WHO Extends Pakistan's Polio Travel Restrictions By Three Months

The World Health Organization's Polio IHR Emergency Committee has extended international travel restrictions on Pakistan for a further three months, concluding after its latest review that the international spread of poliovirus still constitutes a Public Health Emergency of International Concern (PHEIC). The decision, announced September 27, keeps in place a regime of conditional travel measures that has applied to Pakistan for years under the WHO's International Health Regulations.

What the committee found

The Emergency Committee said it remains gravely concerned about continued poliovirus transmission in Pakistan and Afghanistan, singling out ongoing wild poliovirus type 1 (WPV1) circulation in Karachi and southern Khyber Pakhtunkhwa in Pakistan, and in southern Afghanistan. The committee flagged continuous cross-border movement between the two countries as a primary driver of the virus's spread, noting that Pakistan and Afghanistan effectively pose a transmission risk to each other regardless of which side records a given case.

The numbers behind the decision

As of this review, 57 environmental samples collected from sewage sites across Pakistan have tested positive for WPV1 so far in 2026. Four confirmed WPV1 cases have been reported across the two countries this year — three in Afghanistan and one in Pakistan. That is a markedly better picture than 2024, when Pakistan alone recorded 74 confirmed cases, underscoring that the extension is being driven by environmental surveillance data and cross-border transmission risk rather than a surge in diagnosed paralysis cases.

What the restrictions mean in practice

The WHO's polio-related travel measures require states to certify that departing travellers have received a dose of oral polio vaccine within the preceding twelve months, or at least four weeks before travel, before they can exit Pakistan — a condition Pakistan has operated under continuously since the WHO first imposed it. The extension does not add new restrictions; it keeps the existing certification regime in force for another three-month cycle rather than allowing it to lapse.

The vaccination effort underneath this decision

Pakistan has been running its own countermeasure in parallel: a week-long sub-national vaccination campaign that ran September 21-27 targeting 31 million children under five across 115 districts nationwide, which we covered in detail as it launched. That campaign has continued to face access constraints in Bannu, one of the areas the WHO specifically flagged for ongoing transmission risk, illustrating the gap between the scale of Pakistan's vaccination response and the persistence of environmental detections the WHO is reacting to.

Why this keeps coming back

Pakistan's confirmed case trajectory has clearly improved compared with 2024, yet the country has not managed to clear the environmental-surveillance and cross-border-transmission bar the WHO uses to lift travel measures altogether. That gap between declining paralysis cases and persistent sewage-sample positivity is the same dynamic that has kept Pakistan on the WHO's restricted list review after review, and it means the certification requirement is likely to remain a routine feature of international travel out of Pakistan for as long as environmental detections in Karachi and southern Khyber Pakhtunkhwa continue.

Build Better Pakistan's Health Desk tracks Pakistan's polio eradication effort and will report on the next Emergency Committee review as it comes due.