As the world marks Polio Day on 24 October, Pakistan remains the greatest impediment to a polio-free world. It has more cases than any other country, reflecting dual policy failures: to prioritise citizens’ health and to curb violent extremism. Despite signs of impressive improvement, with cases declining fast, there is a real risk of another spike unless steps are taken to fully reverse years of neglect to public health services. The prevalence of the disease and conflict is closely interlinked