Progress Toward Poliomyelitis Eradication - Afghanistan, January 2015‒August 2016

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Vaccinology

Background:

• Global wild poliovirus (WPV) cases reached a historic low in 2015, with only WPV type 1 (WPV1) circulating.
• Afghanistan reported a decline in WPV cases in 2015, with trends suggesting localized circulation in 2016.
• Despite progress, significant challenges impede polio eradication in Afghanistan, including security issues and suboptimal immunization coverage.

Purpose of the Study:

• To report on polio eradication activities and progress in Afghanistan from January 2015 to August 2016.
• To identify persistent challenges and recommend strategies for interrupting endemic WPV transmission.

Main Methods:

• Analysis of reported wild poliovirus cases and detection data in Afghanistan.
• Review of polio eradication initiative activities, including supplementary immunization activities (SIAs) and routine immunization.
• Assessment of factors affecting polio eradication, such as security and population movement.

Main Results:

• Afghanistan reported 20 WPV1 cases in 2015, a decrease from 28 in 2014. January-August 2016 saw eight cases, compared to nine in the same period in 2015.
• Deteriorating security in eastern and northeastern regions limits vaccination access.
• Cross-border transmission with Pakistan persists due to population movement, and routine immunization services remain suboptimal.

Conclusions:

• Systematic implementation of the 2016-2017 National Emergency Action Plan is essential for polio eradication in Afghanistan.
• Key strategies include improving SIAs and routine immunization, engaging local authorities, reaching children in insecure areas, and enhancing cross-border coordination with Pakistan.