Community engagement: the missing piece in solving the puzzle of XDR-typhoid spread in Pakistan.

Typhoid has been a major infectious health threat for the masses in Pakistan with increasing antimicrobial resistance, socio-economic decline, and environmental challenges. Since 2019, the percentage of cases has reduced with the implementation of Typhoid Conjugate Vaccine (TCV) program but reports of widened geographical spread particularly as aftermath of flooding in 2022 and resistance to Azithromycin or Meropenem in adult population are a matter of serious concern. Now is the right time to reconsider whether strategies like mass immunization or health infrastructure development solely can combat the hazards of Extensively Drug-Resistant (XDR)-Typhoid. Public health policies developed due to COVID-19, such as incorporating all stakeholders especially the public through community engagement, may provide a collaborative effort to lessen the prevailing threat of antibiotic resistance.