Pakistan stands at a crucial, precarious juncture in its decades-long battle against wild polio virus. As one of only two remaining endemic countries globally, the nation’s efforts are not just a domestic public health campaign but a critical component of global disease eradication. While the battle remains fierce, recent achievements and a renewed strategic focus offer a strong, if cautious, reason for optimism.
The sheer scale of Pakistan’s Polio Eradication Programme (PEP) is a monumental feat of logistics and human dedication. Driven by a dedicated workforce of over 400,000 vaccinators—the true heroes of this campaign—the program consistently targets over 45 million children in multiple nationwide and sub-national campaigns each year. For instance, the September 2025 sub-national round successfully reached nearly 21 million vulnerable children across high-risk districts. This massive mobilization, often in the face of immense geographic, social, and security challenges, reflects an unyielding political will from the highest levels of government.
Virologically, the trajectory is challenging but contained. While the country experienced a rise in cases in 2024 (74 cases), intensified operations have led to a decrease, with the 2025 tally standing at 30 cases as of late October. Although every single case is a tragedy, this reduction—along with positive trends in environmental surveillance (ES) data, such as a significant decline in positive sewage samples in areas like Peshawar and Quetta—suggests that immunity thresholds are improving and the virus’s spread is being restricted. This data-driven, localized approach, which focuses laser-like on core transmission reservoirs in Khyber Pakhtunkhwa (KP) and central Pakistan, is finally showing dividends.
To push through this ‘last mile,’ the PEP has unveiled a comprehensive Road map to Zero Polio (NEAP 2025–26). This updated strategy focuses on several critical enhancements: improving implementation quality of campaigns, strengthening the synergy between polio vaccination and routine immunization (the ‘Big Catch-Up’), and leveraging detailed data to track and close the gaps for ‘zero-dose’ and ‘missed’ children. Crucially, the program is intensifying cross-border coordination with Afghanistan, recognizing that the two countries form a single epidemiological block where synchronization is paramount to stopping trans boundary transmission.
Yet, complacency remains the greatest threat. The remaining virus pockets persist due to complex, interconnected challenges: vaccine hesitancy fueled by misinformation, security issues that directly endanger front line workers, and low routine immunization coverage in key districts. The recent condemnation of an attack on polio security personnel in Swat is a grim reminder of the sacrifices being made. Eradication is a zero-sum game; the virus only needs one unvaccinated child to survive and spread.
The government and partners have held the line, tightening the circle around the polio virus. Now, success depends entirely on sustained, high-quality execution of the new road map and, most importantly, the unwavering support of parents and communities. Polio eradication is not just a health metric;- it is a promise of a healthier future for every child in Pakistan. The end is in sight, but it demands collective discipline and solidarity to finish the job, once and for all.