WHO sees increasing risk of poliovirus spread in Pakistan and Afghanistan
Two countries have reported six new polio cases in 2023 so far
GENEVA (Web Desk) – Six new poliovirus cases have been reported in Pakistan during the current year so far, the World Health Organisation (WHO) said, with another six from Afghanistan, as it also warned that the vaccination programme continues to miss a significant number of children in the country.
Interestingly, all the polio cases reported in Afghanistan are from Nangarhar province which borders Pakistan.
At the same time, the WHO warned about the imminent threat. “However, there have been 46 WPV1 [Wild Poliovirus Type 1] positive environmental samples to date in 2023, mostly from the endemic East Region (Nangarhar and Kunar provinces), but recently also in environmental samples from Kabul, Kandahar, Zabul and Balkh provinces.”
“This indicates spread of WPV1 from the endemic zones of Afghanistan (East Region) and Pakistan (southern Khyber Pakhtunkhwa) and is a reversal of recent progress. The programme is implementing high quality campaigns and reaching more children than ever before, but the quality will have to be increased further and sustained.”
“Any setback in Afghanistan poses a risk to the programme in Pakistan due to high population movement” it added.
In case of Pakistan, it mentioned after a meeting in Geneva that there had been a large increase in environmental detections, with 60 positive samples found in the three months from September to November, bringing the total in 2023 to 82.
After a period of non-detection, new transmission is occurring in Quetta, Karachi, Islamabad/Rawalpindi and Peshawar, the WHO said.
Meanwhile, it said although implementation of a polio action plan in southern Khyber Pakhtunkhwa had resulted in 160,000 more children being vaccinated, the context remained challenging due to political instability, insecurity in some areas and vaccination boycotts.
“The programme continues to miss a significant number of children in Pakistan.”
When it comes to the global spread risk, the WHO says the actual spread of WPV1 lineages seen predominantly in Afghanistan in 2022 is now being detected in Pakistan in 2023.
High-risk mobile populations in Pakistan represent a specific risk of international spread to Afghanistan in particular, compounded by the large number of returnees from Pakistan into various parts of Afghanistan
Also, the large pool of unvaccinated ‘zero dose’ children in southern Afghanistan constitutes a major risk.
Some areas of Afghanistan still only allow site to site or mosque to mosque immunization response, which has been shown to be less effective than the house to house modality.
Although it is likely transmission of WPV1 has been interrupted in Malawi and Mozambique, the route from Pakistan to Africa remains unknown.
