Karachi has reported its first polio case since December 2024, with a six-month-old boy from Jamali Colony testing positive for wild poliovirus. The diagnosis brings Pakistan’s tally to seven this year, including five cases from Khyber Pakhtunkhwa and two from Sindh. The child was reportedly malnourished, a detail that speaks to the wider deprivation confronting countless families in the country’s largest metropolis. That another polio case has emerged after nearly two years deserves serious attention, particularly when the city has been the focus of repeated vaccination drives.
Pakistan’s overall progress is undeniable. The country recorded 74 polio cases in 2024 and 31 last year, against seven so far in 2026. Four nationwide vaccination campaigns have been conducted this year, reaching millions of children. These gains reflect sustained government efforts and the extraordinary dedication of frontline health workers, many of whom operate in difficult and sometimes dangerous circumstances.
Yet there is a catch. Polio does not announce its presence through paralysis alone. Most infections go unnoticed, allowing the virus to circulate quietly until another child pays the price. The WHO warned in August that Karachi remained a significant reservoir of wild poliovirus despite improvements in campaign quality. The virus had also been detected in the city’s sewage samples during the period when no paralytic cases were reported.
Another difficulty lies in the conditions under which millions of Pakistanis live. Sprawling informal settlements, inadequate sanitation and a constantly shifting population make vaccination a difficult undertaking. Children born into families struggling for food, shelter and basic healthcare can easily fall through the cracks. For such households, missed immunisation is often bound up with the daily struggle to make ends meet. Ergo, blaming parents without examining these circumstances would be grossly unfair.
There is also something troubling about an approach that measures success largely through vaccination tallies while routine healthcare remains beyond the reach of many communities. Campaigns have undoubtedly saved lives. But they cannot indefinitely compensate for overstretched primary healthcare facilities, incomplete birth records and poor follow-up. The answer lies in strengthening the health system that ought to serve children between vaccination rounds. The next campaign aims to reach nearly 24 million children in 97 districts, including Karachi. Authorities should use the latest case to identify children repeatedly missed, examine gaps in routine immunisation and ensure independent verification of coverage. It goes without saying that continued cooperation with Afghanistan remains essential, given the movement of poliovirus across the border. Pakistan has invested decades of effort and considerable resources in eliminating polio. The sharp decline in cases deserves recognition. But behind the national figures are children whose circumstances rarely find their way into official reports. Their continued vulnerability should weigh heavily on a country that has come so close to putting this disease behind it.
