Polio in Afghanistan: Current Challenges and Pathways to Eradication
DOI:
https://doi.org/10.58342/ghalibMj.V.2.I.2.11Keywords:
Polio eradication, Wild poliovirus type 1 (WPV1), Vaccination strategies, Afghanistan, Global healthAbstract
Background: The Global Polio Eradication Initiative (GPEI), launched in 1988, has reduced global polio incidence by over 99.9% and eradicated wild poliovirus types 2 and 3. Afghanistan and Pakistan remain the last reservoirs of wild poliovirus type 1 (WPV1), with transmission hindered by insecurity, restrictions on house-to-house vaccination, vaccine hesitancy, and fragile health infrastructure.
Methods: We searched Scopus, PubMed, and Google Scholar using keywords such as “Afghanistan polio eradication,” “WPV1,” “vaccine hesitancy,” and “house-to-house vaccination.” Both peer-reviewed and grey literature, including WHO and UNICEF reports, were included.
Results: The search identified 34 relevant sources. Findings highlight persistent WPV1 transmission due to insecurity, vaccination restrictions, and population movements. Environmental and genetic surveillance, cross-border coordination, and lessons from India and Nigeria emphasize integrating vaccination with broader health services, using digital tools like Geographic Information Systems (GIS) and Artificial Intelligence (AI), and strengthening community trust through local leaders.
Conclusion: Eradication in Afghanistan requires multi-faceted strategies linking vaccination to broader health services, digital surveillance, community engagement, and sustained political commitment, alongside strong coordination with Pakistan.
References
Update from the Global Polio Eradication Initiative on programmatic challenges and accountability - GPEI [Internet]. [cited 2025 Aug 21]. Available from: https://polioeradication.org/news/update-from-the-global-polio-eradication-initiative-on-programmatic-challenges-and-accountability/
Poliomyelitis [Internet]. [cited 2025 Aug 21]. Available from: https://www.who.int/news-room/questions-and-answers/item/poliomyelitis
Chumakov K, Ehrenfeld E, Agol VI, Wimmer E. Polio eradication at the crossroads. Lancet Glob Health. 2021;9:e1172–5.
Staying the course on the long road - GPEI [Internet]. [cited 2025 Aug 28]. Available from: https://polioeradication.org/news/staying-the-course-on-the-long-road/
Approaching Days of Tranquility: Afghanistan Polio Eradication Initiative | The Communication Initiative [Internet]. [cited 2025 Aug 28]. Available from: https://global.comminit.com/content/approaching-days-tranquility-afghanistan-polio-eradication-initiative
Polio: The beginning of the end. https://cdn.who.int/media/docs/default-source/biologicals/vaccine-quality/polio-the-beginning-of-the-end85aa6ead-a400-45ed-bd21-9508be9d0b6f.pdf?sfvrsn=c3220f24_1&download=true
Progress Toward Poliomyelitis Eradication --- Afghanistan, 1999--2000 [Internet]. [cited 2025 Aug 28]. Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5008a3.htm
Progress Toward Poliomyelitis Eradication --- Pakistan and Afghanistan, January 2000--April 2002 [Internet]. [cited 2025 Aug 28]. Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5124a1.htm
Graham-Harrison E. Afghan Taliban bans polio vaccination teams from southern Helmand. The Guardian [Internet]. 2014 July 8 [cited 2025 Aug 28]; Available from: https://www.theguardian.com/world/2014/jul/08/afghan-taliban-bans-polio-vaccination-teams-southern-helmand-province
Centers for Disease Control and Prevention (CDC). Progress toward poliomyelitis eradication--Afghanistan and Pakistan, January 2010-September 2011. MMWR Morb Mortal Wkly Rep. 2011;60:1523–7.
Mohamed A, Akbar IE, Chaudhury S, Wadood MZ, Ather F, Jorba J, et al. Progress Toward Poliomyelitis Eradication ― Afghanistan, January 2021–September 2022. Morb Mortal Wkly Rep. 2022;71:1541.
Hardy CM, Rathee M, Chaudhury S, Wadood MZ, Ather F, Henderson E, et al. Progress Toward Poliomyelitis Eradication — Afghanistan, January 2023–September 2024. Morb Mortal Wkly Rep. 2024;73:1129–34.
Statement following the Thirty-eighth Meeting of the IHR Emergency Committee for Polio [Internet]. [cited 2025 Aug 28]. Available from: https://www.who.int/news/item/08-04-2024-statement-following-the-thirty-eighth-meeting-of-the-ihr-emergency-committee-for-polio
Sabawoon W, Seino S, Pason BM, Momin NWS, Kanamori S, Bender C, et al. Progress in Access and Oral Polio Vaccine Coverage Among Children Aged <5 Years in Polio Campaigns After the Political Change in Afghanistan. J Infect Dis. 2024;231:e438–45.
General factsheet [Internet]. Global Polio Erdaication Initiative; 2025. Available from: https://polioeradication.org/wp-content/uploads/2025/04/GPEI-general-factsheet-20250401.pdf
Statement of the forty-first meeting of the Polio IHR Emergency Committee [Internet]. [cited 2025 Aug 28]. Available from: https://www.who.int/news/item/10-04-2025-statement-of-the-forty-first-meeting-of-the-polio-ihr-emergency-committee
Administrator. Afghanistan [Internet]. World Health Organ. - Reg. Off. East. Mediterr. [cited 2025 Aug 28]. Available from: http://www.emro.who.int/polio-eradication/priority-countries/afghanistan.html
Shaukat S, Angez M, Alam MM, Sharif S, Khurshid A, Malik F, et al. Molecular Characterization and Phylogenetic Relationship of Wild Type 1 Poliovirus Strains Circulating across Pakistan and Afghanistan Bordering Areas during 2010–2012. PLoS ONE. 2014;9:e107697.
Mbaeyi C, Ul Haq A, Safdar RM, Khan Z, Corkum M, Henderson E, et al. Progress Toward Poliomyelitis Eradication - Pakistan, January 2023-June 2024. MMWR Morb Mortal Wkly Rep. 2024;73:788–92.
Vaccination campaigns - GPEI [Internet]. [cited 2025 Aug 28]. Available from: https://polioeradication.org/news-categories/vaccination-campaigns/
Lin Y. Polio in Afghanistan: a systemic review on eradication interventions and challenges. Zhu T, Anpo M, Sharifi A, editors. E3S Web Conf. 2021;271:03029.
Polio eradication | UNICEF Afghanistan [Internet]. [cited 2025 Aug 28]. Available from: https://www.unicef.org/afghanistan/polio-eradication
Statement of the Forty-second meeting of the Polio IHR Emergency Committee [Internet]. [cited 2025 Aug 28]. Available from: https://www.who.int/news/item/28-07-2025-statement-of-the-forty-second-meeting-of-the-polio-ihr-emergency-committee
Three female polio workers shot dead in Afghanistan – DW – 03/30/2021 [Internet]. dw.com. [cited 2025 Aug 28]. Available from: https://www.dw.com/en/afghanistan-3-female-polio-workers-shot-dead/a-57047830
The world nearly beat polio. But fake records, an imperfect vaccine and missteps aided its comeback [Internet]. CNN. 2025 [cited 2025 Aug 28]. Available from: https://www.cnn.com/2025/08/05/health/polio-eradication-missteps
BUILDING A CLIMATE-RESILIENT, POLIO-FREE WORLD [Internet]. Global Polio Erdaication Initiative; 2024. Available from: https://polioeradication.org/wp-content/uploads/2024/07/GPEI-Climate-Resilient-Health-20240712.pdf
Eradicating poliomyelitis: India’s journey from hyperendemic to polio-free status - PMC [Internet]. [cited 2025 Aug 28]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3734678/
Bellatin A, Hyder A, Rao S, Zhang PC, McGahan AM. Overcoming vaccine deployment challenges among the hardest to reach: lessons from polio elimination in India. BMJ Glob Health. 2021;6:e005125.
Eradicating polio in Nigeria | McKinsey [Internet]. [cited 2025 Aug 28]. Available from: https://www.mckinsey.com/industries/healthcare/our-insights/eradicating-polio-in-nigeria#/
(PDF) Nigeria’s Polio Elimination Playbook: Lessons To Strengthening Health Systems For Other Eradicable Diseases [Internet]. [cited 2025 Aug 28]. Available from: https://www.researchgate.net/publication/364593984_Nigeria's_Polio_Elimination_Playbook_Lessons_To_Strengthening_Health_Systems_For_Other_Eradicable_Diseases
NIGERIA: Vitamin A handouts boost polio vaccine acceptance - Nigeria | ReliefWeb [Internet]. 2010 [cited 2025 Sept 14]. Available from: https://reliefweb.int/report/nigeria/nigeria-vitamin-handouts-boost-polio-vaccine-acceptance
Learning From Experience - GPEI [Internet]. [cited 2025 Aug 28]. Available from: https://polioeradication.org/news/learning-from-experience/
Our Strategy - GPEI [Internet]. 2021 [cited 2025 Aug 28]. Available from: https://polioeradication.org/who-we-are/our-strategy/
Zeng D, Cao Z, Neill DB. Artificial intelligence–enabled public health surveillance—from local detection to global epidemic monitoring and control. Artif Intell Med. 2021;437–53.
The top five tech solutions that helped eradicate wild poliovirus in the African Region [Internet]. Afr. Kicks Wild Polio. [cited 2025 Aug 28]. Available from: https://www.africakicksoutwildpolio.com/the-top-five-tech-solutions-that-helped-eradicate-wild-poliovirus-in-the-african-region/
Polio Diplomacy Between Pakistan and Afghanistan – The Diplomat [Internet]. [cited 2025 Aug 28]. Available from: https://thediplomat.com/2025/01/polio-diplomacy-between-pakistan-and-afghanistan/
Yanni EA, Marano N, Stauffer WM, Barnett ED, Cano M, Cetron MS. Health Status of Visitors and Temporary Residents, United States. Emerg Infect Dis. 2009;15:1715–20.
Administrator. Afghanistan [Internet]. World Health Organ. - Reg. Off. East. Mediterr. [cited 2025 Aug 30]. Available from: http://www.emro.who.int/polio-eradication/priority-countries/afghanistan.html
Tharwani ZH, Shaeen SK, Arshad MS, Khalid MA, Islam Z, Nemat A, et al. Polio amid a humanitarian crisis in Afghanistan: challenges and recommendations. Lancet Infect Dis. 2022;22:168–9.
Technical Advisory Group urges strong action to eradicate polio in Afghanistan - GPEI [Internet]. [cited 2025 Aug 30]. Available from: https://polioeradication.org/news/technical-advisory-group-urges-strong-action-to-eradicate-polio-in-afghanistan/
Fake CIA Vaccine Campaign: When the End Doesn’t Justify the Means | Smart Global Health | CSIS [Internet]. [cited 2025 Aug 30]. Available from: https://www.csis.org/blogs/smart-global-health/fake-cia-vaccine-campaign-when-end-doesnt-justify-means
Abbasi F. “A Disaster for the Foreseeable Future.” Hum Rights Watch [Internet]. 2024 [cited 2025 Aug 30]; Available from: https://www.hrw.org/report/2024/02/12/disaster-foreseeable-future/afghanistans-healthcare-crisis
Administrator. Afghanistan [Internet]. World Health Organ. - Reg. Off. East. Mediterr. [cited 2025 Aug 30]. Available from: http://www.emro.who.int/polio-eradication/priority-countries/afghanistan.html
Closser S, Cox K, Parris TM, Landis RM, Justice J, Gopinath R, et al. The impact of polio eradication on routine immunization and primary health care: a mixed-methods study. J Infect Dis. 2014;210 Suppl 1:S504-513.
GPEI-Closing the gap: the Afghan women gaining ground against vaccine refusals and zero dose children [Internet]. [cited 2025 Aug 30]. Available from: https://www.archive.polioeradication.org/countries/afghanistan/
Asghar H, Diop OM, Weldegebriel G, Malik F, Shetty S, El Bassioni L, et al. Environmental surveillance for polioviruses in the Global Polio Eradication Initiative. J Infect Dis. 2014;210 Suppl 1:S294-303.
How Emergency Operations Centers are aiding the COVID-19 response [Internet]. [cited 2025 Aug 30]. Available from: https://www.gatesfoundation.org/ideas/articles/emergency-operations-centers
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 امیرحسین غفاری, محمد فیصل وردک , عبدالسمیع عظیمی
This work is licensed under a Creative Commons Attribution 4.0 International License.
