Pakistan Polio Update — NEOC Programme Reporting

The Pakistan Polio Update is the National Emergency Operations Centre's periodic report on the state of the eradication programme. Read in sequence, these updates are the most detailed public record of how the effort has actually developed.

What each update covers

• Cases. Wild poliovirus cases confirmed in the period, by district, with the running annual total. Confirmation lags the onset of paralysis by several weeks, so figures are revised.
• Environmental surveillance. Which sewage sampling sites tested positive. Because roughly 199 of every 200 poliovirus infections cause no paralysis, this is the earliest signal the programme has.
• Campaigns. Rounds conducted, children targeted, and — the number that matters — children missed and why.
• Operations. Access constraints, security incidents, community engagement, and changes to strategy.

How to read them

Three habits make these documents far more useful.

Read environmental surveillance before case counts. Falling cases alongside continued sewage positivity means population immunity is suppressing paralysis while the virus circulates — a fragile position, and exactly what preceded the 2019 reversal from 12 cases to 147.

Read missed children, not coverage. Administrative coverage is self-reported and has consistently been the least reliable indicator in eradication programmes worldwide. The missed-children figure, disaggregated by union council and by reason, predicts next year's cases far better.

Watch the geography, not just the totals. A case in a historical reservoir means continued circulation; a case in a district that has been quiet for years means the virus is moving along new routes.

The record these updates trace

Roughly 20,000 cases a year in the early 1990s, then: 306 in 2014, 54 in 2015, 20 in 2016, 8 in 2017, 12 in 2018, 147 in 2019, 84 in 2020, 1 in 2021, 20 in 2022, 6 in 2023, 74 in 2024, 31 in 2025 — and four by September 2026.

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