Killing of Polio Workers and Security Personnel Is Deplorable

Polio vaccinators and the security personnel assigned to protect them have been killed in Pakistan while carrying out vaccination campaigns. The programme has condemned these attacks in the strongest terms, and they remain one of the defining constraints on eradication in the country.

Who is being attacked

The people targeted are not officials. They are local frontline workers — many of them women, recruited from the communities they vaccinate, often earning modest wages — and the police constables assigned to accompany them. A significant proportion of Pakistan's vaccinator workforce is female, because in many households only a woman can enter and speak to the mother.

The cost beyond the deaths

Each attack does damage far wider than the immediate loss.

• Campaigns stop. Rounds are suspended in the affected district, sometimes across a wider area, and children who should have been vaccinated that week are not.
• Access closes. Areas become too dangerous to enter, and the immunity gap that follows is exactly what poliovirus needs. Security-related access constraints in southern Khyber Pakhtunkhwa are currently the largest single driver of Pakistan's remaining cases.
• Recruitment becomes harder. Communities are more reluctant to let family members take the work, particularly women.
• Delivery changes shape. Teams move with armed escorts, which alters how they are perceived at the door and makes the sustained, patient conversations that change a refusing parent's mind far harder.

The connection to the 2014 outbreak

Attacks on vaccination teams, alongside the two-year vaccination ban in North Waziristan, were central to the collapse that produced 306 cases in 2014 — Pakistan's worst year since 2000 and the immediate cause of the WHO's declaration that poliovirus spread constituted a Public Health Emergency of International Concern. See polio cases in 2014.

What has been done

Security planning is now integrated into campaign planning rather than added afterwards: police deployment coordinated with microplans, high-risk union councils identified in advance, campaign timing adjusted, and community-based vaccinators recruited from within areas where outside teams cannot safely work. See the high-level security review.

What should be said plainly

The people who knock on doors with a cool box and a tally sheet are doing one of the most consequential jobs in Pakistani public health, for very little money and at real personal risk. Every child in the country who will never be paralysed owes something to them.

Related: frontline workers · vaccine heroes