This document provides an update on polio eradication efforts in Afghanistan. It notes that 5 provinces and 47 districts are at high risk for polio, with districts categorized from fully accessible to inaccessible. In 2016, all confirmed polio cases were reported from access-compromised areas. To strengthen polio eradication, the approach focuses on gaining access, implementing alternative strategies, engaging communities, and enhancing monitoring. Lessons from 2015-2016 highlight the importance of strong coordination, maintaining neutrality, and improving quality in accessible but limited areas. Opportunities include political support and neutrality, while challenges include inaccessibility, knowledge gaps, and possible funding issues.

1. Update on Polio Eradication
in Afghanistan
Najibullah Safi, MD, MSc. HPM
Director General, Preventive Medicines
Ministry of Public Health, Afghanistan

2. Context
• High risk:
– 5 provinces
– 47 districts
• Access status:
– Category 1- fully accessible
– Category 2- partially
accessible
– Category 3-accessible with
limitations
– Category 4- inaccessible
08-Dec-16
Risk categorization of districts, 2016
2

3. Confirmed Polio cases 2016
08-Dec-16 3

4. Approach for strengthening PEI
• Maintain program neutrality and gain access to reach
all children
• Implementation of alternate strategies i.e. Polio plus
and PTT for inaccessible areas
• Focus on identified high risk areas and persistently
missed children
• Strong household and community engagement
• Enhanced monitoring and accountability of all
stakeholders at all levels
08-Dec-16 4

5. Lessons learnt from the implementation of
2015-16 NEAP
• Strong coordination and accountability is critical
• Continue adaptation to local security context
• Maintaining neutrality
• High quality and focused activities
• Tailored plans to local context
• Right selection of FLWs, quality training, sustaining
motivation
• Need to focus on improving quality of SIAs in
accessible areas with limitations (cat. 3)
08-Dec-16

6. Opportunities
• Political support
• Neutrality of the program
• Support from community elders and religious leaders
• Ongoing negotiation with communities and AGEs
• Enormous support from partners
• Virus circulation has been limited to four districts
• All cases are reported from access compromised areas
• No virus has been isolated from the environment
during 2016
08-Dec-16 6

7. Challenges
• Inaccessibility
• New and more complicated groups of AGEs
emerging
• The number of children missed is of great
concern
• Knowledge about polio is substantially bellow
desired level in high risk districts
• Maintaining program neutrality
• Limitation in supervision and monitoring
• Possible funding gaps
08-Dec-16 7

8. Thanks
08-Dec-16 8