Poliomyelitis, once responsible for paralyzing and killing up to half a million people annually, nearly vanished after the development of the poliovirus vaccine in 1955. Mass vaccination campaigns, particularly the oral polio vaccine, had all but eradicated the disease by the turn of the century, with only a few regions still reporting cases.
However, a troubling resurgence of polio cases in Pakistan has reignited global concerns about the disease’s potential to spread once again.
Polio Cases Rising in 2024
Whereas in the year 2023, the number of cases in Pakistan seemed to be at zero with only six reported cases of the wild poliovirus. In 2024, there was a marked increase in this number to reach 73. The rise of the disease is mainly due to the war in Afghanistan as the war persists and does not allow immunisation.
According to the WHO, other infectious diseases such as pneumonia, dengue fever, and measles also are on the rise in Afghanistan, making matters worse. Zulfiqar Bhutta, a leading child immunization strategist, highlighted the association between the surge in polio cases in Pakistan with spillover from Afghanistan. “It has spread to all districts of Pakistan. We’ve snatched defeat from the jaws of victory,” Bhutta said, warning of the dangers of complacency in the face of the virus.
Challenges in Eradicating Polio in Conflict Zones
The situation in Afghanistan has several challenges facing the total elimination of polio. According to Bhutta, the restrictions imposed by the Taliban on female health practitioners, the unhygienic environment, and regional instability are severe barriers to the country’s immunization program. For instance, the lack of credible information regarding polio cases in Afghanistan makes it hard to track and control the disease.
Pakistan has expended an estimated $10 billion since 2011 on polio immunization programs, but the country’s progress has been uneven. Immunization rates vary widely across provinces, with Punjab reaching 85% vaccination coverage but Balochistan only achieving 30%. Bhutta highlighted that to eradicate polio in Pakistan, vaccination coverage must reach 85-90% in all provinces.
The Way Forward: Improving Immunization Strategies
Bhutta has further urged that a comprehensive review of immunization strategies be done, where the focus is not only on polio but on strengthening routine immunization programs for other infectious diseases as well. Bhutta further asserts that the Taliban are not enemies but have common health issues. His experience working with the Taliban in the delivery of smallpox vaccines during times of negotiated peace provides hope for future collaboration on addressing health challenges in Afghanistan.
The resurgence of polio in Pakistan is a harsh reminder of the challenges that still lie ahead in the global fight against infectious diseases. A concerted effort from local and international health authorities, along with cooperation from all parties involved, including the Taliban, will be crucial to prevent further setbacks in the fight against polio.