• Shahella Idrees Shakeel, Matthew Brown, Shakeel Sethi, and Tim K Mackey.
• Joint Master's Program in Health Policy and Law, University of California, San Diego School of Medicine - California Western School of Law, San Diego, CA, USA.
• Bmc Public Health. 2019 Jan 17; 19 (1): 79.

BackgroundOn April 28, 2014, the World Health Organization (WHO) declared polio a "Public Health Emergency of International Concern" (PHIC) under the authority of the International Health Regulations. Although polio has been eradicated from nearly every nation on earth, Pakistan is one of three countries where wild polio and vaccine-derived polio strains remain, thwarting global eradication efforts.AimsPolio eradication progress is complicated by security and conflict issues at the border area between Pakistan and Afghanistan. In addition to security issues, other critical challenges, such as maintaining cold supply chain for vaccines, active and sentinel surveillance, false beliefs about vaccines, distrust of healthcare workers, and accessibility to conflict areas due to terrorist activities, all play a role in the continued persistence of Polio. In response to these challenges, we assess the local and international policy environment and its impact on polio eradication in Pakistan.FindingsBased on our analysis of existing barriers and challenges associated with polio eradication in Pakistan, this study discusses why employing "vaccine diplomacy" represents a key policy and advocacy strategic approach to achieve the overall end game of polio eradication. Specifically, we identify a set of concrete public health, international development, and diplomatic and policy recommendations that can act synergistically under the umbrella of health and vaccine diplomacy to finally put an end to polio.

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