ISLAMABAD: Global efforts to wipe out polio are faltering and in urgent need of reform, the Independent Monitoring Board (IMB) has warned, as Pakistan confirmed 26 new cases of the virus this year.
In its latest report titled The Glass Mountain, the watchdog said that after nearly four decades and $22bn spent, the campaign has reached a “critical inflection point,” with transmission persisting in Pakistan and Afghanistan despite sustained efforts.
In a letter to WHO Director-General Dr Tedros Adhanom Ghebreyesus, IMB Chairman Sir Liam Donaldson wrote, “The confluence of persistent viral transmission, geopolitical instability, and financial pressures now threatens the programme’s long-term success.”
While acknowledging early optimism in 2023, the board noted a resurgence of the virus in areas previously considered under control. However, Pakistan’s ongoing commitment to eradication efforts has been recognised, with the IMB urging stronger national ownership and integrated strategies.
Localising leadership
The report recommended transferring oversight of polio eradication in Pakistan and Afghanistan to the WHO Eastern Mediterranean Region’s Ministerial Polio Subcommittee. This move aims to localise leadership, reduce perceived foreign ownership of the programme, and build greater community trust—especially important given the threats polio workers have faced in the region.
The IMB also highlighted structural issues within the Global Polio Eradication Initiative (GPEI), including funding mechanisms not tied to performance, and fragmented coordination with national immunisation programmes. It stressed the need for innovation, accountability, and better integration with essential health services.
In response, the GPEI’s 2026 Action Plan has been adopted by the global Polio Oversight Board, signalling renewed focus. WHO-EMRO Regional Director Dr Hanan Balkhy said the upcoming low transmission season offers a key opportunity to stop wild poliovirus circulation in both Pakistan and Afghanistan.
Call for reform
A senior Pakistani polio expert supported the IMB’s call for reform, stating that government ownership, programme restructuring, and better accountability would strengthen the campaign. They added that despite challenges, Pakistan remains fully engaged at the highest levels.
While the IMB questioned claims of transmission being interrupted between 2021 and 2023, it acknowledged Covid-19 restrictions may have contributed to reduced spread.
Despite environmental and political disruptions, Pakistan continues to push forward. Officials hope that with enhanced strategy, integration, and leadership, the country can finally turn the tide against polio.
