NEW DELHI: With the Pakistani government facing crises in the form of anti-government protests in Islamabad, and flood waters that have claimed hundreds of lives and displaced several thousand people, another crisis looms large.

With a meeting of the Independent Monitoring Board (IMB) on Polio being scheduled for September 30, Pakistan has failed to implement any of recommendations that would enable the regulatory authority to review the travel restrictions imposed on the country. The restrictions were imposed by the World Health Organisation in May this year, owing to the prevalence and increase of polio cases in the country. Pakistan remains one of the few countries in the world that has not managed to eradicate the polio virus, with the strain of polio indigenous to Pakistan being found in five other countries in the past two years indicating spread through travel.

There has been an increase in Polio cases every year in Pakistan, with 2014 thus far seeing over 60 cases of polio, compared to eight cases in the corresponding period last year. The reason for this increase is partly attributable to violence directed at polio workers, rendering Pakistan as one of three countries in the world, along with Afghanistan and Nigeria, where polio has not been eradicated.

This year, a new strain of polio was identified in Pakistan, with the World Health Organisation (WHO) warning that Peshawar has the world’s largest reservoir of the polio virus and that 90 percent of Pakistani polio cases were linked to this highly contagious strain of the disease which is found in Peshawar’s sewers.

The attacks against polio-workers in Pakistan escalated once it became known that the CIA had paid a Pakistani doctor, Shakil Afridi, to fake a vaccination campaign in Abbottabad, to acquire DNA samples from children inside a compound where al-Qaeda leader Osama bin Laden was based. The American intelligence’s scheme, in a bid to prove that bin Laden was in Abbottabad, involved comparing the DNA samples of the children to those of bin Laden’s sister, who had died in Boston in 2010.

This incident exacerbated the distrust of foreign intelligence services in Pakistan, and the Taliban have waged an all-out war against polio workers, repeatedly attacking health teams and denouncing vaccinations as part of a larger western/CIA agenda. The Afridi incident did grave damage to the credibility of the healthcare programme in Pakistan, which has seen previous success as polio figures declined from 350,000 to 250 in a span of twenty-five years.

The CIA came under widespread criticism for jeapordising the campaign. InterAction, a coalition of 200 non-governmental organisations, issued a statement reading: "The CIA's use of the cover of humanitarian activity for this purpose casts doubt on the intentions and integrity of all humanitarian actors in Pakistan, thereby undermining the international humanitarian community's efforts to eradicate polio.”

The distrust was fuelled by conspiracy theories that claim vaccinations are “un-Islamic” or an American ploy to sterilise children. The practice of marking houses that have been vaccinated, in order to differentiate them from houses that are still to be included in eradication efforts, was beset with rumours that vaccinators - accused of being CIA operatives - mark houses to be targeted by US drones.

The Taliban imposed ban on immunization has deprived about 170,000 children under the age of five from receiving polio vaccinations. The WHO states that Pakistan had 91 cases of polio in 2013, compared with 58 in 2012, with many attributing the attacks on polio campaigns which have resulted in the lack of access to people in need of vaccinations as a key reason for this increase.