HANGU — On April 14, 2026, gunmen opened fire on a police vehicle escorting polio vaccinators in Hangu, Khyber Pakhtunkhwa province, killing one officer and wounding four others.
Pakistan and Afghanistan are the only two countries where polio remains endemic. Three new polio cases were confirmed in Pakistan in 2026, including two in Khyber Pakhtunkhwa province—the same region where the April 14 attack occurred.
Polio cases in Pakistan have fluctuated in recent years, with 74 confirmed cases in 2024, approximately 30 in 2025, and three reported so far in 2026. Khyber Pakhtunkhwa and Balochistan provinces account for the majority of recent cases and also experience the highest concentration of terrorist activity.
The Pak Institute for Peace Studies recorded 699 militant attacks in Pakistan in 2025, with Balochistan alone reporting 254 incidents—the second-highest provincial total after Khyber Pakhtunkhwa. Pakistan was ranked first on the Global Terrorism Index 2026, with 1,139 terrorism-related deaths recorded in 2025. Attacks by Tehrik-i-Taliban Pakistan (TTP) rose by 24 percent that year.
TTP and affiliated Islamist militant factions are responsible for the overwhelming majority of attacks on polio campaigns. The group has banned door-to-door vaccination in areas under its influence and treats polio teams as legitimate targets. Since the 1990s, more than 200 polio workers and police escorts have been killed in Pakistan, according to Pakistani officials. Government data from 2012 onward document 96 deaths and 170 injuries from such attacks, including 61 police officers and 27 health workers.
In November 2024, an attack on a police van escorting a polio team killed nine people, including five children. Insecurity caused by Baloch militants also disrupts vaccination logistics and endangers the security forces that vaccinators depend on.
Community-level resistance compounds operational risks. Over 200 community refusals of polio vaccination occurred in Khyber Pakhtunkhwa during 2024 campaigns. Peer-reviewed research attributes these refusals to conspiracy theories, religious objections, militant intimidation, and community hostility linked to grievances against the state. Some residents associate polio teams with government actions such as displacement and aerial strikes.
In June 2024, the Pakistani government launched Operation Azm-e-Istehkam, a counterinsurgency campaign aimed at improving security. Despite these efforts, the WHO Polio Emergency Committee described the first half of 2026 as a “critical opportunity” to interrupt poliovirus transmission.