PAKISTAN enters its latest polio campaign in a better position than it did a year ago. Only four cases have been reported so far in 2026, compared with 31 last year. That is real progress, but it would be a mistake to read too much into the decline. As vaccinators move through 115 high-risk districts to reach more than 31m children, the real test is whether they can get to those who are repeatedly missed. Southern KP remains the clearest warning. Three of this year’s four cases have come from Bannu Division, while WHO has estimated that around 250,000 children in southern KP remain unreached, largely because of insecurity. Karachi, too, continues to show signs of transmission through environmental surveillance, while positive sewage samples elsewhere indicate how easily the virus can survive even when case numbers are low. National coverage figures matter little if the same vulnerable children keep slipping through the net. Until they are reached, campaign after campaign, the virus will continue to find room to circulate.

That is why the reported boycott of polio-security duties by Levies and Khasadar personnel in the merged districts is worrying. Their grievances may be genuine, but vaccination cannot be allowed to suffer as a result. The government must resolve the dispute quickly and ensure that workers can enter the areas where access is already difficult. The recent 28pc rise in vaccinators’ stipends is welcome recognition of the difficult and dangerous conditions many of them work in. Pakistan is also right to synchronise campaigns with Afghanistan, where cross-border movement continues to complicate eradication efforts. The task now is clear: find the children who are still being missed, protect the teams trying to reach them, strengthen routine immunisation and respond quickly when sewage surveillance detects the virus. Pakistan has pushed polio into a much smaller corner over the past two years. It cannot afford to leave that corner untouched.

Published in Dawn, September 22nd, 2026