GPEI Delegation Concludes Visit to Pakistan

A delegation from the Global Polio Eradication Initiative concluded a visit to Pakistan, completing its assessment of programme performance and the conditions for interrupting transmission.

Who the GPEI is

The Global Polio Eradication Initiative is a partnership rather than a single organisation: national governments together with the World Health Organization, Rotary International, the US Centers for Disease Control and Prevention, UNICEF, the Bill & Melinda Gates Foundation and Gavi. It has coordinated the global effort since 1988, when wild poliovirus was paralysing an estimated 350,000 children a year across 125 countries.

That number is now two countries — Pakistan and Afghanistan — which is why delegations come here rather than anywhere else.

What a delegation examines

• Surveillance quality. Whether the programme would actually detect virus if it were circulating — measured by non-polio acute flaccid paralysis detection rates and stool sample adequacy, not by case counts.
• Campaign performance. Independent post-campaign monitoring and missed-children analysis at union council level, rather than self-reported coverage.
• Access. The security-related constraints in southern Khyber Pakhtunkhwa, which the programme has identified as the largest single driver of remaining cases.
• Cross-border coordination. Whether campaign timing and data sharing with Afghanistan are functioning, given the two countries are treated as one epidemiological block.
• Community engagement. Refusal rates and what is being done in the communities where they cluster.

Why the assessment is usually candid

These reviews, along with the independent Technical Advisory Group and the CDC's periodic assessments published in MMWR, are generally franker about weaknesses than programme documents. That is their function: the partnership's funders are committing money against an uncertain completion date, and an over-optimistic assessment serves nobody.

Where Pakistan stands

2024 closed at 74 cases, 2025 at 31, and by September 2026 four cases had been reported — three of them from the Bannu division in southern Khyber Pakhtunkhwa. In August 2026 the WHO Polio IHR Emergency Committee again extended the Public Health Emergency of International Concern.

The trajectory is improving. The constraint is unchanged.

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