Just as Pakistan's polio program was making significant progress in its fight to eradicate the disease, it has been hit by a devastating bout of violence. Six vaccination campaign workers were shot and killed yesterday and today, and two others were injured, in attacks in Karachi and Peshawar, in the northwestern part of the country.
Health officials have suspended the country's 3-day mass vaccination campaign in greater Karachi as they investigate the attacks and beef up security to protect health workers. Authorities in Khyber Pakhtunkhwa province, where Peshawar is located, plan to go ahead with the vaccinations because they think the attack is not related to polio activities.
The attacks come 5 months after two incidents in which two polio workers were shot and wounded and another was killed in Karachi. In mid-October, another polio worker was shot and killed in Quetta, in Balochistan province.
Yesterday, a male polio worker was fatally shot, and today four women were killed within about 20 minutes of each other in three apparently coordinated attacks in poor Karachi neighborhoods, including Gadap, where the July shootings occurred. Another woman was killed in Peshawar. Taliban insurgents have repeatedly threatened campaign workers, but so far no one has claimed responsibility for the current or previous attacks. Pakistani officials and international groups supporting the polio campaign are still trying to piece together what happened, says Bruce Aylward, who heads the Global Polio Eradication Initiative  (GPEI) at the World Health Organization in Geneva, Switzerland.
"The implications [of the attacks] run way beyond polio," Aylward says, because targeting health workers will deprive Pakistani children from receiving other basic health services as well. Local leaders and community authorities have "got to assume responsibility and assure that the message gets out that this is not acceptable," Aylward says.
Pakistan is one of the world's three remaining polio hotspots . After cases skyrocketed in 2011, the country stepped up its eradication efforts, and there have been just 56 cases so far this year, down from 173 this time last year. The worst reaction to these "horrible, awful" events would be to let this opportunity be squandered, Aylward says. Planning is already under way for the January vaccination campaigns in the so-called low transmission season, when the "virus is at its weakest," he says, and GPEI will continue to support Pakistan's antipolio drive after that. "We will get this done."