Bannu emerges as major hurdle to anti-polio efforts

Peshawar: Bannu Division has emerged as a significant obstacle in Pakistan's government's anti-polio initiatives in Khyber Pakhtunkhwa, according to officials. The country has reported only five polio cases this year, with all four cases occurring in Khyber Pakhtunkhwa, one of which is in Sindh. The Emergency Operation Centre (EOC) of Khyber Pakhtunkhwa (KP) recently conducted its fourth week-long polio campaign, which concluded on September 27.

The campaign met an overall target of 99pc, but achieved only 86pc coverage in Bannu, the epicenter of poliovirus. Bannu also recorded the second-highest number of parents refusing their children's vaccination, with 4,701 cases, trailing only Peshawar, which topped the list with 5,635 refusals. The campaign missed vaccinating 5,873 children in Bannu due to their unavailability during house-to-house visits, and had a total of 83,989 children skipping immunization, a figure similar to the previous campaign.

Vaccination refusals rose to 20,167 from 19,605. Despite ongoing threats, vaccinators persevered in reaching people in districts plagued by violence, though pockets of resistance, particularly in southern areas, persist due to reluctance towards the oral polio vaccine (OPV). A recent World Health Organisation (WHO) report highlighted that Pakistan has reported just five polio cases in 2026, a stark contrast from 31 cases in 2025 and 74 in 2024.

The WHO noted that sustained local poliovirus transmission continues to be concentrated in three critical areas - the South Region of Afghanistan, Southern Khyber Pakhtunkhwa, and Karachi. The South Region in Afghanistan remains the most worrying area due to intense virus transmission and persistent, undetected circulation. Afghanistan, like Pakistan, is a polio-endemic country, reporting 36 cases this year, up from 21 in 2025.

Meanwhile, Southern Khyber Pakhtunkhwa, particularly Bannu Division, continues to pose substantial operational and security challenges for implementing high-quality vaccination activities. Karachi, too, remains a significant reservoir for poliovirus transmission, with widespread environmental surveillance indicating ongoing local transmission.

EOC KP has been focusing particularly on high-risk districts before every campaign, conducting training sessions for workers to engage communities and address vaccination refusals, thus ensuring supervision and quality assurance of vaccinations in line with the international commitment that every child under five years of age must receive two OPV drops during each campaign.

The campaign, synchronized with Afghanistan, aimed to ensure that children crossing the Pak-Afghan border receive OPV on either side. Of the 31 million children targeted nationwide, KP has 7.3 million in 37 districts, but except Bannu Division and Peshawar, targets remained far from being met in almost every campaign. Officials at the EOC said that while most children are protected, poliovirus needs just one unvaccinated child to continue circulating.

They emphasized that the virus is still present, but the system is working towards early detection, rapid response, and high campaign coverage to achieve the country's polio-eradication goal. Before every campaign, the chief secretary holds meetings with deputy commissioners and district health officers to ensure quality immunization, especially in areas with opposition to polio vaccination.

However, even with these efforts, some districts, especially those in Bannu Division, continue to record cases of vaccination refusal and missed children. In a bid to acknowledge the bravery of polio workers, the government recently increased their wages by 30pc.