Five female health workers involved in Pakistan's polio eradication efforts were gunned down Tuesday in two of the country's main cities amid militant resistance to immunization campaigns.

Unidentified gunmen killed four of the women in Karachi and a fifth in Peshawar. Two male volunteers were also injured in Tuesday's attacks, according to Sindh's health department. As a result, an ongoing polio vaccination campaign has been suspended throughout Sindh Province, according to the department.

Tuesday’s violence highlights a new trend of deadly attacks targeting women, who had previously been avoided unless they were members of religious minorities, says Jameel Yusuf, the former head of Karachi’s Citizens-Police Liaison Committee.

“This calls for serious measures. It is now time for clerics to come out openly. They seem more scared of terrorists than anyone else,” he says by phone. “It is a national issue, in which the health of the people, the children – our future generation – is at stake.”

Attacks on volunteers and health personnel working on polio vaccinations have increased sharply in 2012. While the motives for the attacks remain unclear, popular suspicion about polio vaccination drives surged after it was revealed that the CIA set up a face vaccination drive in Abbottabad as part of its hunt for Osama bin Laden.

Additionally, opponents of polio immunization, including Maulana Fazlullah, the militant leader in Swat, have derided it as a campaign to “make Muslims sterile.” The pushback on polio shots has led to attacks on campaign volunteers even as the number of infections is rising.

But the attacks also point to a larger issue in Pakistan: the basic failure of the state to protect its citizens. According to the Human Rights Commission of Pakistan, more than 1,800 people were killed in targeted attacks in Karachi, Pakistan’s financial capital, in the first 10 months of 2012. And attacks and targeted assassinations by militant groups are common throughout the country.

The polio eradication efforts are a focal point for the violence.

In July, a volunteer was killed in an attack in Karachi. Gunmen also fired at a United Nations vehicle in July, injuring a doctor working on the campaign. A local newspaper reported that communication officers working on the polio campaign refused to work in at least one area of Karachi unless their security was guaranteed.

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Mr. Yusuf, who played a key role in developing police reforms and in assisting investigations such as that of the Wall Street Journal reporter Daniel Pearl’s assassination, says a three-pronged strategy involving clerics, the police, and local administrators is needed to ensure that the campaign goes ahead.

Yusuf said it should be made mandatory for clerics to use the loudspeakers installed at mosques “for the welfare of the people,” to combat the idea propagated commonly in Pakistan that “polio vaccination has something to do with family planning.” “They should speak out that this [misconception] is illegal, wrong, and against the sharia [Islamic law].”