Despite monumental progress in global polio eradication, Pakistan and Afghanistan remain the last strongholds of the poliovirus. The ongoing struggle to eliminate this crippling disease reflects a complex interplay of religious, political, and security challenges. While the global community has made remarkable strides in polio eradication, these two nations continue to face daunting obstacles that hinder vaccination efforts and put the health of millions of children at risk.
Polio, a highly contagious viral disease, predominantly affects children under the age of five, causing paralysis and, in severe cases, death. Thanks to the Global Polio Eradication Initiative (GPEI), which began in 1988, cases of polio worldwide have decreased by over 99%. According to the World Health Organization (WHO), the number of polio cases globally dropped from 350,000 in 1988 to just 29 in 2023.
However, Pakistan and Afghanistan’s inability to eliminate the virus remains a significant concern. In 2024, Pakistan reported 22 new polio cases, a stark contrast to the near-zero figures achieved by most countries. Afghanistan’s numbers, though slightly lower, also underscore the persistence of the virus in the region. These figures are alarming when compared to international standards, as most of the world is polio-free. The situation in these two countries threatens to undermine decades of global progress and poses a risk of the disease spreading to previously polio-free regions.
One of the biggest hurdles in Pakistan and Afghanistan is the widespread misinformation about polio vaccines. In conservative areas, particularly in Pakistan’s Khyber Pakhtunkhwa (KP) province and Afghanistan’s rural regions, polio vaccination campaigns are often met with suspicion. Many people believe that the vaccine is a Western conspiracy aimed at sterilizing Muslim children or that it violates Islamic principles.
Religious clerics in both countries have played a dual role. While some have actively supported vaccination campaigns, others have perpetuated myths that deter families from vaccinating their children. This resistance has led to significant gaps in immunization coverage, particularly in areas where access to reliable information is limited.
Political instability has also hampered polio eradication efforts in both countries. Pakistan’s fragmented governance structure often results in a lack of coordination between federal and provincial health authorities. This disconnect is particularly evident in KP and Balochistan, where vaccination drives frequently falter due to logistical challenges and inadequate funding.
In Afghanistan, the political scenario is even more precarious. Following the Taliban’s return to power in 2021, international funding for health programs, including polio eradication, faced significant cuts. Although the Taliban has occasionally supported vaccination efforts, their inconsistent policies and lack of coordination with international agencies have severely hampered progress.
The most daunting challenge to polio eradication in both countries is the persistent threat of violence against health workers. Polio vaccination teams in Pakistan and Afghanistan often operate in conflict zones where militant groups view them as agents of foreign powers. In 2024 alone, 12 polio workers and security personnel were killed in attacks in Pakistan, primarily in KP and Balochistan.
In Afghanistan, the situation is similarly dire. Health workers face threats not only from militant groups but also from local warlords and criminal gangs. The lack of security severely limits the reach of vaccination campaigns, leaving large populations of children unvaccinated.
As of 2024, Pakistan has reported 22 new polio cases, primarily from KP and Sindh provinces. These cases represent a troubling increase compared to the 15 cases reported in 2023. The majority of these infections are linked to the Type 1 Wild Poliovirus, the most severe form of the disease.
While these numbers may seem small compared to historical figures, they are a stark reminder of the challenges that remain. According to WHO, achieving zero polio cases requires consistent immunization coverage of at least 95% in every community. In Pakistan, however, vaccination rates in some regions remain as low as 50%, far below the threshold needed to halt transmission.
To put Pakistan’s situation into perspective, consider India, which was declared polio-free in 2014. Through rigorous immunization campaigns, robust surveillance, and strong political commitment, India achieved what once seemed impossible. Similar success stories can be found in Nigeria, which eradicated polio in 2020 despite facing challenges like those in Pakistan and Afghanistan.
These comparisons highlight the gap between Pakistan’s current efforts and international best practices. While financial aid and technical support from organizations like WHO and UNICEF continue to flow into Pakistan, the country’s inability to fully utilize these resources remains a significant obstacle.
The Pakistan government has taken several steps to combat polio, but these efforts often fall short due to systemic issues. The Emergency Operations Centre (EOC) for Polio Eradication coordinates vaccination campaigns and surveillance activities, but its effectiveness is hindered by a lack of accountability and insufficient funding.
In 2024, the government launched a new National Polio Eradication Strategy aimed at improving vaccination coverage in high-risk areas. Prime Minister Shehbaz Sharif has called for greater cooperation between federal and provincial authorities and urged religious leaders to play a more active role in dispelling myths about the vaccine.
However, critics argue that these measures are insufficient. The government’s failure to address the root causes of resistance, such as poverty, illiteracy, and lack of access to healthcare, continues to undermine vaccination efforts. Moreover, the lack of security for health workers remains a glaring issue that demands urgent attention.
The World Health Organization has repeatedly emphasized the need for Pakistan and Afghanistan to intensify their efforts to eradicate polio. In its 2024 report, WHO highlighted the importance of strengthening immunization systems, improving surveillance, and ensuring the safety of health workers.
WHO has also called for greater community engagement to build trust in vaccination campaigns. This includes involving local leaders, religious scholars, and community influencers to counter misinformation and encourage vaccination.
The eradication of polio in Pakistan and Afghanistan is not just a public health challenge; it is a test of political will, societal attitudes, and international cooperation. To achieve this goal, both countries must:
- Strengthen security measures to protect health workers and ensure the reach of vaccination campaigns.
- Invest in community education programs to dispel myths and build trust in vaccines.
- Enhance coordination between local, national, and international stakeholders.
- Address systemic issues like poverty and illiteracy that hinder immunization efforts.
- Ensure consistent funding for polio eradication programs, even in the face of political instability.
The fight against polio in Pakistan and Afghanistan is far from over. While the challenges are immense, the stakes are even higher. Eradicating polio is not just about protecting individual lives; it is about safeguarding the health and future of entire generations. With concerted efforts, unwavering commitment, and the support of the global community, the dream of a polio-free world can still become a reality.
The views expressed in this article are the author’s own and do not necessarily reflect Coverpage’s editorial stance.
