Wild Poliovirus Transmission Persists In Afghanistan And Pakistan

Polio stays a public well being emergency of worldwide concern regardless of a continued decline in case numbers, in keeping with the World Well being Group’s (WHO) Director-Common report introduced to the Government Board.

The report warns that progress towards eradication stays fragile. Some 38 circumstances of untamed poliovirus kind 1 had been reported globally by 22 October 2025, down from 62 throughout the identical interval in 2024. All circumstances occurred in Afghanistan and Pakistan, the one two international locations the place wild poliovirus stays endemic.

Environmental sampling has continued to detect the virus past core transmission areas, together with throughout the low-transmission season, suggesting silent unfold even the place no medical circumstances are instantly seen.

Transmission concentrated in endemic reservoirs

Wild poliovirus kind 1 persists in a small variety of reservoirs, significantly in southern Afghanistan, and the southern space of Khyber Pakhtunkhwa in Pakistan, the report notes. 

In Afghanistan, operational and communication methods are being adjusted to enhance protection. Supplementary immunization improved markedly within the japanese area in early 2025, contributing to reductions in transmission. Vaccination groups proceed to make use of site-to-site approaches within the south, supported by transit posts and advocacy for house-to-house vaccination to achieve missed youngsters.

Pakistan is implementing the Polio Nationwide Emergency Motion Plan 2024–2025 with a phased technique aimed toward restoring an emergency posture, closing operational gaps and sustaining excessive immunity. Whereas high-level political dedication and intensified supervision have improved efficiency, subprovincial variation persists in elements of Khyber Pakhtunkhwa, Quetta and Karachi.

Each international locations are making use of risk-categorization fashions to establish and attain migrants, cellular teams and different missed youngsters, whereas strengthening coordination alongside virus corridors and addressing surveillance gaps. Microplanning, focused campaigns, fractional-dose inactivated poliovirus vaccine and expanded subnational surveillance are a part of these efforts.

The International Polio Eradication Initiative (GPEI), which leads implementation with nationwide authorities, says its 2026 Motion Plan will prioritize the low-transmission season to interrupt remaining chains of unfold and shut immunity gaps amongst persistently under-immunized populations.

Vaccine-derived poliovirus outbreaks in low-coverage areas

Past the 2 endemic international locations, circulating vaccine-derived poliovirus stays a persistent problem the place routine immunization protection is weak.

WHO reported 151 circumstances of circulating vaccine-derived poliovirus kind 2 throughout 13 international locations as of late October 2025, in contrast with 182 circumstances throughout 16 international locations a 12 months earlier. Regardless of the decline, transmission continues in northern Nigeria, the Lake Chad Basin, the Horn of Africa, significantly south and central Somalia, Ethiopia and Yemen.

Well being specialists say these outbreaks happen when weakened strains of the oral polio vaccine flow into for extended durations amongst under-immunized youngsters, permitting the virus to mutate and unfold.

Some international locations have recorded progress. Madagascar’s outbreak of circulating vaccine-derived poliovirus kind 1 was declared closed in Might 2025. Within the Democratic Republic of the Congo, circumstances have fallen sharply in recent times following focused responses, dropping to a single case in 2025. 

Restricted detections of circulating vaccine-derived poliovirus kind 3 had been reported in Guinea, Cameroon and Chad, with outbreak responses underway.

New environmental detections, together with in Papua New Guinea and a number of other European international locations, underscore the chance of worldwide unfold via journey, inhabitants motion and surveillance gaps.

Vaccination instruments and integration increase

Whereas the usual oral polio vaccine stays the first software in eradication efforts, new merchandise embrace the expanded use of the novel oral polio vaccine kind 2 and mixture formulations.

With help from Gavi, the vaccine alliance, Senegal and Mauritania turned the primary international locations to introduce the hexavalent vaccine into routine immunization schedules this 12 months.

WHO companions are additionally emphasising the combination of polio actions into broader well being companies. Coordination between GPEI, the Important Programme on Immunization and Gavi has been strengthened to achieve zero-dose youngsters with a number of vaccines and to align polio property with routine immunization programs.

Addressing the Government Board, a Gavi consultant urged international locations to advertise built-in approaches to reaching zero-dose and under-vaccinated youngsters with life-saving vaccination and first well being care, significantly in humanitarian and complicated emergency settings, and to speed up the transition of polio programme infrastructure into nationwide programs to make sure long-term resilience.

Humanitarian pressures complicate supply

Within the Japanese Mediterranean Area, which incorporates each the endemic international locations, ongoing crises proceed to pressure well being companies. 

Regional Director Hanan Balkhi informed the board that the area carries practically half of the world’s humanitarian burden and accounted for 40% of assaults on well being care final 12 months.

She stated WHO responded to 62 outbreaks in 2025 and delivered provides to disaster settings, together with Gaza and Sudan, however funding cuts have diminished the regional well being emergency workforce by about half. 

Tens of millions of remedies are actually in danger, whereas clinic closures in Afghanistan and disruptions in Sudan have restricted entry to important companies.

Cross-border collaboration between Pakistan and Afghanistan continues, supported by regional oversight and diplomatic engagement, to maintain polio eradication actions.

Though the Polio Eradication Technique has been prolonged via 2029, financing stays a constraint. Donors have pledged $ 4.7 billion of the $ 6.9 billion required, leaving a $ 2.2 billion shortfall.

The Director-Common’s report cautions that sustained political dedication, stronger routine immunization programs and sufficient assets can be important to interrupt remaining transmission and safe an enduring polio-free world.

Picture Credit: GPEI, RAJA IMRAN BAHADR / Unsplash..