Bannu Remains Key Challenge In Pakistan Polio Campaign

Pakistan’s anti-polio campaign is facing one of its toughest operational challenges in Bannu Division, where health officials say missed vaccinations and refusal cases continue to threaten the country’s push to stop poliovirus transmission. The concern has become sharper because Bannu accounts for four of the five polio cases reported in Pakistan so far this year.

The latest nationwide vaccination drive ended on September 27 and reached 99 percent of its overall target, according to the Emergency Operation Centre in Khyber Pakhtunkhwa. In Bannu, however, coverage stood at 86 percent, leaving a gap in an area already identified as a major hub of poliovirus activity.

Officials reported 4,701 vaccination refusal cases in Bannu, making it the second-highest district-level concern after Peshawar, where 5,635 refusal cases were recorded. Bannu also had 5,873 children who were missed because they were unavailable during door-to-door visits, while Peshawar recorded 10,558 such missed children.

Across the campaign, nearly 83,989 children were missed, a figure officials said was almost unchanged from the previous round. Refusal cases also rose, reaching 20,167 compared with 19,605 in the earlier campaign. Health experts warn that even small pockets of unvaccinated children can keep the virus circulating, especially in areas where access, security and community trust remain difficult.

A recent World Health Organisation report noted that Pakistan has recorded five polio cases in 2026, a sharp decline from 31 cases in 2025 and 74 cases in 2024. The same assessment warned that active transmission remains concentrated in three key geographies: southern Afghanistan, southern Khyber Pakhtunkhwa and Karachi.

Southern Khyber Pakhtunkhwa, including Bannu Division, continues to face security and operational obstacles that make high-quality vaccination campaigns harder to complete. Karachi has also been identified as a significant reservoir because environmental surveillance continues to detect poliovirus, showing that transmission risk has not ended despite the drop in confirmed cases.

Officials said vaccination planning is being coordinated with Afghanistan so children crossing the border can receive oral polio vaccine on either side. Khyber Pakhtunkhwa targeted 7.3 million children in 37 districts as part of the broader national goal of reaching 31 million children, but authorities acknowledge that Bannu and Peshawar remain the most difficult areas to cover fully.

The provincial response now depends on improving community engagement, strengthening supervision and reducing refusals before the next campaign. Officials said the government has also increased polio worker wages by 30 percent, recognising the risks vaccinators face while working in difficult areas. Health teams say the country’s eradication target can only be protected if every child under five receives the required oral vaccine doses during each campaign.