Though the polio immunization campaign in the country started in 1974,[6] the efforts for eradication officially started in 1994.[7] The infection remains endemic despite over 100 rounds of vaccination being carried out in the past decade.[8] Pakistan had the world's highest number of polio cases in 2014.
Eradication efforts in the 20th century
The Expanded Programme of Immunization (EPI) was begun in Pakistan by the World Health Organization (WHO) in the 1970s to combat deaths from six vaccine-preventable diseases.[13] In 1980, the EPI had vaccinated just 2% of the population against polio; by 1990, the coverage had increased to 54%.[6] In a 1994 interview, CDC officials predicted total polio eradication in Pakistan within two to three years; by 1995, the WHO projected total eradication by the year 2000, a target that the organization reaffirmed in 1998.[14]
However, despite donor attention, the rate of vaccinations sagged. By 1991, only 83 percent of Pakistani children had been vaccinated.[15] Research by the Center for Disease Control (CDC) in April 1998 cited a failure to vaccinate, vaccine failure, and inadequate immunization strategies as causes for the continued incidences of polio in this time.[16] Reasons for under-vaccination included the population being uninformed, considering vaccination unimportant, and having to travel long distances to vaccination sites.[16] In response to these challenges, organizations including the WHO, United Nations Children's Fund (UNICEF), CDC, Rotary International, and the Bill and Melinda Gates Foundation pulled together to develop and fund intensive eradication campaigns, including door-to-door vaccinations.[17]
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