Pakistan is increasingly emerging as a key reservoir of poliovirus, raising alarm within the international community that the country could evolve into a hub for broader cross-border transmission. At present, only two countries worldwide — Pakistan and Afghanistan — continue to report endemic circulation of the wild poliovirus. Notably, Afghanistan, despite being under Taliban rule, has recorded a significant decline in cases.
In contrast, Pakistan has reported more than 100 active cases of the WPV1 strain over the past two years. This resurgence is attributed to a combination of systemic issues, including corruption, administrative failures, government inaction, barriers to access in vulnerable communities, and widespread vaccine hesitancy. This trend is particularly concerning given that the country has received over $100 million in international funding for polio eradication efforts since 2023.
The World Health Organization has highlighted that WPV1 has now been detected across all major provinces of Pakistan, from the relatively developed Punjab to the less developed Khyber Pakhtunkhwa. According to the WHO’s Polio IHR Emergency Committee, active transmission continues into 2025, including in Lahore and multiple districts within the central epidemiological corridor of the country.
The committee noted that the upward trend in cases became evident as early as mid-2023, particularly in Khyber Pakhtunkhwa, Sindh, and Balochistan. Of additional concern is the reappearance of the virus in Gilgit-Baltistan, which reported its first WPV1 case in over eight years — a development underscoring the persistent threat posed by entrenched transmission zones.
Pakistan’s situation stands in stark contrast to the progress achieved by several low-resource African countries that have successfully eliminated active poliovirus transmission. UNICEF has warned that as long as the virus continues to circulate in endemic countries, all nations remain at risk of imported cases, especially those with fragile healthcare systems and strong travel or trade links to affected regions.
The WHO has also expressed dissatisfaction with the response of the Islamabad government, stressing that political commitments must be translated into effective, high-quality vaccination campaigns. Particular emphasis, it noted, should be placed on core reservoir areas and regions where transmission remains persistent.
Experts point to deep structural weaknesses within Pakistan’s healthcare system as a central factor behind the failure to eradicate the disease. Shanzeh Sheikh of Duke University argues that the government has largely neglected the health needs of the broader population and failed to implement the necessary containment measures. Medical professionals across the country, she notes, have repeatedly voiced frustration over the lack of meaningful government initiative, while the persistence of polio exposes the underdevelopment of primary and public healthcare infrastructure.
Among the key challenges identified are inadequate transportation for medical teams in remote areas, insufficient training, vaccine shortages, poor coordination and accountability, political interference, and the unequal distribution of quality healthcare, which remains largely accessible only to elites.
Development consultant Nawab Ali Khattak echoes these concerns, emphasizing that polio continues to resurface due to logistical obstacles, security threats, misinformation, and corruption. He notes that volunteers involved in vaccination campaigns have at times boycotted efforts due to delays in vaccine delivery, bureaucratic inefficiencies, lack of coordination, and resource shortages. According to Khattak, the disease persists within a complex environment shaped by weak governance, ideological divisions, and systemic dysfunction.
Although approximately 44 million children were vaccinated in 2025, more than one million missed immunization, leaving them vulnerable to infection. Health workers have also reported numerous incidents of families refusing vaccination or even attacking vaccination teams. Fear surrounding the vaccine is fueled by conspiracy theories claiming that polio drops contain harmful substances, alcohol, or pork, or are designed to sterilize Muslim children — narratives often promoted by extremist groups and certain religious figures.
Sindh-based educator Assadullah Channa attributes much of the crisis to the government’s failure to confront extremist narratives effectively. He argues that authorities have avoided challenging fundamentalist elements, allowing years of misinformation to shape public perception and drive vaccine rejection. According to Channa, the persistence of polio is also a reflection of political neglect, with successive governments failing to counter extremist propaganda, while the current leadership remains preoccupied with political and judicial maneuvering at the expense of urgent public health priorities.