This document summarizes the polio situation in the Eastern Mediterranean Region as of October 2021. It reports that Afghanistan and Pakistan continue to have cases of wild poliovirus type 1 and circulating vaccine-derived poliovirus type 2. Sudan has had an outbreak of cVDPV2 that may now be stopped, but cross-border risks remain. Somalia, Egypt, and Yemen also have had poliovirus outbreaks or events. The document discusses opportunities and risks in the region and ensuring polio assets transition smoothly to continue their sustainable impact.

1. Update on polio eradication in the
Eastern Mediterranean Region
Agenda item 2(b)
Hamid Jafari
Director, Polio Eradication
Sixty-eighth session of the WHO Regional Committee for the Eastern Mediterranean
Cairo, Egypt, 11–14 October 2021

2. Afghanistan and Pakistan: WPV1 and cVDPV2
(environmental surveillance and cases), 2021*
* As of 8 October 2021
25
18
10
5
3
1
2
1
0
48
27
29
14
2
3
2
1
0
0 20 40 60 80
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
2021
Number
Wild poliovirus type 1 (WPV1) and
circulating vaccine-derived poliovirus
type 2 (cVDPV2) isolates by month
WPV1 cVDPV2
Human (AFP) Environmental
WPV1 cVDPV2
Both WPV cases
reported in January

3. * As of 8 October 2021
Polio outbreaks and events, last 6 months*
Isolates from environmental samples only included for countries of the Eastern Mediterranean Region
Endemic WPV and cVDPV2 co-circulation
cVDPV2 outbreak
cVDPV2 event
cVDPV1 Outbreak
Other countries of the Eastern Mediterranean Region
Countries not in the Eastern Mediterranean Region
Source:
Environment
Human (AFP)
Wild cVDPV1 cVDPV2 VDPV2

4. • Regional Committee resolution, 2020
• Established Regional Subcommittee
• Regional ownership of challenges & solutions
• Strong outbreak response by Member States
• Highest-level commitment in Pakistan
– Polio Oversight Board visit, engagement of Prime
Minister and provincial leadership
• Regional and global support for health and
humanitarian needs in Afghanistan
– Visit by Director-General and Regional Director
Regional response

5. Opportunities and risks
• Afghanistan and Pakistan
– Unprecedented epidemiological opportunity to stop polio
– Risk of resurgence in Afghanistan and parts of Pakistan
• Sudan cVDPV2
– May have stopped the outbreak, cross-border risks remain
• Somalia cVDPV2
– Gradually improving access, risk of persistence and spread
• Egypt cVDPV2
– Strong national response, residual risk of spread
• Yemen cVDPV1
– Overall strong response, risk of persistence in Saadah

6. • The Seventy-first World Health Assembly endorsed the Strategic Action Plan on Polio Transition
• Regional Steering Committee on Polio Transition overseeing transition in 6 priority countries
• Carefully balancing eradication and transition through cross-programmatic integration
• Focus on immunization, integrated surveillance, emergency response systems, essential polio functions
• The Integrated Public Health Teams approach endorsed as an interim measure
• National Polio Transition plans in all 6 countries: Need to commence implementation in next biennium
Iraq Syrian Arab
Republic
Libya
Sudan Somalia Yemen
Ensuring polio assets have sustainable
impact – Polio Transition