📢 Publish Your Research for Free - Full APC Waiver, No Hidden Charges. Submit Your Article Today! Submit Now →
JImage

ARTICLE TYPE : REVIEW ARTICLE

Published on :   29 Aug 2026, Volume - 2
Journal Title :   WebLog Journal of Internal Medicine | WebLog J Intern Med | WJIM
Source URL:   weblog icon https://weblogoa.com/articles/wjim.2026.h2905
Permanent Identifier (DOI) :   doi icon https://doi.org/10.5281/zenodo.22510001

From Resurgence to Eradication: Reframing Pakistan’s Polio Landscape, 2020–April 2025

Umar Saeed 1 *
Zahra Zahid Piracha 2
Munir Akmal Lodhi 1
Qudrat Ullah Malik 1
Muzamil Hasan Najmi 1
Muhammad Rehan Uppal 3
Rizwan Uppal 3
Muhammad Saad Uppal 3
1Clinical and Biomedical Research Center (CBRC), Foundation University School of Health Sciences (FUSH), Islamabad, Pakistan
2International Center of Medical Sciences Research (ICMSR), Islamabad, Pakistan
3Islamabad Diagnostic Center, F8 Markaz, Islamabad, Pakistan

Abstract

Pakistan, together with Afghanistan, remains one of the final reservoirs of endemic Wild Poliovirus type 1 (WPV1). This review synthesizes Pakistan's polio trajectory from 2020 through April 2025, focusing on case trends, environmental surveillance, programmatic responses, and persistent barriers to eradication. The review used published and grey literature from WHO, the Global Polio Eradication Initiative (GPEI), CDC, UNICEF, Pakistan Polio Eradication Programme reports, and peer-reviewed articles. Pakistan experienced major fluctuation during the review period: 84 WPV1 cases in 2020 during COVID-19 disruptions, one case in 2021, a localized outbreak of 20 cases in 2022, six cases in 2023 with continuing environmental detections, and a resurgence to 74 cases across multiple districts in 2024. By April 2025, seven cases had been reported, while environmental surveillance continued to detect WPV1 in several districts. The evidence shows that low case counts can mask persistent transmission, especially when sewage surveillance remains positive. Key barriers include vaccine hesitancy, misinformation, insecurity affecting frontline workers, missed children, migration, cross-border transmission with Afghanistan, malnutrition, and poor sanitation. Pakistan's programmatic strengths include expanded environmental surveillance, repeated national and subnational immunization days, female frontline vaccinators, integrated health services, and adaptive hotspot targeting. Eradication will require uninterrupted vaccination, security for health workers, community trust-building, rapid response to environmental signals, and synchronized cross-border action until both paralytic cases and environmental detections reach zero.

Keywords: Polio; Pakistan; Wild Poliovirus Type 1; Environmental Surveillance; Vaccine Hesitancy; Eradication; Immunization

Citation

Saeed U, Zahid Piracha Z, Akmal Lodhi M, Ullah Malik Q, Hasan Najmi M, Rehan Uppal M, et al. From Resurgence to Eradication: Reframing Pakistan’s Polio Landscape, 2020–April 2025. WebLog J Intern Med. wjim.2026. h2905. https://doi.org/10.5281/zenodo.22510001
Read Full Article