pakistan despite significant financial investment, especially from international funding agencies. There is a significant amount of misinformation and mistrust among certain communities regarding the safety and efficacy of the polio vaccine. A vast majority of Pakistanis people believe that the vaccine contains harmful substances or is part of a conspiracy. This is largely due to the failure of the government that panders to the fundamentalists, in erecting an overarching narrative to counter years of brainwashing by the extreme right that got most people to shun the vaccine in Pakistan. Even where campaigns proceed, the quality of implementation remains uneven. A detailed report from the Provincial Emergency Operations Centre on the February 2 to 8 campaign revealed that of 237,216 children, 2.6 percent still missed the vaccination dose in Karachi and Hyderabad alone. During the recent nationwide vaccination campaign, an incident took place on February 10 in Lahore where some parents refused to vaccinate their children. They attacked polio workers, called others to join them and even beat the police officers who came to stop the violence. Sadly, this was not a one-time event. Such attacks happen often and vaccination campaigns are sometimes delayed because of security threats. Just weeks before this latest attack on polio workers, two people, including a police constable, were killed on December 16, 2025, when unidentified assailants opened fire on a polio vaccination team in Bajaur district of Khyber-Pakhtunkhwa. The police constable had been deployed to ensure the safety of the vaccination team, while the second individual affected was a civilian who was present at the scene. The incident occurred just one day after the government initiated its final nationwide polio campaign of the year, scheduled to continue until December 21. The campaign involves the participation of more than 400,000 vaccinators across the country, each entrusted with administering two drops of the oral polio vaccine to millions of children under the age of five. Nationally, the Independent Monitoring Board reported in September 2024 that more than four million planned vaccinations were missed in that year. Under pressure to meet targets, some teams resorted to unethical practices. These practices distort data, undermine trust and mask the true scale of vulnerability, particularly in high-risk areas like Khyber- Pakhtunkhwa and Balochistan. Logistical challenges persist as well; maintaining the cold chain for vaccine storage and distribution remains a major hurdle in remote regions, compromising vaccine effectiveness. Behind these operational failures lies a deeper crisis of mistrust and misinformation. Some religious leaders claim the vaccine contains traces of pork or alcohol or that it is designed to sterilize Muslim children. Madaris have propagated the belief that the polio campaign is a plot to reduce the global Muslim population. Although a laboratory under the Drug Regulatory Authority of Pakistan certified the vaccine as halal in 2015, rumours persist, entrenched by years of misinformation and a lack of sustained counter-narratives from the state. Meanwhile, the virus continues to circulate in Pakistan. According to the US Center for Disease Control and Prevention, there is evidence of widespread transmission in Karachi, Peshawar, Quetta and Central Pakistan, even though reported case numbers remain relatively low. Limited access to healthcare in remote areas, underreporting and surveillance challenges mean the true burden may be higher than official figures suggest. The persistence of polio is also a reflection of political neglect. Successive governments have failed to build a coherent national narrative supporting vaccination or to counter extremist propaganda. The current government has been pre-occupied with political and judicial manoeuvring leaving little attention for public health crises. This failure to prioritize polio eradication has allowed misinformation to flourish and operational gaps to widen. — The writer is an educator, based in Sindh. (channaassadullah320@gmail.com)