CHR News Desk
New Delhi, Nov 23
Pakistan’s polio crisis is deepening, with the number of confirmed wild poliovirus (WPV) cases climbing to 52, a sharp rise compared to just six cases last year.
Health officials on Friday reported two new cases in the Khyber Pakhtunkhwa (KP) province, specifically in the Dera Ismail Khan district, which has recorded five cases this year alone.
Pakistan remains one of only two countries where polio is endemic, alongside Afghanistan. Despite extensive global and national efforts to eradicate the disease, challenges such as vaccine hesitancy, misinformation, and security threats persist, particularly in southern KP, a hotspot for the virus.
The Regional Outbreak
Balochistan has reported the highest number of cases in 2024, with 24 confirmed infections, followed by Sindh with 13, KP with 14, Punjab with one, and Islamabad with one case. Southern KP, plagued by insecurity and vaccine resistance, remains a focal point, contributing significantly to the national total.
The latest data underscores a worrying trend in vaccination efforts. In a door-to-door campaign conducted from October 28 to November 3, 95,000 children out of 6.38 million targeted were missed. Of these, 17,479 were due to parental refusals, while others were absent during vaccination visits. These gaps highlight the challenges of achieving universal coverage, a critical component in halting the virus’s spread.
“Each unvaccinated child represents a significant risk to the broader population,” a senior health official said. “To achieve eradication, the entire eligible population must be immunised.”
Historical Context and Challenges
The 2024 surge follows two years of relatively low cases, with 20 WPV cases reported in 2022 and just six in 2023. However, the numbers pale in comparison to 2020, when 84 cases were recorded, and 2019, which saw 147 cases spread across 43 districts. The resurgence underscores the fragile progress made in recent years and the virus’s resilience in the face of complex sociopolitical barriers.
Pakistan’s polio programme faces numerous hurdles. Insecurity in rural and tribal areas has endangered health workers, who are often targeted by militant groups propagating conspiracy theories about vaccination campaigns. These groups have fuelled fears that vaccines are linked to espionage or sterilisation, leading to widespread mistrust.
Geographic challenges and cultural resistance further complicate eradication efforts, particularly in regions like southern KP and parts of Balochistan.
A Collaborative Approach
Recognising the shared epidemiological block between Pakistan and Afghanistan, both countries have sought to align their vaccination campaigns to combat cross-border transmission. Global health agencies, including the World Health Organization (WHO) and UNICEF, have intensified support for local initiatives, but on-the-ground implementation remains fraught with difficulties.
The resurgence of vaccine-derived poliovirus type 2 (cVDPV2) adds another layer of complexity. Though cVDPV2 cases have significantly declined—from 135 in 2020 to eight in 2021—health experts remain vigilant about its potential re-emergence in vulnerable populations.
Global Implications
Pakistan’s polio crisis extends beyond its borders, representing a critical global health challenge. Polio eradication, a decades-long international effort, hinges on eliminating the virus in the last endemic regions. Even a single case poses a threat, as the virus can rapidly spread in unvaccinated communities.
Experts warn that the rise in WPV cases in Pakistan is a stark reminder of the fragility of eradication efforts. While significant progress has been made globally—polio once paralysed thousands of children annually—the persistence of the virus in Pakistan and Afghanistan threatens to undermine these achievements.
The Road Ahead
Pakistan’s government has pledged to intensify vaccination drives and combat misinformation. Community engagement initiatives aim to address parental fears and resistance, while security measures seek to protect health workers in conflict-prone areas.
However, experts caution that eradication requires sustained political commitment, increased funding, and innovative strategies to overcome entrenched barriers. With 2024 nearing its end, the window to curb the outbreak and achieve a polio-free status is narrowing, but health officials remain hopeful.
For Pakistan, the stakes are clear: ending polio within its borders is not just a national priority but a global imperative.
