Polio Eradication Campaign: Afghanistan Still Leading the List of Polio Cases
By: Amin Kawa
Afghanistan is grappling with not only poverty and hunger crises but also a healthcare crisis. Inefficiency in the healthcare system, failure to take preventive measures against the spread of infectious diseases, and a reduction in humanitarian aid are among the key factors contributing to this crisis. Over the past 21 months, the Taliban have limited women’s involvement in providing healthcare services, significantly reducing women’s access to healthcare. The absence of women in polio eradication campaigns has exacerbated the crisis. The Ministry of Public Health, under the Taliban’s administration, has confirmed a recent case of Polio in the province of Nangarhar. The victim is a four-year-old child diagnosed in a hospital in Pakistan. Nonetheless, a complementary polio vaccination campaign has been launched in the country. It is said that during this period, 6.4 million children will be vaccinated in Afghanistan. Studies indicate that over the past five years, more than 90 polio cases have been reported in the country. Physicians state that polio is an acute and highly contagious viral disease that primarily affects children under the age of five.
On Saturday, May 13, the Ministry of Public Health, under the Taliban’s administration, announced the registration of a polio case in the Bati Kot district of the province of Nangarhar through a press release. Earlier, Pakistani media had reported a positive polio case registered in one of their hospitals, involving a four-year-old Afghan child. However, the Ministry of Health, under the Taliban’s administration, stated that the risk of contracting this virus in Afghanistan has not been eliminated, and the possibility of positive polio cases in eastern provinces, particularly Nangarhar, still exists. In a press release, the ministry mentioned that the polio vaccination campaign would start on Monday, May 15, and continue for four days in 217 districts across the country. According to the press release, 23 provinces will be covered in this campaign, and during the four-day campaign, 6.4 million children in Afghanistan will be vaccinated.
Meanwhile, Dr. Nikwalishah Moman, the head of the National Emergency Operations Center for Polio Eradication, has stated to the media that with the implementation of sustained vaccination campaigns, this virus can be eradicated in the country. He confirmed the registration of a positive polio case in the province of Nangarhar, and the patient is a four-year-old child. This comes after two positive cases of polio were reported in Paktika and Kunar provinces in the previous year. Afghanistan, Pakistan, and Nigeria are among the countries in the world where polio cases have been registered, while in other countries, the virus has been eliminated due to preventive vaccination measures. Due to traditional beliefs in some rural areas, people in Afghanistan refrain from vaccinating against polio, leading to the spread of various diseases in these villages.
How many polio cases were registered in the past five years in Afghanistan?
According to the statistics provided by the Ministry of Public Health, currently operating under the control of the Taliban, 90 children have been affected by this disease from 2018 to the current year. The statistics of registered polio cases in the country show that 21 children were affected in 2018, and eight children in 2019. There were 56 cases in 2020 and four cases in 2021. However, two positive cases of polio were registered in 2022, and in the latest case, a four-year-old child in the Beti Kot district of the province of Nangarhar has been diagnosed with polio. Meanwhile, published statistics by the Hasht-e Subh Daily indicate that in the past Solar year (equivalent to 2021/22), six cases of polio have been reported in the provinces of Nangarhar and Kunar.
Why is polio vaccination not implemented?
Health practitioners in the country state that if vaccination campaigns had been properly implemented in the past few decades, this virus would have been eradicated from the country. They consider the lack of timely information dissemination as one of the factors contributing to the failure of polio campaigns. According to them, due to traditional beliefs, people believe that vaccination leads to infertility and they refuse to vaccinate their children. One of the doctors in the province of Kabul, who prefers to be anonymous, told the Hasht-e Subh Daily, “The negligence of the Ministry of Public Health has prevented the eradication of this disease. Now that the Taliban is in power, they should promote this campaign through mosques, but unfortunately, they are not doing so. Illiteracy and poverty are other factors preventing the eradication of polio in the country.”
This doctor explains, “The restrictions imposed by the Taliban on women’s work have made women less willing to participate in this campaign. Female vaccinators are required to have a male guardian. When a woman doesn’t have a male guardian, she is not treated equally. This in itself reduces access to health services. Afghan society is also traditional. When there are no female vaccinators, no one is willing to send their young children to a male to get vaccinated. Another issue is the lack of awareness about the spread of the virus and caring for children. The majority of people do not adhere to health precautions, do not believe in vaccination, and even consider it forbidden. In such a situation, we will witness dozens of these cases being reported because information dissemination and access to doctors are limited, and the registration of cases is limited too, therefore, the number of positive cases is significantly higher.”
Previously, the Taliban had not allowed vaccinators in their controlled provinces and districts to implement the polio vaccine. According to reports, several vaccinators have been killed by the Taliban and other terrorist groups in different provinces of the country. However, the Taliban have recently announced that female vaccinators, while having their guardians with them and observing their hijab, can participate in vaccination campaigns.
However, The Global Polio Eradication Initiative has stated that Afghanistan is under the influence of continuous transmission of the wild poliovirus which is a native strain. This organization, which is led by six partners, has emphasized they are committed to their political commitment, financial resources, and technical support at all levels to reach the last child in Afghanistan with the vaccine.
Meanwhile, Bill Gates, the owner of Microsoft, stated in an interview with the American newspaper “The Telegraph” on Tuesday, October 17, 2022, that he is willing to meet with the Taliban to help eradicate polio. Mr. Gates added, “To be honest, I don’t know if there is any sensitivity around it or not. I do almost anything to help the polio campaign; it is the top priority of the Bill and Melinda Gates Foundation.” Before these remarks, he had committed to working on polio eradication in Afghanistan and Pakistan during a meeting with Imran Khan, the former Prime Minister of Pakistan. According to reports from Pakistani media, the country had only one polio case in 2021, while there were 20 positive cases of the virus in Pakistan last year.
What is polio and how is it transmitted?
The World Health Organization (WHO) states that polio is a viral disease. According to this organization, the virus usually affects children under the age of five. This disease does not have specific symptoms. Health experts say that symptoms similar to the flu, such as high fever, headache, sore throat, and nausea, are also observed in this disease.
Regarding the transmission of polio, the World Health Organization says, “The virus is mainly transmitted from person to person through the fecal-oral route, or less commonly through a common vehicle (such as contaminated water or food), and replicates in the intestine. From there, it can attack the nervous system and cause paralysis.”
The World Health Organization (WHO) adopted a resolution in 1988 to globally eradicate polio. The adoption of this resolution demonstrates the commitment and initiative of the world to eradicate polio. This resolution is supported by governments, the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), Rotary International, and UNICEF, and later joined by the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance.
The polio vaccination campaign is being launched in Afghanistan while the accurate statistics on polio cases in the country have not been provided. Due to widespread poverty, climatic challenges, lack of access to proper and complete nutrition, and unvaccinated children in some areas, polio continues to pose a threat to children in the country.