WENTY-ONE children have been paralysed by polio in Pakistan this year, the latest two in Kohistan and Badin.

a 6 Each new case is a painful reminder that we remain one of only two countries where the virus still spreads. That a disease wiped out in most of the world still stalks our children is not just a health failure, it is a governance crisis. Billions of dollars have been invested in our eradication programme over three decades. Thousands of vaccinators have risked their lives to reach children in remote and conflict-affected areas. Yet security threats, poor coordination, weak accountability and misinformation have left gaping holes in coverage. The National Institute of Health has acknowledged that despite progress, children remain at risk in areas where vaccine acceptance is low.

Recent environmental surveillance showing poliovirus in over a third of districts underscores how fragile progress is.

Campaigns cannot succeed if the same shortcomings crop up in every round. The latest is due from Sept 1 to 7, targeting over 28m children under five in 99 districts, with southern KP to be covered from Sept 15. But unless coverage gaps are plugged, the exercise risks delivering few results. Parents in many areas still distrust the drops, swayed by rumours that the vaccine is unsafe. Workers often inflate coverage data to satisfy superiors. Political leaders make statements but do little to build community support or strengthen health services. Even basics like clean water and waste disposal essential for breaking f aecal-oral transmission remain neglected. The state must confront these failures honestly.

Securing front-line workers, prosecuting attackers, ensuring transparent data and consistently engaging community leaders are vital steps. Linking campaigns with routine immunisation and sanitation would build trust. Pakistan cannot allow another generation to live under the shadow of an incurable but preventable disease. Political will, consistency and accountability are the only way out of this long-running tragedy.