Pakistan has confirmed its first case of polio after more than a year, damaging the country’s hopes of eradicating the virus. Health officials have announced that a baby boy in North Waziristan, bordering Afghanistan, is paralysed after contracting polio. Dr Shahzad Baig, a coordinator with the Pakistan Polio Eradication Programme, confirmed the “deeply saddening” case. “This is the most critical time for the programme. The detection of this latest case of wild poliovirus is not unexpected,” Baig said. “The Pakistan programme anticipated this risk and put in place contingency plans to enable a rapid response. It continues to intensify its efforts to eradicate all remaining residual transmission of any strain of poliovirus.” Pakistan’s new prime minister, Shehbaz Sharif, said he will hold an emergency meeting of the national polio taskforce. The case has created fear of a new outbreak in vulnerable areas around the Afghan border where vaccination campaigns are treated with suspicion and refusal is common. According to the World Health Organization, Pakistan is among one of only two countries, along with Afghanistan, still to eradicate the crippling polio virus, which has disabled and killed millions. Baig said: “It is important to emphasise that the number of polio cases has been significantly reduced this year due to the unwavering commitment of health workers, support of communities, and various stakeholders. The programme continues to take pride in these efforts.” The last case of paralysis as a result of polio in Pakistan was reported in January 2021. Afghanistan, in 2021, reported four polio cases, but low detection numbers mask a larger presence of the virus. Polio workers and their guards are frequently targeted in Pakistan, where Islamist militants and hardline clerics encourage beliefs that government vaccination is a cover to sterilise children and allow infiltration by western spies. Zainab Wazir, from North Waziristan, told the Guardian why she refused the vaccine for her two children: “The US are using the so-called polio vaccination cover for their own interests, and objectives like espionage and injecting infertility into our children, which is our future and they are destroying them. “Tribal people are forced to take these vaccinations from their own government’s hands. It is made up of alcohol and pig fat to humiliate the Muslim population.” Militant groups in Pakistan have killed more than 100 healthcare workers and security staff since 2012. In northwest Pakistan in April 2019, more than 25,000 children were taken to hospital after the spread of unfounded rumours that a polio vaccine was causing sickness. Baig said: “The programme has worked closely with the community to address vaccine refusals and hesitancy across Pakistan, particularly in the tribal areas. Community engagement practices have started with female religious support persons, who are offering awareness-raising sessions to women in the area. This is, so far, [is] running very successfully. “In addition, the provision of health camps is making major ground in addressing vaccine refusal. This has decreased significantly over the last 18 months, and it is important to note that the current case is not a refusal.”