To end polio, we must reach the children still being missed

Further challenges

The challenge extends beyond the two remaining countries where wild poliovirus is endemic. In countries such as Somalia and Yemen, outbreaks of variant poliovirus exploit gaps in population immunity, particularly among children who have repeatedly missed vaccination. Insecurity, displacement and weak health services make closing these gaps especially difficult. Families on the move, within and across borders, must not fall through those gaps: a child's protection should not depend on where their family happens to be during a campaign.

In June this year, the Technical Advisory Group on Polio Eradication reported that high-quality vaccination campaigns had helped suppress virus circulation in parts of Pakistan, including the Peshawar and Quetta areas. The task is to extend and sustain that quality wherever transmission persists.

Trust is as important as the logistics. Most parents want to protect their children, but repeated campaigns generate frustration where families lack reliable access to other basic services. Misinformation can deepen mistrust. In Pakistan, we heard from female frontline health workers who are trusted and central to the communities and are best placed to listen to families, answer questions and deliver vaccines. Building on existing efforts to support these workers, programmes must sustain safe working conditions and give a meaningful voice in how campaigns are designed.

Regional leadership and international solidarity are essential to finishing the job. Saudi Arabia, through the King Salman Humanitarian Aid and Relief Centre (KSrelief), is among the largest contributors in the programme's history. Beyond financial support, the Kingdom contributes to strategic and technical discussions through its representation on the Polio Oversight Board and Polio Research Committee. Its engagement also supports efforts to integrate polio eradication with broader essential health services, helping reach vulnerable communities and sustain the gains made

That support is essential, but no single donor can finish the job alone. National authorities must lead, with WHO, UNICEF, Rotary International, and local and religious leaders alongside them. The laboratories, surveillance networks and workers trained to find poliovirus also strengthen the Eastern Mediterranean Region's ability to detect and respond to outbreaks of polio.

Gains under threat

These gains are now threatened by severe financial pressures. With the GPEI's 2026 budget reduced by 30%, programmes face difficult choices precisely when sustained intensity is essential. Reduced financing risks weakening vaccination campaigns, surveillance, laboratory capacity and rapid outbreak response. The consequences are greatest in insecure and remote communities, where reaching a single child may require substantially more resources than in accessible settings.

Following World Polio Day on 24 October, we call on political leaders to turn their commitments into concrete action: securing access to every child, enabling vaccination at the doorstep wherever possible, protecting frontline health workers, including female vaccinators, and strengthening coordination across borders. These are not simply operational challenges; they require sustained political engagement at the highest levels. At the same time, donors must provide predictable financing through the end of eradication, allowing programmes to plan campaigns, maintain surveillance and respond quickly wherever the virus is detected.

Abdul Rahman's father made a difficult journey to protect his son. Millions of other parents cannot make that journey, and their children must not be left behind. Failing to finish the job now would put decades of progress at risk. Ending polio is no longer primarily a question of whether we have the tools; it is whether we can secure access, sustain political commitment and finance the final effort. Every child missed is a reminder that eradication remains unfinished.