As healthcare workers and community organizers fight to eradicate polio, they must also fight for their lives. More than 50 workers have died at the hands of violent religious extremists, who threaten and kill people due to unmerited conspiracy theories regarding vaccines. Since the death of Osama bin Laden in 2011, these conspiracy theories have grown more prominent and dangerous. Extremist violence is a major factor hindering Pakistan's polio eradication efforts.
The government of Pakistan and its contributors recognize that the most vulnerable areas are the areas that are the most difficult to reach due to security, and are doing their best to address this. The people of Pakistan also understand that polio is not the singular concern; other basic services are needed from the government to ensure the well-being of people no matter if they live in rural issues or have migrated. Polio is a consequence of the need for rural development.