Editor in Chief: Moh. Reza Huwaida Monday, January 18th, 2021

Challenges before Anti-Polio Campaign

Afghanistan is one of the three countries, alongside Pakistan and Nigeria, in the world where polio remains endemic. The number of reported cases has been reduced in recent years in the wake of effective campaign against poliovirus. Polio Eradication Initiative (PEI) seeks to immunize every single child in the country to minimize its risk. The decline in polio fills the air with optimism, but there are obstacles which impede the campaign.
Reports show that the number of officially reported wild poliovirus type 1 (WPV1) cases in Afghanistan dropped from 80 in 2011 to 37 in 2012. The downward trend continued with 8 cases of WPV1 confirmed, in eastern part of the country, during January-September 2013, compared with 26 within the same period in 2012. In 2016, 13 polio cases were registered, down from 20 the year before and 28 in 2014. In 2015, in which polio reduced to a great extent, 40 per cent of cases were reported from eastern Nangarhar province, which borders Pakistan.
In 2017, the total cases of polio in the country was 14. However, the cases had been reported 21 last year in Afghanistan – 15 cases were in restive provinces such as Kandahar, Helmand and Uruzgan. In the current year, two cases of polio has been reported so far in Kandahar province.
The international efforts decreased the number of endemic countries from 123 in 1988 to two in 2015, when Nigeria was delisted from polio-endemic countries. Nonetheless, Nigeria returned to the list when four cases of polio were found out in August 2016 in state of Borno – where the Islamic extremist group Boko Haram is active, but no cases were reported in 2017.
Although the campaign against polio continues, as the Taliban have agreed to vaccinate children in the mosque in restive provinces, they refused house-to-house vaccination. Omer Zawak, spokesperson to Helmand Governor, is cited as saying that the anti-polio campaign had been implemented without pause in the Taliban-dominated areas except for Nawzad and Musa-Qala districts. It is said that the reason behind the Taliban’s disagreement for polio campaign in the two districts were not clear.
Three reasons are believed to be behind the militants’ opposition to the administration of oral polio vaccine (OPV) to kids. First, the fake vaccination scheme, which was used as a cover to track the whereabouts of Osama bin Laden in 2011, triggered mistrust and hatred among terrorist networks. Second, they may consider the anti-polio campaign a ploy by the US policy-makers rendering recipients impotent or infertile so as to reduce the Muslim population as the Taliban once called it even against Islam. Third reason is vis-à-vis female workers. Militants’ attacks against female health workers, in Afghanistan and Pakistan, might be mainly the result of their misogynistic view and their mindset denying women’s social role and discriminating them on the grounds of their gender.
Health workers are threatened not only by terrorist groups but also by counter insurgency war. For example, dozens of health workers and patients were killed in October 2015 as a result of the US military air attack on the Kunduz Trauma Center. Similarly, eight polio workers were killed while performing their duty in 2014. War is a serious threat to health workers impeding their activities. 
Few years back, parents were also said to lose their trust in health workers in the Taliban-dominated areas and tribal belts as a result of the Taliban’s campaign against polio vaccination. 
With this in mind, a National Islamic Advisory Group for Polio Eradication was founded in 2016 to bridge the gap between parents and health workers, brought about by the militant fighters. Consequently, almost 90 per cent of Afghans accepted how critical immunization was for their children and the improvement paved the ground for the implementation of 2016 polio-free in 99 per cent of Afghanistan’s districts.
The clerics have to continue their support for anti-polio campaign and endorse polio vaccines through issuing decree.
Constitutionally, the state is committed to “provide free preventative healthcare and treatment of diseases as well as medical facilities to all citizens in accordance with the provisions of the law.” Thus, Afghan government has to pave the ground for smooth implementation of anti-polio campaign across the country. The government should also ensure the safety of health workers to support the process of the campaign.
To sum up, the government has to provide a safe ground for health workers and make sure that every single child is vaccinated against polio so that Afghanistan could be free from polio.