• Global polio regulators demand “new ideas” and “rural ownership” or eliminate work
• Responsibility to Pakistan, to which Afghanistan transfers
• Report term Pakistan’s claim on progress claims in 2021-23 “by-products of possible preventive measures”
Islamabad: 26 new ones as reported by Pakistan Cases of polio This year, the Global Polio Monitoring Committee issued a clear warning, saying effort Eliminating this disease is failing.
After 37 years and $22 billion in investments, the world has reached a “turning point” and traditional methods provide reduced returns.
It said that the “Glass Hill” of eliminating polio calls for fresh thinking and clear state ownership for success, it said.
IMB Chairman Sir Liam Donaldson said in a letter to World Health Organization Director Tedros Adhanom Ghebreyesus that the report titled “Glass Hill” reached a critical moment.
“The convergence of ongoing viral spread, unprecedented geopolitical disruption and serious financial constraints has created conditions that fundamentally challenge the survival and success of the program,” Mr. Donaldson wrote.
He noted that optimism in early 2023 was replaced by a “striking reality of recovery” as the virus’s historical reserves (a reference to Pakistan and Afghanistan) were restored.
IMB, who works on behalf of international donor agencies, said new thinking, institutional courage, strategic realism and clear state ownership are the only ways to succeed.
The board identified several “systemic stubborn weaknesses”, including “performance blind funding provides resources for McHayism, regardless of the outcome; fragmented integration approaches fail to leverage the synergy of basic immunity; lack of national vagabonds and trading behavior;
To address these deeply rooted problems, fundamental shifts in strategy and accountability are proposed.
The IMB raised the responsibility for moving to stop the wildlife polio virus in Pakistan and Afghanistan, to the Eastern Mediterranean Region (EMRO) Ministerial Polio Subcommittee.
Donaldson believes that this can hit the ongoing “thinking that polio eradication is something that the West wants” rather than a regional priority,” with the potential to reduce community funerals, boycotts and security threats that lead to deaths of polio workers, especially in Pakistan.
The proposal has now been formalized as the polio monitoring committee adopted the 2026 GPEI action plan on Sunday.
WHO-Emro Regional Director Hanan Balkhy said in a post on X that the upcoming transmission season is the best opportunity to stop wild poliovirus in Afghanistan and Pakistan.
Mr. Donaldson’s letter also pointed to a huge change in the geopolitical landscape, citing major damage to the global polio initiative.
“The withdrawal of the United States from whose demolition, the demolition of the US Agency for International Development and the survival of the CDC’s global health authorization represents the most significant destruction in GPEI history,” Sir Donaldson said.
It also noted that the Democratic Republic of Congo has changed the landscape of polio due to the completion of the report, two severe monsoon-related floods occurred in different regions of Pakistan, earthquakes in Afghanistan, a child malnutrition crisis in Borneo and a potential peaceful settlement in the Democratic Democratic Republic of the Congo.
Pakistan’s claim presents challenges
The report also challenges Pakistan’s recent advancement claims. Although Islamabad asserted that it interrupted the spread of polio from 2021 to 2023, the IMB said it could be due to unintentional consequences of shared restrictions, which are “hostility to multiviral spread” rather than the result of programmatic improvements.
The operating environment for polio is constantly changing. Following the IMB meeting, with the finalization of the report, two severe monsoon-related floods in different regions of Pakistan, earthquakes in Afghanistan, the child malnutrition crisis in Borno and potential peaceful settlements in the Eastern Democratic Republic of the Congo.
A Pakistani polio expert in anonymous condition agreed with the IMB’s assessment, highlighting the lack of accountability, innovation and integration.
“It’s interesting that despite the intense participation of PMS, government ownership is still being questioned,” the expert said. “The IMB report questioned money and time that went against the target, and questioned the feasibility of the plan in the viral cycle and re-pavement.”
As a solution, experts recommend “real transfer of management and ownership to the government, reorganize the program, integrate with EPI and maintain long-term ongoing underperformance to solve the problem at a high level”.
Posted at Dawn on September 22, 2025
