Afghanistan | Programme areas | Polio Eradication Initiative

Polio Eradication Initiative

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(data as of 30 June 2018)

Situation update

Fewer children were paralysed by polio in the world in 2017 than ever before, with the virus limited to a few areas in Afghanistan and Pakistan. In Afghanistan, the programme continues to implement the National Emergency Action Plan for Polio Eradication, and to operate and adapt in the midst of a fluctuating security situation to reach the maximum number of children while maintaining programme neutrality. 14 polio cases were reported in 2017, and by 30 June 2018 there were 9 reported cases, mostly limited to a relatively small area in the southern and eastern regions, access challenges being the key reasons.  

Achievements

  • The Technical Advisory Group (TAG) reviewed progress in polio eradication in November 2017 and noted improved campaign quality in very high-risk districts and improvement in population immunity. The TAG also noted that Afghanistan stopped all outbreaks in 2015–2016.
  • A new outbreak in the sothern region was caused mainly by inaccessibility and was limited to a relatively small area. It had a lower peak than in the past. In the eastern region, outbreaks caused by repeated importation of the polio virus were quickly controlled.
  • 4 National Immunization Days (NIDs) and 6 Sub-NIDs conducted in 2017, targeting around 10 and 6 million children respectively. Three mop-up campaigns were also conducted. In 2018, a total of 3 NIDs and 6 Sub-NIDs will be conducted. 
  • Post-campaign monitoring data reflected more than 94% coverage in each campaign during 2017. Number of inaccessible children went down from 391,000 in January 2017 to around 138,000 in March 2018 and up again in May, when 996,326 children were reported inaccessible, mostly in the Southern region.
  • A special vaccination strategy was implemented in 2017 targeting seasonal nomadic population in the south-eastern region. 
  • Children on the move are immunized by cross-border teams (CBTs) and permanent transit teams (PTTs). 12,979,912 children were vaccinated by PTTs and 75,653 by CBTs in 2017. By 30 June 2018, 6,884,052 children were vaccinated by PTTs and 424,033 by CBTs.
  •  In 2017, 50,050 returnee children from Pakistan and Iran were vaccinated with OPV and 25,603 with IPV at cross-border sites, and in 2018, by 30 June, 11,310 children of returnees had received OPV and 6,801 received IPV.
  • IPV campaigns in 30 districts vaccinated over 1.1 million children in 2017, and in 2018, 62 723 were vaccinated with IPV in January. 
  • National and Regional Emergency Operation Centres (EOC) were instrumental for closer oversight and improved coordination in implementing the National Emergency Action Plan (NEAP).
  • Environmental surveillance was expanded and currently covers 20 sites in 9 provinces.
  • AFP surveillance focal points were increased from 693 in 2016 to 733 in 2017 and AFP reporting volunteers from 20,974 to 28,543.
  • An internal AFP review concluded in October 2017 that overall, AFP surveillance looks good in areas reviewed. There is a sensitive surveillance system and a strong community network of reporting volunteers. Overall documentation quality is satisfactory.
  • Cross-border coordination with Pakistan on surveillance and vaccination continued. 
  • Active engagement with religious scholars for polio eradication continued. 

Programme risks and challenges

Some of the programme's risk and challenges include a deterioration of the security situation and on and off bans on campaigns, which result in children not being reached. High-risk mobile populations, straddling populations and refusals remain a challenge. 

Way forward

The way forward to eradicate polio in Afghanistan includes:

  • Maintaining programme neutrality, and gaining and maintaining access for vaccination. 
  • Continuing EOC coordination and NEAP implementation.
  • Following 15 district plan to stop the transmission in the southern region and implementing the Northern corridor action plan. 
  • Addressing refusals, improving campaign quality and focusing on missed children through improved microplanning and monitoring.
  • Continuing to map and vaccinate high-risk mobile populations (e.g. nomads, returnees, refugees, guests). 

Related links

Afghanistan monthly and quarterly polio snapshots

Polio Eradication Initiative

2016 Annual Report of the Polio Eradication Initiative, Afghanistan

Photo story: The people at the heart of polio eradication in Afghanistan

WHO Fact Sheet on Poliomyelitis

National Emergency Action Plan for Polio Eradication 2016 – 2017 

Photo essays

Photo essays

Photo essays

Key health-related statistics

Population (m) 31,5
Health expenditure (% of GDP) 9.5
Adult (15+) literacy rate (%) 34.3
Life expectancy at birth F/M (2010) 62-64

Sources: Central Statistics office, Afghanistan National health Accounts, Afghanistan Living Conditions Survey, Afghanistan mortality survey. 

See Afghanistan health profile

Afghanistan country health profile

Regional Health Observatory

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