Despite progress over the last 10 years, overall immunization coverage remains low with disparities throughout the country, particularly between rural and urban areas and secure and insecure zones. Among children under five years of age, the most vulnerable are those living in hard-to-reach communities. These children are mainly at risk of measles, pneumococcal pneumonia, rotavirus and other vaccine-preventable diseases.
Geographical barriers and functional challenges for the sustained and continued provision of vaccine coverage are all factors impacting on the outreach and coverage capacity of the national immunization programme, which ultimately increases the risk of outbreaks. Since January 2011, approximately 3000 cases of measles have been reported. Mortality due to vaccine-preventable diseases has significantly decreased during the past 10 years, however, infant and under-five mortality rates in Afghanistan remain among the highest in the world.
WHO provides technical and operational support to the national Expanded Programme on Immunization. Additional partners include: UNICEF, Immunization Basics, the GAVI Alliance, Centers for Disease Control, UN Foundation and the International Measles Initiative. Programme implementation is carried out by the Ministry of Public Health, in coordination with organizations implementing the basic package of health services. Additionally, multi-partner forums such as the national Immunization Coordination Committee Task Force, National Immunization Technical Advisory Committee, the Measles Validation Committee and Surveillance Committee, support the overall national and subnational coordination process.