Polio eradication continues to remain a big challenge. The first case of this year has already emerged in Lakki Marwat district of Khyber Pakhtunkhwa. Last year, it may be recalled, polio had returned with a vengeance affecting as many as 136 children against 12 reported cases in 2018, and just eight the year before, prompting the Independent Monitoring Board of the Global Polio Eradication Initiative to point out that in early 2018, the programme was believed to be on the brink of interrupting wild poliovirus transmission, but just over a year later the "epidemiological picture in the country" represents a huge "reversal of the trajectory to global polio eradication." Something somewhere had gone amiss.

The reasons for last year's resurgence of the poliovirus have been variously ascribed to different reasons by different people. The Monitory Board blamed political divide although there is a consensus among all political parties, inside and outside the government, on the issue. According to some others, the vaccine does not work in this country because it needs to be stored and transported at cooler temperatures, but then India with similar weather and other conditions has been able to banish this crippling disease which afflicts children under five years of age. Considering that over a year ago, the poliovirus was on the retreat, the problem seems to be administrative slackness. The major hindrance, however, has been community resistance, especially in KP and parts of Sindh, where the incidence of polio was the first and second highest, respectively, in 2019. Parents refuse to have their children administered polio drops due to religious extremists' propaganda that polio vaccination is a Western scheme to reduce Muslim population by rendering Muslim children infertile. If that is not bad enough, these people have killed several health workers and their police escorts vaccination campaigns.

Going forward, the polio eradication programme is preparing to launch two nationwide anti-polio drives in February and April to plug the immunity gap that surfaced last year. These campaigns have two noteworthy aspects. One is that they are to be conducted in tandem with Afghanistan, where polio is endemic, and people move frequent across the border. Another important feature of the campaigns, as described by the National Emergency Polio Programme Coordinator, is breaking resistance by engaging identified community influencers. Instead of forced vaccination, he explained, the aim is to let people express their concerns and ask questions which would be address based on logic and science using people these communities trust. The effort is expected to bring about a significant drop in new cases by mid-2020. Hopefully, the new approach will help wipe out the scourge of polio sooner rather than later.