This week, India announced restrictions on travellers from Pakistan. Visitors will now be required to possess evidence of polio vaccination because India wants to maintain its polio free status.
The announcement by the Indian government is the first step in what is being seen as a move to isolate Pakistan internationally by requiring travellers to produce evidence of polio vaccination. This move comes after polio virus discovered in Syria and Egypt was traced back to Pakistan in June this year.
This was confirmed by August. Global isolation is nothing new to Pakistan. Already the country is seen by many as a source of terrorism and restrictions are placed on those travelling there or coming from Pakistan. While many Pakistanis are angered by the latest move, many say that they saw it coming.
There has been great debate this year over what to do to contain the polio virus. In January, the government committed to eradicate polio. By November, reported polio cases exceed the previous year’s total.
Pakistan continues to struggle with polio the same way it continues to fight other internal problems, for which in most cases it has itself to blame.
"The polio story in Pakistan," says Aziz Memon, a Rotarian who works actively through his organisation to fight the virus, "symbolises the helplessness of the government."
But that is not all, it also illustrates the power of the clergy and militants who have battled against polio vaccines, terming it an international conspiracy to render Muslims impotent.
As numbers of polio cases being discovered in Pakistan rise - the latest figure for the year stood at 70, what becomes clear is that the clerics are winning.
Not only have people been encouraged to refuse the vaccination, but workers administering the drops and the policemen protecting those workers have both been targeted.
After the Afridi case in which a Pakistani doctor was used by the United States through an international NGO to trace the DNA of the Osama Bin Laden family, the government is suspicious of moves to inoculate.
"The media misreported the Afridi affair. In most instances they said Afridi administered polio drops, which are given orally, while in fact he had taken DNA blood samples," says Memon, who adds that because of this there is widespread suspicion of the anti-polio campaign in Pakistan.
Even the government is increasingly suspicious of international agencies who want to come in and fight polio. Intelligence agencies do not give clearances and many foreign NGOs are not allowed to operate. In contrast, there is no check on the religious extremists who propagate an anti-polio message.
"Like in the case with extremism, the government does not act against the extremists but is very sensitive to those who want to fight the extremists," comments political analyst Talat Masood.
READ: Dr Afridi ‘hero’ for US, cause of trouble for fellow medicos
Politics has also come in between. The national campaign against polio, which was once being spearheaded by Aseefa Bhutto, the youngest daughter of Asif Zardari and Benazir Bhutto is now in limbo with the change of government earlier this year. Maulana Fazlur Rehman of the Jamiat Ulema Islam (F) said the issue of polio and drones was linked and have to be considered in that context.
Since April, bureaucrats have taken over running of the campaign as is the case with most such projects in the country. All the bureaucrats want, say observers, is more funding.
At the same time, volunteers in the programme, who are paid a pittance even by local standards, are targeted regularly. The latest attack took place in November. Since July 2012, 30 people have been targeted by extremists, and not one attacker has been apprehended.
The same is the case with terror attacks in the country, only at a larger scale. Red-tapism is also written large on the anti-polio campaign. While the World Health Organisation (WHO) provides much of the support, there have been instances where the vaccine has not been properly refrigerated and loses its efficacy.
People who were given drops also contracted polio but no one bothered to check where the cold chain was broken. The latest such case took place in Sindh this month.
Like most other things, the government is ceding the fight against polio to extremists and militants. The Tehreek-e-Taliban Pakistan has called an end to the anti-polio drive and linked it to drone attacks. A TTP commander issued a statement that it would not allow the polio campaign as long as drone attacks continued in Pakistan.
So far India has slapped restrictions but it is expected that other countries will soon follow suit. Despite its close ties, China is expected to soon announce restrictions. In many respects, the polio campaign in Pakistan is rudderless and most likely to sink.