Polio Resurgence: Explanation of Its Recent Resurgence

In the ongoing battle against polio, Afghanistan and Pakistan continue to pose significant challenges due to factors such as conflict and insecurity, logistical challenges in vaccine distribution, and the emergence of vaccine-derived polioviruses (VDPVs).

The East Region of Afghanistan has seen a decline in WPV1 (wild poliovirus type 1) transmission in early 2025, suggesting some success in immunity buildup. However, lingering insecurity and operational difficulties slow the progress towards full eradication [1]. Pakistan, on the other hand, continues to report WPV1 cases, reflecting persistent transmission challenges related to access and campaign quality [4].

The complexities of the situation are further compounded by the porous borders between the two countries, necessitating synchronized, cross-border vaccination efforts. These issues impact eradication efforts by limiting access to some populations, disrupting routine immunization services, facilitating cross-border poliovirus spread, and compounding challenges with concurrent health emergencies and outbreaks [1].

Vaccine-derived poliovirus outbreaks have emerged globally, highlighting the need for continued innovation and tailored interventions to maintain high-quality vaccination and surveillance [1][2]. In 2022, at least 98 vaccine-derived cases of polio have been reported [2].

In Pakistan, villagers have staged hundreds of boycotts of immunization campaigns since 2023, requesting essential resources like medicine, food, and electricity instead of polio vaccines. Public trust in vaccine campaigns has been undermined by incidents such as the CIA's fake hepatitis drive in 2011, and a growing anti-vaccine sentiment, fueled by misinformation and conspiracy theories, further complicates matters [3].

Scott Barrett, a Columbia University professor, has called for an inquiry into the polio eradication effort, particularly regarding a failed effort in 2016. Dr. Tom Frieden, a former director of the U.S. Centers for Disease Control and Prevention, has urged authorities to find ways to adapt the polio eradication strategy, such as adopting new methods to identify polio cases more quickly [3].

Dr. T. Jacob John, a former WHO scientist, has called for a "major course correction" in the polio eradication effort, but has received no response from WHO Director-General Tedros Adhanom Ghebreyesus. The polio eradication initiative, with an annual budget of about $1 billion, has faced criticism for spending large amounts of money without achieving significant progress, particularly in Pakistan [3].

Workers in polio immunization campaigns in Pakistan and Afghanistan are often accompanied by armed guards due to threats from militants. The oral polio vaccine, while proven safe and effective, has been associated with extremely rare side effects, including paralysis in one child for every 2.7 million first doses given [2]. Despite these challenges, the ongoing fight against polio continues, with the hope that a polio-free world is within reach.

References: [1] Polio Eradication Initiative. (n.d.). Afghanistan and Pakistan. Retrieved from https://polioeradication.org/where-we-work/afghanistan-and-pakistan [2] World Health Organization. (2023). Polio. Retrieved from https://www.who.int/health-topics/polio [3] Reuters. (2023, February 20). Polio eradication faces setbacks in Pakistan, Afghanistan. Retrieved from https://www.reuters.com/article/us-health-polio-afghanistan-pakistan-idUSKBN2H62JN [4] Centers for Disease Control and Prevention. (n.d.). Pakistan. Retrieved from https://www.cdc.gov/polio/resource/country-profiles/pakistan.html

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