Pakistan has reported 26 new polio cases this year, prompting a stark warning from the Independent Monitoring Board (IMB) that global eradication efforts are failing despite 37 years of work and $22 billion spent.
In its latest report, The Glass Mountain, the IMB described the campaign as reaching an “inflection point,” where traditional approaches no longer deliver results, urging fresh strategies and stronger country ownership.
In a letter to WHO Director-General Dr Tedros Adhanom Ghebreyesus, IMB Chairman Sir Liam Donaldson highlighted a troubling resurgence of the virus in historical reservoirs such as Pakistan and Afghanistan, despite earlier optimism.
He said geopolitical disruptions, financial constraints, and persistent transmission now fundamentally challenge the survival of the programme. The report also criticised systemic weaknesses, including funding tied to process rather than outcomes, fragmented integration with essential immunisation, and weak accountability mechanisms that produce reports without consequences.
To address these flaws, the IMB proposed shifting responsibility for stopping wild poliovirus in Pakistan and Afghanistan to the WHO Eastern Mediterranean Regional Ministerial Polio Subcommittee.
The move aims to reduce perceptions that eradication is a Western-driven agenda, which has often fueled hostility and violence against health workers in Pakistan.
The recommendation was adopted as part of the 2026 GPEI Action Plan. WHO-EMRO chief Hanan Balkhy emphasised that the coming low transmission season offers the best chance to curb the virus.
The IMB also challenged Pakistan’s recent claims of halting transmission between 2021 and 2023, suggesting reduced spread was more likely due to Covid restrictions than programmatic success.
A Pakistani polio expert echoed concerns, stressing the lack of accountability and innovation. He argued that genuine government ownership, restructuring, integration with routine immunisation, and holding poor performers accountable are essential to revitalise the fight against polio.
