Core Team — How Pakistan's Polio Programme Is Organised

Pakistan's polio programme is not a single office. It is a chain of accountability that runs from the Prime Minister's National Task Force down to the two-person team knocking on a door in a Union Council — and the reason it is built that way is that polio campaigns fail at the last hundred metres, not at the top.

National Task Force and political oversight

At the apex sits the National Task Force on Polio Eradication, chaired at head-of-government level, with the provincial chief ministers and federal ministries represented. Its function is political rather than technical: securing funding, unlocking access, and making eradication a standing item on the national agenda rather than a seasonal health campaign.

National Emergency Operations Centre (NEOC)

The NEOC in Islamabad is the operational brain of the programme. It is led by a government-appointed National Coordinator who reports to the federal health leadership and the National Task Force. Critically, the NEOC is a single integrated floor where government staff sit alongside seconded technical staff from the World Health Organization, UNICEF and other partner organisations — one plan, one data set, one set of decisions.

The NEOC sets the national campaign calendar, approves the microplans that define which team covers which street, runs the data systems that show coverage in near real time, and directs outbreak response when a case or a positive environmental sample is confirmed.

Provincial and district structures

Each province and territory runs a Provincial Emergency Operations Centre (PEOC) mirroring the national model, with its own coordinator and its own control room. Below that, district emergency operations centres (DEOCs) handle the actual execution: recruiting and training teams, moving vaccine through the cold chain, monitoring coverage ward by ward, and following up the children who were missed.

The districts are not treated equally. Risk tiering concentrates staff, supervision and campaign frequency where transmission is most likely — see high-risk areas and risk tiers for how that classification works.

The frontline workforce

The largest part of the programme by far is its frontline: the vaccinators, social mobilisers, area supervisors, union council medical officers and community health workers who deliver campaigns across every province and administrative territory. A national immunisation round targets around 45 million children under five, which is only achievable because hundreds of thousands of workers move through the country in the same week.

A disproportionate share of that workforce is female, because in many communities only a woman can enter a household and speak to the mother. That work carries real risk, and frontline workers have been killed doing it. Their role is described further in frontline workers: the frontline of defence.

Surveillance and laboratory

Running alongside the campaign structure is a separate detection system: acute flaccid paralysis surveillance in health facilities and communities, and environmental sampling of sewage at sites across the country, with testing at the WHO-accredited Regional Reference Laboratory at the National Institute of Health in Islamabad. This is what tells the programme whether its campaigns are actually working. See polio surveillance in Pakistan.

Partners inside the structure

WHO provides technical and surveillance capacity; UNICEF leads communication, community engagement and vaccine supply; Rotary International, the Bill & Melinda Gates Foundation and bilateral donors provide funding and advocacy. They are embedded in the emergency operations centres rather than operating parallel programmes — a design choice that has been central to the programme's coherence.