Afghanistan is one of only three countries in the world where polio remains endemic, together with Pakistan and Nigeria. But there is a growing sense of optimism that polio will be the second disease, after smallpox, to ever be eradicated.
In many ways, the map of polio mirrors the conflict in Afghanistan. The challenge to reach and vaccinate every child is as much diplomatic as it is operational and medical.
Immunization is not a matter of parental refusal – memories of an era when polio was common are still fresh in Afghan minds – but efforts are still needed to dispel myths around the vaccine and to convince families who are afraid of immunization.
Ongoing conflict and political instability make it difficult to access hard-to-reach areas, and migration along the porous and rugged border between Afghanistan and Pakistan further complicates vaccination efforts, making children on both sides vulnerable to contracting the debilitating disease. This means that polio transmission has become highly localized in pockets in the south and the east of Afghanistan, so eradication efforts focus on planning at the district- and sub-district levels.
For Afghanistan to halt wild polio virus transmission, all children need to be vaccinated. While there has been a near 100 per cent increase in families’ awareness about the importance of polio vaccination in accessible districts, a sizeable number of children are still not being reached.