ISLAMABAD (AP) — Pakistan began a nationwide vaccination campaign Monday to protect 45 million children from polio after a surge in new cases that has hampered years of efforts to stop the disease in one of the two countries where it has never been eradicated.

Pakistan regularly launches such campaigns, but violence targeting the health workers and police assigned to escort them is common. Militants falsely claim the vaccination campaigns are a Western conspiracy to sterilize children.

The campaign is the third this year and will continue until Sunday “in response to the alarming increase in polio cases,” said Ayesha Raza Farooq, the prime minister’s adviser for the polio eradication program. “We are re-energized in our efforts to combat polio,” she said in a statement.

During the door-to-door campaign, children younger than 5 will be vaccinated and given drops of Vitamin A supplements to enhance their immunity.

Prime Minister Shehbaz Sharif recently met with front-line health workers, urging them to ensure no child was left unvaccinated by going door-to-door.

Anwarul Haq, who is the coordinator of the National Emergency Operations Centre for Polio Eradication, also urged parents to fully cooperate with polio workers. “Polio has no cure, but it can be prevented with this readily available vaccine,” he said.

Pakistan has recorded 41 cases across 71 districts so far this year, Farooq said. Most were reported from southwestern Balochistan and southern Sindh province, following by Khyber Pakhtunkhwa province and eastern Punjab province.

The surge in cases in new locations is worrying authorities since previous cases were from the restive northwest bordering Afghanistan, where the Taliban government in September suddenly stopped a door-to-door vaccination campaign.

Authorities in Pakistan say the Taliban’s recent decision will have repercussions beyond the Afghan border, as people from both sides frequently travel to each other’s country.

Pakistan and Afghanistan are the only two countries in the world where the spread of polio has never been stopped. It is one of the world’s most infectious diseases, so it continues to spread anywhere people are not fully vaccinated. In severe cases, polio can cause permanent paralysis and death.

In Afghanistan, a Public Health Ministry spokesman said Monday that vaccinations have started in 16 of the country’s 34 provinces. The campaign will last three days and target 6.2 million children under the age of 5, said Sharafat Zaman.

“It is worth mentioning that we do not have any positive confirmed cases of polio in 2024 and we are trying to prevent this virus through vaccination,” said Zaman.

Data from the World Health Organization says there have been 23 confirmed cases in Afghanistan this year. That’s up from six cases in 2023.

The immunization will take place in mosques and community hubs known as hujra, rather than door-to-door. That means people will have to take children to vaccinators, instead of health workers going house-to-house as is the norm.

Zaman did not respond to questions about who is carrying out the immunizations, what will happen to female polio workers, and what impact a mosque or hujra-based campaign will have on vaccination rates.

Women are not allowed to enter mosques or hujras.

Mothers or female carers may face other hurdles to access polio vaccines for children, like not being able to move freely without a male guardian or not being allowed in front of a man who is unrelated to them through blood or marriage.

The WHO has been contacted for comment about the Taliban-led vaccination drive.