High-Risk Polio Areas in Pakistan

Systematic classification of districts into four epidemiological tiers and targeted focus on Super High-Risk Union Councils (SHRUCs).

Understanding the 4 District Risk Tiers

The National Emergency Operations Centre categorizes Pakistan's 153 districts into four distinct levels (Tiers). This tiered mapping optimizes vaccination resources and operational strategies depending on the virus presence:

Tier 1 (Core Reservoir)

Districts where wild poliovirus transmission has been active for over 18 months, regularly exporting the virus to other areas.

Tier 2 (High-Risk)

Districts that border core reservoirs or show frequent environmental positive wastewater samples.

Tier 3 (Vulnerable)

Districts with moderate risk due to vaccination coverage gaps or high mobile transit populations.

Tier 4 (Low-Risk)

Districts with high population immunity and no environmental or clinical detections for consecutive years.

District Risk Tiers Distribution by Province

Breakdown of all 153 districts in Pakistan by risk classification tier

Province / Region	Tier-1	Tier-2	Tier-3	Tier-4	Total Districts
AJK	0	0	0	10	10
Balochistan	3	4	10	16	33
Gilgit Baltistan	0	0	2	8	10
Islamabad	0	0	1	0	1
Khyber Pakhtunkhwa	2	16	10	6	34
Punjab	0	4	6	26	36
Sindh	6	10	8	5	29
Grand Total	11	34	37	71	153

Super High-Risk Union Councils (SHRUCs)

Within Tier 1 core reservoirs, specific neighborhoods or Union Councils are categorized as Super High-Risk Union Councils (SHRUCs). These areas are highly congested, experience high population density and transit flows, suffer from poor drainage infrastructure, and hold the largest pools of vaccine-hesitant families.

The National Programme places a laser focus on these 40 specific SHRUCs to interrupt wild poliovirus transmission entirely.

Super High-Risk Union Councils (SHRUCs) by District

Distribution of the 40 high-priority neighborhoods across districts

Province	District	Number of SHRUCs
Khyber Pakhtunkhwa	Peshawar	18
Sindh	Karachi	8
Balochistan	Killa Abdullah	5
Balochistan	Pishin	3
Balochistan	Quetta	6
Total SHRUCs		40

District-Wise Stats

Check specific city and district-wise details of polio cases (WPV1 & cVDPV2) mapped across Pakistan.

View District Cases

Environmental Surveillance

Our network of 115 sewage collection points provides vital early alerts that direct local strategies.

Learn How We Track The Virus