PAKISTAN’S rollout of the world’s first cancer-prevention vaccine has been sobering. A 12-day campaign, ending tomorrow, to vaccinate 13m girls against HPV — the virus that causes cervical cancer — has reached just 4.5m. That is barely a third of the target. Cervical cancer is the second most common cancer among Pakistan’s women, with two in three of those diagnosed not surviving. Yet a vaccine that is safe, free, and long proven elsewhere has struggled to gain acceptance. It is already part of immunisation schedules in Saudi Arabia, Indonesia and Bangladesh. The uptake failure reveals a problem Pakistan has long known but not fixed: the gap between medical science and public trust. In Karachi, the country’s largest city, only a third of eligible girls were vaccinated, with coverage in Keamari a dismal 12pc. By contrast, smaller districts in interior Sindh surpassed 80pc, helped by local leaders who urged families to participate. Where trusted voices were absent, social-media agitators filled the void, fuelling suspicion. The pattern is familiar. Polio campaigns have faced the same cycle of myth-making and refusals — and, at their worst, vaccinators being roughhoused, kidnapped, or killed. Now HPV teams too are coming under pressure. In Mandi Bahauddin, a Lady Health Worker was beaten while carrying out vaccinations, underscoring the risks borne by front-line staff. Such incidents deepen mistrust and deter other vaccinators, leaving girls unprotected against a deadly but preventable disease.

The missing link is awareness. A few social media posts and a minister publicly vaccinating his daughter cannot substitute for sustained engagement. Parents need to hear not only from doctors but also from those they trust, such as teachers and religious leaders. Civil-society groups can help map refusal hotspots, address concerns in local languages, and reassure parents through direct communication. Out-of-school girls — nearly half the target group — must also be reached with dedicated outreach. The government must learn from this first phase. Risk-mapping resistance, investing in parental counselling, and integrating HPV into routine immunisation is essential. Above all, it must treat this not as a one-off campaign but as a long-term commitment. The WHO wants 90pc of girls worldwide vaccinated against HPV by 2030. Pakistan aims to meet this goal. It will not do so without treating communication as seriously as logistics. Vaccinating girls now can protect lives later.

Published in Dawn, September 26th, 2025