The Technical Advisory Group (TAG) on polio eradication convened in Kabul on 19 and 20 February to review Afghanistan’s modified strategy for optimizing site-to-site vaccination campaigns and the challenges in interrupting wild poliovirus (WPV1) transmission. This marked the first in-country TAG meeting in seven years, highlighting the urgency of protecting hard-won gains and addressing ongoing risks. TAG welcomed the strong commitment of the Honorable Minister of Public Health, national leadership, and the entire Afghanistan polio eradication team.
TAG endorsed the programme’s ‘Strategic Reset’ to optimize site-to-site vaccination while stressing the need for stronger leadership, community acceptance, and broad government engagement. The group highlighted the importance of bringing vaccination services closer to communities, tracking and reducing missed children, and encouraging families to access vaccination sites through better community engagement. TAG also urged the full mobilization of government institutions to provide administrative and political support, while leveraging polio assets to strengthen routine immunization in high-risk areas.
Progress and challenges
Afghanistan remains one of the last two polio-endemic countries, with WPV1 transmission persisting in the southern corridor, a key epidemiological route where population movement between Afghanistan’s southern provinces and neighboring Pakistan continues to facilitate virus spread.
However, encouraging progress has been made in the eastern region, where sustained efforts have reduced cases and environmental detections. TAG highlighted this as a critical opportunity to stop endemic transmission in the East while calling for urgent measures to contain the outbreak in the South and prevent further spread.
The shift from house-to-house to site-to-site vaccination has increased the number of missed children, particularly in high-risk areas. Population movement, operational constraints, and limited community engagement have also posed challenges. TAG emphasized the need for stronger local leadership, consistent programme implementation across all provinces, and measures to prevent disruptions by local authorities.
TAG’s key recommendations
To ensure progress, TAG set clear epidemiological and operational targets. By mid-2025, the goal is to eliminate persistent virus lineages in the East, prevent new WPV1 cases in the East and South Regions, achieve a decline in environmental detections in the South, and prevent local transmission in other parts of the country.
Immediate actions in the South include full engagement of provincial and district governors, public health leaders, and religious figures to create an enabling environment. Community-based mobilization should track and reduce missed children, and a six-month plan to introduce ‘Pluses’ (such as soap and diapers) should be implemented to improve vaccine uptake. Additionally, vaccination campaigns must improve to ensure at least 80% of surveyed areas meet quality standards by June 2025.
A critical moment for eradication
Despite the challenges, Afghanistan has a unique opportunity to end polio transmission by the end of 2025. However, success hinges on strong national and provincial leadership, sustained government commitment, and full coordination with regional partners, particularly Pakistan. TAG called for an ‘All of Government and All of Society’ approach to ensure uniform support and prevent funding shortages from undermining progress.
With continued effort and commitment, Afghanistan can move closer to a polio-free future. TAG urged all stakeholders to act decisively in this critical window of opportunity to protect every child from polio once and for all.
