Eradication of Polio in Pakistan?

Recently, Pakistan reported four new cases of polio: one from Khyber Pakhtunkhwa and three from Balochistan, bringing the total number of polio cases to 39 this year. Currently, only three countries still have the disease: Pakistan, Afghanistan, and Nigeria. Pakistan launched its polio eradication program in 1994, which initially yielded positive results. According to UNICEF, in the early 1990s, Pakistan reported about 20,000 polio cases annually.

Thanks to government efforts, only one case was reported in 2021, from Balochistan. However, in 2022, the number rose to 20 cases, all in Khyber Pakhtunkhwa. In 2023, there were six cases: four from Khyber Pakhtunkhwa and two from Sindh. The 39 cases reported so far this year indicate that government efforts may not be as strong as before.

One potential reason for this is the reduction in funding for the polio program. In 2022, the government allocated $180 million to the program, increased to $187 million in 2023, but decreased by 57% to $80 million in 2024. This shows a lack of the same seriousness and sensitivity towards polio eradication as seen before. Polio will continue to spread until it is eradicated everywhere. It is crucial that children everywhere receive polio drops to protect them from the virus.

When the virus establishes itself in a region, it can easily affect children who have not received the polio vaccine. In 2013, the Global Polio Eradication Initiative launched a comprehensive strategy to eradicate polio, focusing on eliminating it from the last remaining areas and maintaining a polio-free world. However, this has yet to be fully implemented in Pakistan.

Polio is a highly contagious disease caused by the poliovirus, primarily affecting children under five, targeting the nervous system, and leading to paralysis or death. Although there is no cure, vaccination is the most effective way to protect children. Repeated vaccinations have saved millions from polio. Polio has once again emerged as a major threat in Pakistan and Afghanistan, raising global concern.

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The World Health Organization (WHO) only declares a region polio-free if no new cases have emerged in all countries within the region for three consecutive years. Pakistan and Afghanistan, despite coming close to eradication several times, are still far from achieving it.

Experts believe that in both countries, misinformation about polio, parents’ reluctance to vaccinate their children, and limited safe and accessible vaccine distribution contribute to the problem. Overpopulation, inadequate healthcare, and poverty also exacerbate the situation in many areas.

The WHO’s Emergency Committee on Polio states that movement between Pakistan and Afghanistan has significantly contributed to the spread of polio. They suggest the return of Afghan refugees from Pakistan could be one cause of increased cases in Afghanistan, while Pakistani officials argue that cases in Pakistan are due to infected individuals crossing from Afghanistan.

In addition to symptomatic cases, asymptomatic carriers, including adults, can carry the virus. If sewage samples reveal poliovirus in an area, it is considered evidence of its presence there.

Some regions of Pakistan, like Karachi, Quetta, Chaman, Qilla Abdullah, Lahore, and areas of Khyber Pakhtunkhwa, are considered reservoirs of the virus. According to Pakistan’s National Institute of Health, samples from eight sewage locations in Karachi (Keamari and Malir), Sukkur, Jacobabad, Hyderabad, and Lahore showed the virus, genetically linked to the YB3A polio virus cluster across the border. To

This cluster was reportedly eradicated in Pakistan in 2021 but re-entered the country last year. The increase in polio cases in 2024 raises serious questions about the performance of both federal and provincial governments. Polio is taken very seriously worldwide, and its continued presence in Pakistan is deeply regrettable. Both federal and provincial governments should reevaluate their current policy on polio eradication, addressing any gaps immediately. If funding is an issue, more funds should be allocated to prevent further spread.

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