Silent Spread: The Unseen Battle Against Polio in Pakistan
Despite decades of determined effort, Pakistan’s dream of a polio-free future remains just that — a dream. While official figures for 2025 may appear encouraging at first glance, with 26 confirmed cases of wild poliovirus so far — significantly lower than the 74 cases reported last year — a more troubling narrative is unfolding beneath the surface. This isn’t a story of victory, but of silent transmission, dangerously persistent and alarmingly widespread.
What the Numbers Don’t Show
In August 2025 alone, out of 126 sewage samples collected across 87 districts, 51 tested positive for poliovirus. That’s a 40% positivity rate — a major red flag for public health experts. Even more disturbing are the results from Sindh, where 24 out of 29 samples (over 80%) showed the presence of the virus. This environmental data paints a picture of hidden spread, where the virus continues to circulate silently in communities even in the absence of reported clinical cases.
These figures raise serious concerns: how effective are the ongoing vaccination campaigns if the virus is still being detected so widely?
Fatigue, Frustration, and Fading Trust
Pakistan’s polio eradication program has been running for over thirty years, relying heavily on door-to-door vaccination campaigns. But years of repetition have led to what experts call “eradication fatigue.” Communities are growing weary. Vaccine refusals are rising. Misinformation, long fueled by conspiracy theories, is thriving in areas where the state is seen as absent or untrustworthy.
But the editorial argues — quite rightly — that blaming conspiracy theories alone oversimplifies the problem. When the government fails to provide clean drinking water, reliable health services, or quality education, it becomes difficult to persuade skeptical communities to accept polio drops. Vaccination campaigns, no matter how scientifically sound, cannot succeed without public trust. And trust, in turn, depends on the state’s ability to deliver on basic needs.
Polio and the Legitimacy of the State
The battle against polio has now become more than a health campaign — it is a test of state legitimacy. A government’s ability to eliminate a preventable disease is often seen as a reflection of its competence and commitment to public welfare. In Pakistan’s case, the lingering presence of poliovirus highlights systemic failures in governance, service delivery, and crisis management.
The editorial further connects the issue with climate change. Recurrent floods, mass displacements, and other climate-induced disasters have made millions of Pakistanis more vulnerable. Migrant families living in makeshift shelters are some of the hardest to reach, often slipping through the cracks of vaccination drives. In these vulnerable communities, polio finds a haven — thriving in conditions of inequity, instability, and neglect.
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Frontline Workers: Heroes at Risk
Adding to the complexity is the threat faced by the very people on the front lines. In September, three vaccinators were kidnapped in Tank, a stark reminder of the dangers health workers face in parts of the country. Attacks, threats, and intimidation against vaccinators are tragically not new, but they continue to compromise the reach and effectiveness of eradication efforts.
Despite these risks, thousands of dedicated health workers continue to brave dangerous terrain and hostile environments to protect children from a crippling disease. Their courage deserves more than just praise — it demands action, safety, and meaningful support.
A Global Responsibility
Polio is now endemic in only two countries: Pakistan and Afghanistan. Each new case within their borders poses a global threat. The continuation of the virus could trigger travel restrictions, reduce international funding, and squander billions of dollars already invested in global eradication. The world is watching — and waiting — for Pakistan to turn the tide.
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Beyond Vaccines: A Call for Systemic Change
The editorial concludes with a powerful message: Vaccines alone will not defeat polio. What Pakistan needs is a holistic, integrated approach that addresses the root causes of mistrust and vulnerability. This includes:
Rebuilding public trust through transparent governance and consistent delivery of essential services.
Integrating vaccination into broader healthcare reforms, so that polio drops aren’t seen as isolated or suspicious efforts, but as part of a larger commitment to child and community health.
Linking polio eradication to climate recovery strategies, recognizing that health crises cannot be separated from environmental and social upheaval.
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The Final Mile Is the Hardest
Pakistan stands at a crucial crossroads. The country has made significant progress in reducing polio cases, but the risk of resurgence is dangerously real. The virus is still out there — silently spreading, quietly surviving, and patiently waiting for the next opportunity to strike.
Defeating polio once and for all is possible. But it will take more than medical campaigns. It will require political will, community engagement, infrastructure rebuilding, and an unwavering commitment to equity and justice.
Polio’s final chapter in Pakistan has yet to be written — and it is up to us how that story ends.