Pakistan will on Monday resume vaccination campaigns to stamp out polio after a break imposed by the coronavirus has left more children vulnerable to the crippling disease. The eradication campaign has been paused for nearly four months since the last week in March, when vaccination workers halted operations and switched to fighting Covid-19. Millions of children have missed drops during the hiatus in both Pakistan and neighbouring Afghanistan, swelling the pool of under-protected under-fives who are at risk. The global fight against the poliovirus, which has been backed by hundreds of millions of dollars from the UAE, has pushed the infection close to extinction in the past 30 years. Pakistan and Afghanistan are the only two countries still recording cases of the wild virus, though there have been other small outbreaks elsewhere linked to mutated vaccine strains. Yet the endgame in the final haunts of the virus has proven frustratingly difficult in the face of violence and conspiracy theories. This year's pause came as Pakistan had just overhauled its efforts after a difficult 2019 had seen cases rise to 147 from 12 in 2018. Dr Hamid Jafari, director of polio eradication for the World Health Organisation in the Eastern Mediterranean region, said almost 80 million vaccination opportunities had been missed due to the suspension. “We are particularly concerned about Pakistan and Afghanistan,” he told The National. “The intensity of poliovirus circulation is increasing due to suspended vaccination campaigns and consequent increase in vulnerable children and the ensuing high polio transmission season in late summer months.” Millions of children had been denied drops in Afghanistan even before the suspension, because of a Taliban edict banning vaccination teams from territory they control. Vaccinations are expected to resume where possible in Afghanistan soon. Fears door-to-door vaccinators would spread Covid contributed to the original decision to halt operations. “We are focused now on the opportunity to restart these critical vaccination activities, starting with the highest risk areas, whilst observing strict Covid-19 infection control and prevention measures,” said Dr Jafari. Targeted campaigns in Pakistan's high priority districts will begin from July 20, including in Faisalabad, Attock, South Waziristan, and parts of Karachi and Quetta. Nationwide sweeps will start again in the last quarter of the year. “The impact of Covid-19 on our economy and communities is unprecedented,” Dr Zafar Mirza, Prime Minister Imran Khan's special assistant on health services, said last week. Pakistan has reported 59 cases in 2020 so far, with several months of the high-risk, late summer season still to come. “With the disruption of essential immunisation services due to the Covid-19 pandemic, children are continuously at a higher risk of contracting polio and other vaccine-preventable diseases,” he warned. The UAE has donated hundreds of millions to polio eradication, focussing on support to Pakistan. Sheikh Mohamed bin Zayed, Crown Prince of Abu Dhabi and Deputy Supreme Commander of the Armed Forces, has committed more than $327 million. Global donors including the UAE between them pledged $2.6bn at <a href="https://www.thenational.ae/uae/health/abu-dhabi-forum-sees-dh9-5bn-pledge-to-wipe-out-polio-for-good-1.939838">an Abu Dhabi forum in November</a> to try and finish the job.