The reporting of disease in any country depends on the vigilance and accounting.
It indicates as robust health reporting organisation.
In countries with poor health and poor health reporting organisation, it is obvious one does not come to know unless there is an epidemic.
Since the issue of Polio has been raised this is what is comment from POLIO ERADICATION & ENDGAME STRATEGIC PLAN 2013-2018
The GPEI Strategic Plan 2010-2012 saw a number of breakthroughs. The intense focus on
interrupting transmission led to success in India – widely considered the country with the most
technically challenging conditions for interrupting poliovirus transmission in the world.
http://www.polioeradication.org/Portals/0/Document/Resources/StrategyWork/PEESP_CH5_EN_US.pdf
Polio endemic nations are Northern Nigeria, Pakistan, southern Afghanistan.
In Nigeria, the programme introduced house-based microplans for the first time in 2012, heavily informed by the success in areas of India that overcame similar issues with missed areas and missed populations. The development of house-based microplans requires a physical walk-through of all areas by local leaders and supervisors to determine daily vaccinator work areas by enumerated households. These microplans are tightly linked with vaccinator tally sheets, capturing the teams' work by household and allowing cross verification. This is in contrast to previous microplans that simply named an area, established an estimated number of children that the team should cover and allowed the teams to simply record tallies of their achievements, making it difficult to hold them accountable for missed children or areas.
One cannot blame Pakistan for Polio becoming endemic.
This religious conflict in the tribal areas of Pakistan is one of the biggest hindrances to effective polio vaccination. Epidemiologists have detected transmission of wild poliovirus from polio-endemic districts in Afghanistan, most of which are located in the southern region of this country bordering Pakistan, to tribal areas of Pakistan
This transmission has resulted in new cases of polio in previously polio-free districts. The local Taliban have issued fatwas denouncing vaccination as an American ploy to sterilize Muslim populations. Another common superstition spread by extremists is that vaccination is an attempt to avert the will of Allah. The Taliban have assassinated vaccination officials, including Abdul Ghani Marwat, who was the head of the government's vaccination campaign in Bajaur Agency in the Pakistani tribal areas, on his way back from meeting a religious cleric.
Education, awareness and enlightenment will one day surely come to Pakistan and God Willing, Polio will get eradicated in Pakistan.
Not an impossibility, when Nigeria, also a Muslim country comprising of 50.4% of Nigeria's population, has already taken Polio Eradication seriously.