While vaccine distrust has sparked debates amid a measles outbreak in the United States, Pakistan is in a deadly battle to wipe out polio.
Long eradicated in the West, polio remains endemic in Pakistan after the Taliban banned vaccinations, attacks targeted medical staffers and suspicions lingered about the inoculations.
The persistence of this crippling, sometimes fatal virus shows just how difficult wiping out a disease can be, even amid campaigns seeing thousands of vaccinators go into the field to offer polio drops to children, sometimes under armed guard.
“When we leave in the morning, we do it at the risk of our life,” vaccinator Rubina Iqbal said. “We don’t know whether we will come back alive or not.”
Polio is a highly contagious virus generally transmitted in unsanitary conditions. There is no cure for the virus, which mostly affects children under 5, though it can be prevented with a vaccine.
In the US, polio terrified mothers and fathers as outbreaks caused more than 15,000 cases of paralysis each year until Dr Jonas Salk invented a vaccine in the 1950s. After eradicating smallpox in 1980, authorities turned their attention to polio.
In Pakistan, the disease and the backlash against vaccinations is mostly in its northwest and the port city of Karachi, although the vaccination drive is country-wide.
The scope of the vaccinators’ efforts in Pakistan is impressive. In January, officials targeted some 35 million children during a nationwide campaign, said Dr Rana Muhammad Safdar, who oversees the country’s polio emergency operations center.
Smaller campaigns are held more frequently in areas where the virus is believed to be especially prevalent. Workers at central bus stops and train stations also vaccinate child travelers.
Neighbouring India was declared polio-free in 2014 a massive logistical feat for the country of 1.2 billion people.
Many experts thought success was near in Pakistan in 2012 but then the number of cases shot up last year.
But instead of parents’ groups worried about autism and celebrities relying on a discredited scientific article like in the US, Pakistan’s anti-vaccine campaign has been waged at the end of the barrel of an assault rifle.
The Pakistani Taliban banned vaccinations in 2012 after US Navy SEALs launched a raid in Abbottabad in 2011 that killed al-Qaida leader Osama bin Laden.
Ahead of the raid, the CIA sent in a local doctor who claimed to be conducting a hepatitis vaccine program to collect DNA from children at bin Laden’s home. That sparked widespread distrust, in a country where many also fear the inoculations are a plot to sterilize Muslim children.