Afghanistan is one of three countries, along with Pakistan and Nigeria, to still experience active transmission of the polio virus. Although polio cases have decreased since 2001, the deteriorating security situation in Afghanistan, combined with frequent population movement between polio-endemic areas in Afghanistan and Pakistan, has contributed to a rise in infection (80 confirmed cases in 2011 and 31 cases in 2012). Management and accountability issues are another challenge to eradication. Recent data show that failure to vaccinate children is, in most cases, a system rather than security failure. To improve eradication efforts, the Afghan Ministry of Public Health (MoPH) developed a National Emergency Action Plan (NEAP) for polio eradication, which addresses five pillars: advocacy, management/accountability, access, creating demand, and routine immunization. Polio eradication efforts in Afghanistan are led by the MoPH, with support from several international partners, including USAID, the Canadian International Development Agency (CIDA), the International Committee of the Red Cross (ICRC), the United Nations Children’s Fund (UNICEF), the World Health Organization (WHO), the Gates Foundation, Rotary International, and Japan.
- Surveillance: USAID supports the WHO’s Acute Flaccid Paralysis (AFP) Polio Surveillance Network in Afghanistan, which operates at the national, regional, provincial, and district levels. Community-based monitoring is the hallmark of the system. Working with local non-governmental organizations (NGOs), the AFP network includes more than 10,000 reporting volunteers (mullahs, traditional healers, pharmacists, and shrine keepers) who are linked to nearby health facilities. The network gathers essential information about polio risk and vaccination, helping to identify needed community interventions and vaccination campaigns.
- Social Mobilization and Communication: Through UNICEF, USAID helps disseminate polio messages through media. Outreach efforts also include sending social mobilizers and communication officers to high-risk communities.
The MoPH, with support from international partners, has:
- Achieved adequate immunity levels in most parts of Afghanistan, with 84 percent of Afghans living in areas free of circulating polio virus.
- Conducted four comprehensive national and four limited sub-national (high-risk areas only) immunization days per year. In addition, the MoPH maintains 11 year-round immunization posts on the Pakistan/Afghanistan border to vaccinate at-risk children.
- Provided periodic, supplemental doses of polio vaccine (SIADs) where needed.
- Negotiated with the military to promote “de-confliction” in high-risk areas during immunization days, which facilitated the movement of vaccination teams.
Last updated: September 30, 2013