Pakistan is again being told that polio eradication is close. The Global Polio Eradication Initiative’s Technical Advisory Group has set benchmarks running through 2026 and into 2027, while cautioning that fewer reported cases and fewer positive sewage samples should not be read as proof that the virus has been beaten. Pakistan has heard this before. It has stood near the finish line more than once, only to slip back. The present moment is therefore unusually unforgiving. Pakistan had only eight cases in 2017, one in 2021 and six in 2023. By the end of 2025, the number had risen again to 31. The first case reported this year, from Sujawal, was genetically linked to an environmental sample from Hyderabad.
This week, First Lady Aseefa Bhutto-Zardari met representatives of UN agencies in Pakistan and reaffirmed the country’s commitment to working closely with the UN country team on national development priorities. She was told that the next 12 months would be crucial for polio eradication. That warning should sit uneasily with every polished development pledge made in Islamabad. With fewer than four years left before the 2030 SDG deadline, Pakistan remains one of only two countries where polio is still endemic.Pakistan Travel Guide The failure is not a lack of activity. Pakistan can run vaccination drives on a massive scale. Millions of children have been reached. Hundreds of thousands of workers, many of them women, go from door to door in difficult neighbourhoods, remote settlements and areas where security threats are deemed part and parcel of the job. Their work deserves respect and recognition. Sadly, repeated campaigns have still not been enough because the same weak points keep returning.
In southern Khyber Pakhtunkhwa, access is shaped by insecurity, militancy, suspicion and cross-border movement. In Balochistan, difficult terrain and a lack of state capacity add to the challenge. In Karachi, the problem is urban, crowded and deeply political. Tragically speaking, refusals are heavily concentrated in 30 districts, with Karachi alone accounting for 58 per cent in the first campaign of 2026. These are different battles and cannot be fought with one national script. Security is now central to the polio question. Attacks on vaccinators and police escorts have made campaigns harder and more dangerous. More than 200 polio workers and police escorts have been killed since the 1990s. Protection is, therefore, necessary, but a health programme that arrives under armed guard cannot by itself repair public trust. Many families are not simply “anti-vaccine”. Some are asking why the state can find their door for polio but not for clean water, basic medicines or routine care.
That question should worry Islamabad more than any donor review. Polio has survived not because Pakistan lacks campaigns, but because campaigns have been made to carry the burden of a weak public-health system. The country needs better-paid frontline workers, reliable routine immunisation, child-by-child tracking, honest audits of missed children, stronger border vaccination and a serious plan tied to sanitation and local clinics. *
