Pakistan is one of only two countries where poliomyelitis (polio) remains endemic, the other being Afghanistan. While other neighbouring countries in South Asia have been polio-free for many years, Iran and Bangladesh, both Muslim countries, were declared polio-free in 2006 and 2014, respectively. However, Afghanistan and Pakistan, both bordering Muslim countries, have not yet been able to eradicate the poliovirus. Nigeria was also on the list of polio-endemic countries, but it was officially certified free from poliovirus in 2020 by the World Health Organization (WHO).
Due to deep-rooted misconceptions and misinformation about anti-polio vaccines among some sections of religious groups, they are often portrayed as a Western agenda, with claims that the vaccine contains ingredients that will cause sterilisation in children. However, facts and data prove otherwise. Pakistan has one of the fastest population growth rates, approximately 2.55 per cent in South Asia, with high fertility rates and a large youth population.
Other key challenges Pakistan faces include cross-border migration between Pakistan and Afghanistan, resistance and refusal from parents, restricted access in rural and northern areas, geographical barriers, and attacks on polio vaccination teams. These factors contribute to the recurrence of polio cases in Pakistan. The law and order situation and conflicts in some parts of Khyber Pakhtunkhwa and Balochistan have impacted the frequency and outreach of anti-polio vaccination campaigns. Resistance from parents has also been reported in some urban centres such as Karachi.
The Polio Immunisation Programme in Pakistan has been a crucial initiative to eradicate polio from the country. In Pakistan, immunisation, including the polio vaccine, is free; polio workers go door to door to administer polio drops to children under the age of five years.
The Pakistan Polio Eradication Programme was launched in 1994 by then Prime Minister Mohtarma Benazir Bhutto. She personally administered the first oral polio vaccine drops to her daughter, Aseefa Bhutto Zardari, who later became an ambassador for the anti-polio campaign. That marked the beginning of Pakistan’s polio immunisation programme to eradicate the disease and to save millions of children from its crippling effects.
This year, a nationwide polio campaign aims to vaccinate over 45 million children
Aseefa Bhutto Zardari took up the cause of her mother by becoming an ambassador for polio eradication, advocating for mass vaccination and community awareness. She has urged elected representatives, local government officials, religious leaders, and community elders to stand with polio teams, facilitate access to communities, and help counter misinformation and hesitancy.
When the Polio Eradication Initiative was launched in Pakistan three decades ago, it achieved remarkable milestones. The number of cases was reduced from 20,000 in 1994 to 31 cases in 2025. Thus, Pakistan has reduced polio cases by 99.8 per cent. The data scientifically proves that anti-polio vaccines have worked and have saved the lives of millions of children.
Although there was a decline in positive detection of the poliovirus in 2025, 31 cases were still reported, including 19 from Khyber Pakhtunkhwa, nine from Sindh, and one each from Punjab and Gilgit-Baltistan. The number of cases remains significantly alarming.
International and national experts convened by the World Health Organization (WHO) and the Aga Khan University in 2025 unanimously concluded that “all available science and evidence indicate that, despite challenges, ending polio in Pakistan and globally is within reach.”
However, the emergence of new polio cases puts the tireless efforts of the Expanded Programme on Immunisation (EPI) and hardworking male and female polio workers at risk, and Pakistan lags in achieving its ultimate goal of becoming polio-free. There is a trained workforce of 400,000 frontline polio workers in the Polio Eradication Programme who work with dedication under harsh and challenging conditions—in floods, snow, difficult terrains, deserts, and mountains.
According to the World Health Organization’s press release in January 2026, “Science indicates that ending polio in Pakistan and worldwide is within reach if we sustain the ongoing partnership and eradication efforts. However, the detection of wild poliovirus type 1 in Germany last November is a strong reminder that the cost of inaction would be far greater than the cost of action, since no country and no child will be safe until the virus is fully eradicated everywhere.”
The tragic incidents involving the killing of polio workers and violence against them in Pakistan are of great concern. Thirty-nine incidents of violence or obstruction involving polio teams, police, and security personnel escorting vaccination teams during door-to-door campaigns were reported in 2024. In these incidents, polio vaccination campaigns came under attack 25 times, while 15 health workers were killed and seven kidnapped across Pakistan. As a result, more than a million children missed their polio vaccination doses in 2024. The harsh reality is that such violence has further undermined efforts to eliminate polio in Pakistan. Polio workers deserve respect and appreciation.
This year, a nationwide polio campaign aims to vaccinate over 45 million children. It is therefore imperative for federal, provincial, and district governments to reassess their strategies and devise collective and localised approaches to build trust among communities, particularly parents, while also strengthening surveillance.
Before the launch of polio vaccination campaigns, community mobilisation, engagement, and awareness initiatives should be carried out well in advance, involving credible religious scholars. Civil society, non-governmental organisations, the media, and the private sector must also share responsibility by collaborating and intensifying joint efforts to spread awareness and educate communities about the public health risks posed by the poliovirus.
The safety and protection of polio teams must be strengthened, as they are frontline workers who go door to door administering polio drops. Local governments and district administrations must be involved in designing localised awareness campaigns and facilitating polio teams, so that Pakistan can become a poliovirus-free country.