Progress Toward Poliomyelitis Eradication - Afghanistan, January 2023-September 2024

Area of Science:

• Public Health
• Epidemiology
• Global Health Security

Background:

• The Global Polio Eradication Initiative has significantly reduced wild poliovirus (WPV) cases since 1988.
• WPV types 2 and 3 are eradicated, but WPV type 1 (WPV1) transmission persists in Afghanistan and Pakistan.
• Political changes in Afghanistan in 2021 initially improved access for vaccination campaigns.

Purpose of the Study:

• To report on immunization and surveillance activities for polio eradication in Afghanistan.
• To assess progress and challenges in polio eradication efforts in Afghanistan from January 2023 to September 2024.

Main Methods:

• Review of immunization campaign data and surveillance reports for WPV1 cases.
• Analysis of vaccination coverage rates and factors affecting campaign implementation.
• Monitoring of WPV1 case incidence and geographic distribution.

Main Results:

• Afghanistan reported 23 WPV1 cases in 2024 (Jan-Sep), an increase from 6 cases in 2023 and 12 over the previous three years.
• House-to-house vaccination coverage reached 90%-98% in June-July 2024.
• Significant challenges include Pakistani repatriation of Afghans, humanitarian crises, program constraints, and restrictions on female participation, with a recent national restriction on house-to-house campaigns in September 2024.

Conclusions:

• Continued WPV1 transmission in Afghanistan poses a risk to regional and global eradication efforts.
• Addressing challenges like repatriation, humanitarian issues, and participation restrictions is crucial.
• Nationwide house-to-house vaccination and strengthening routine immunization are essential for polio eradication in Afghanistan.