Pakistan is a country where C.S. Lewis’s saying does not apply. Lewis wrote that

children are not a distraction from more important work. It is the most important job.

Unfortunately, Pakistan ranks third in the world as the country with the most unvaccinated children. But why is this happening? Is the influence of parents’ perceptions and attitudes towards vaccination a significant factor contributing to a failed vaccination coverage?

Children in Pakistan are treated as second- and third-class citizens, especially since their fundamental human rights, such as access to healthcare, are violated daily. Pakistan signed the United Nations Convention on the Rights of the Child (UNCRC) in 1990, but since then it has continuously violated it due to political instability in the country and cultural misunderstandings that lead to tragic deficiencies in the healthcare sector.

We need to shed light on what is happening with the lack of vaccinations for children at this moment in Pakistan and what the global impact of this deficiency is .Based on an article by Frontier’s Post on November 8, it has come to light that 500,000 children missed their polio vaccinations in October 2024.

Pakistan has reported 48 cases of polio this year, with 23 of them reported from Balochistan, 13 from Sindh, ten from Khyber Pakhtunkhwa (KP), one from Punjab, and one from Islamabad. The increase in cases prompted Pakistan to conduct a national polio vaccination campaign from October 28 to November 3, aiming to vaccinate over 45 million children against the infection. Since late 2018, Pakistan has seen a resurgence of polio cases, highlighting the fragility of the gains made in previous years, when cases dropped to six in 2023, 20 in 2022, and just one in 2022.

“This year I don’t have the exact number but we expect around 500,000 refusals, non-availability [of people for vaccinations],” said Malik Mukhtar Ahmed Barath, the Prime Minister’s coordinator for national health services, in an interview with Arab News.” But we will not leave them [the children], we will chase them, we will track them, we will identify them, and we will vaccinate them for this polio.”

But what are the reasons that children in Pakistan cannot be safely vaccinated against polio? The first reason is political instability and terrorist attacks succeeding one another, the most recent being a bombing at the railway station in the city of Quetta (the capital of the province of Balochistan) where at least 26 people lost their lives. Seven people, including five children, were killed when a bomb targeted police traveling to guard vaccination workers this month. Days earlier, two police escorts were fired upon by militants.

The second reason that prevents the healthcare system from functioning adequately is the lack of knowledge and understanding among parents regarding basic medical science and easily transmissible diseases. The third and most serious reason is the influence of religious fanaticism as a method of hindering progress and science. Religious opposition from Muslim fundamentalists in the tribal areas of Pakistan is one of the greatest obstacles to effective polio vaccination. Epidemiologists have traced the transmission of the wild poliovirus from areas of endemic polio in Afghanistan, most of which are in the southern part of that country bordering Pakistan, to the tribal areas of Pakistan. This transmission has led to new cases of polio in areas that had previously been polio-free. Local Taliban have issued fatwas condemning vaccination as an American plot to sterilize Muslim populations. Another common superstition spread by extremists is that vaccination is an attempt to thwart the will of Allah. The Taliban have killed vaccination officials, including Abdul Gani Marwat, who was head of the government vaccination campaign in the Bajaur Agency in the tribal areas of Pakistan, while returning from a meeting with a religious cleric. In the past year, there have been several reports of kidnappings and beatings of vaccinators.

The government itself does not take responsibility for the lack of polio vaccinations and shifts the blame to Afghanistan. Regarding the recent increase in polio cases, Barath, (a Pakistani politician who has been a member of the National Assembly of Pakistan since February 2024) said that there is nothing wrong with Pakistan’s polio program, adding that the country has one of the best surveillance systems for monitoring the disease. He said that one of the main reasons for the increase in polio cases this year was due to a repatriation operation that Pakistan started in 2023 against “illegal immigrants,” resulting in many Afghan refugees who had not been vaccinated against polio traveling to other parts of the country and spreading the infection.

Humanity has experienced firsthand and paid with so many deaths over the past four years during the COVID era what a contagious disease means. There is no longer the margin for an entire humanity to pay the price of the spread of the disease and the deaths in a country due to the lack of vaccinations. Therefore, it becomes clear that if we do not want to experience something similar to the tragedy of COVID with polio, now that people travel freely and borders have opened, awareness campaigns about the usefulness of childhood vaccination against polio in Pakistan must be initiated, and international organizations must intervene with awareness campaigns.This time, regarding the issue of childhood polio in Pakistan, UNICEF, which has remained silent so far, needs to take a more active role in awareness and prevention. But let’s be honest, equal importance must be given to combating terrorism as we discuss a country where people are being targeted in waves by terrorist attacks .Therefore, when you are fighting for survival, is there room and awareness for proper health management?

Even if it doesn’t exist, it’s time for parents to find this awareness because people, even if you confine them to concentration camps, have the inherent need to protect their children at all costs and do the best for them. As Oriana Fallaci writes in her book “Letter to a Child Who Was Never Born,” “But the moment will finally come when I will let you go, to cross the road by yourself, with the red light.” And in fact, I will push you. Without my act increasing your freedom, since it will bind you to me with the slavery of my tenderness, the slavery of your remorse. It is what is sometimes called the slavery of family.”