Pakistan Monday launched its first nationwide anti-polio campaign of the year to immunize children under the age of five against the crippling disease. The move follows a surge in new infections in 2022.

While no new case has been reported in Pakistan so far this year, the highly infectious wild poliovirus paralyzed 20 children last year. That compares to just one infection reported in 2021.

National eradication program officials said that more than 360,000 health workers would deliver polio drops to at least 44.2 million children across 156 districts during the five-day campaign. They noted that children would also be administered an additional vitamin A supplement to boost their immunity against infectious diseases.

The 20 polio cases in Pakistan in 2022 were reported in Khyber Pakhtunkhwa province, mostly in its violence-hit North Waziristan district on the Afghan border.

An official statement quoted Prime Minister Shehbaz Sharif as saying on Sunday the resurgence of cases has raised concerns among Pakistan’s global partners, including the World Health Organization and other stakeholders.

The previous nationwide polio campaign in Pakistan was organized last August but was disrupted by catastrophic floods triggered by erratic summer monsoon rains. Authorities later carried out special polio drives in flood-affected districts and vaccinated children against the virus there.

Pakistan has repeatedly come close to eradicating polio but long-running propaganda in conservative rural areas that the vaccines cause sterility in children, coupled with deadly militant attacks on vaccinators, have set back the mission.

The latest militant attack on a polio team took place earlier this month in Dera Ismail Khan district in Khyber Pakhtunkhwa, wounding four policemen escorting health workers.

Officials also blame the 2011 killing of al-Qaida chief Osama bin Laden by the United States military in the Pakistani city of Abbottabad for dealing a serious blow to national polio eradication efforts.

A Pakistani doctor organized a fake vaccination campaign to help the U.S. troops locate the hideout of the fugitive terror leader and kill him. Pakistani authorities later arrested the doctor and a court subsequently sentenced him to 23 years in prison.

Pakistan and Afghanistan are the only countries where polio continues to cripple children. Afghan officials detected two cases in 2022 and have reported no new ones this year.

The global polio eradication program has identified Pakistan, Afghanistan, parts of Somalia and Yemen as areas where outbreaks are very difficult to control, according to Hamid Jafari, the director of polio eradication for WHO’s eastern Mediterranean region.

“These are countries, and in fact some national areas, that are prone to be affected by repeated polio outbreaks., and these are usually complex countries, countries that have fragile health systems, conflicts, other complex challenges,” Jafari explained in a video statement tweeted Monday.

“Moreover, these countries export polio virus. So, when there is an outbreak in these countries, the neighboring countries are affected because of international spread but also distant international spread,” he added.

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