The Southern Region of Afghanistan and Farah province in the Western Region remain polio-endemic: in 2011, 85% of polio cases occurred in these areas. The other cases were reported in nine previously polio-free provinces, the result of importations from this endemic zone and from neighbouring Pakistan.
In the endemic zone, the immunization status of children was worse in 2011 than in 2008, uncovering a steady decline in the quality of Supplementary Immunization Activities (SIAs). The 28 worst-performing districts have been identified in Hilmand, Kandahar and Uruzgan provinces in Southern Region and Farah province in Western Region.
In addition to problems accessing children in insecure areas, serious flaws in the management and accountability of the polio eradication programme persisted in 2011. Poor access and management were compounded by a failure to sufficiently communicate to parents and communities the importance of polio eradication.
Communication in Action: overview of community engagement.
In Asia, persistent poliovirus transmission is highly localized in a few districts. The approach in Asia therefore focuses on district- and sub-district-specific plans to achieve exceptionally high coverage with very frequent supplementary immunization activities to boost population immunity to >95% – the threshold required to stop transmission in Asia.Engaging local political and administrative leaders to ensure the quality of supplementary immunization activities is also important.
Interrupting the remaining poliovirus transmission in Afghanistan has been declared an emergency by the World Health Assembly. In response, the National Polio Emergency Action Plan has been developed which recommends the following emergency approach.
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