Pakistan at Excellent Momentum to End Polio, Says Global Delegation

A visiting delegation from the global polio eradication partnership assessed Pakistan as having strong momentum toward ending poliovirus transmission.

What momentum means here

In an eradication programme, momentum is not the same as progress toward a target. The target is zero, and zero has to be held for three consecutive years with no detection in people or in the environment before certification is possible. A country can have excellent momentum and still not finish.

Pakistan's record demonstrates exactly this. The country reached 8 cases in 2017 — at the time its lowest total ever — and recorded 147 two years later. It recorded a single case in 2021, and 74 in 2024. Momentum is real, and it is also reversible.

What the assessment usually rests on

• Falling case counts. 74 in 2024, 31 in 2025, four by September 2026.
• Narrowing geography. Transmission concentrated in fewer districts, with three of 2026's four cases coming from a single division.
• Campaign performance. Improvements in missed-children numbers in districts that had been persistently weak.
• Surveillance sensitivity. Confidence that the programme would detect virus if it were circulating — which is what makes a low case count meaningful rather than merely quiet.
• Political commitment. Sustained attention from federal and provincial leadership, which has historically been the variable that determines whether technical capability translates into results.

The caveat the programme itself applies

Environmental surveillance is the check on optimism. Falling case counts alongside continued poliovirus-positive sewage samples mean population immunity is suppressing paralysis while the virus keeps circulating. That is a good position and an unstable one, because immunity falls as soon as campaign quality slips or newborns refill the susceptible pool.

It is precisely what preceded 2019. See 2018 and 2019.

What would convert momentum into completion

One thing above all: campaigns running consistently in the southern Khyber Pakhtunkhwa union councils where security-related access constraints currently prevent them. The programme has been explicit that this is where children are missing critical vaccination and where the virus continues to circulate.

Related: eradication within reach · surveillance