Pakistan, Nigeria, and Afghanistan remain the only countries in the world where polio is still a serious threat. This review article addresses the political, sociological, and epidemiological factors behind the failure in eradication. A relatively popular Nigerian conspiracy theory about polio vaccines spread in Pakistan and, as a result, there is some considerable resistance to polio vaccination. Conspiracy theories about vaccines have a long history, and the fact that polio vaccinators were used as spies in order to plan for Bin Laden's death has made polio vaccination a bigger challenge. Furthermore, vaccination is strongly correlated with literacy and Pakistan is still struggling against illiteracy. However, these obstacles are by no means insurmountable, and a joint effort by the government, policymakers, education department, community mobilizers, and public health professionals can indeed make major improvements.
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Andrade et al. (2018) studied this question.