Progress Toward Poliomyelitis Eradication — Afghanistan, January 2016–June 2017

Abstract

What is already known about this topic? Afghanistan is one of three countries where transmission of indigenous wild poliovirus (WPV) has never been interrupted. The Southern and Eastern regions of the country continue to be the main areas where WPV cases and positive environmental samples are identified. What is added by this report? The number of WPV type 1 cases reported in Afghanistan has declined yearly since 2014 when 28 cases were reported to 13 in 2016, indicating continued progress toward eradication. Factors contributing to this decline include increased focus on hard-to-reach populations, improved partner coordination, and successful negotiation to obtain access for campaigns, resulting in fewer children being missed during campaigns. During the October 2016 National Immunization Days (NIDs) 4.4% of children were missed because of security issues; <1% of children were missed because of insecurity during the May 2017 NIDs. The identification of a new corridor for transmission between Afghanistan and Pakistan in the Southeastern region, as well as ongoing case detection in the Southern region, highlight persistent immunity gaps. What are the implications for public health practice? To interrupt poliovirus transmission, Afghanistan’s polio program will benefit from further refinement of strategies to vaccinate hard-to-reach populations and improve campaign quality, especially in the south. Prioritizing coordination between Afghanistan and Pakistan on surveillance and vaccination activities for their shared mobile populations is important to stop ongoing cross-border transmission and reduce the risk for poliovirus circulation in hard-to-reach areas of Afghanistan.