Afghanistan is intensifying efforts to eradicate polio by the end of next year, but security remains a major challenge especially in the southern provinces where the virus is localized, says a health expert.
“We are focusing on four priority areas - improving access to children in conflict-affected areas, maintaining a polio-free status in areas that are now virus-free, focusing on mobile groups especially repatriated refugees and displaced populations, and maintaining close coordination with Pakistan to avoid the ping-pong movement of the virus across the border,” said Arshad Quddus, head of the World Health Organization (WHO) polio programme in Afghanistan.
Polio remains endemic in Pakistan, Afghanistan, Nigeria and Chad, according to WHO. So far this year, 13 cases have been reported in seven districts in Kandahar, Helmand and Farah provinces. Most were children under two.
According to the Health Ministry, focusing on the southern region involves concerted efforts to reach all children in conflict-affected areas. Priority is also given to immunization in southern and eastern border regions, it said in a statement.
Government data shows that 85 percent of the population now live in polio-free areas, but the virus is still circulating in 13 districts, including the seven where recent cases have been detected.
|From 2001, we shifted from a centre-based strategy to house-to-house campaigns with well defined service delivery structures. Since then, there has been success.|
Insecurity in the polio-affected districts, according to health workers in Kabul, makes supervision and monitoring of eradication campaigns difficult. People in these areas also tend to have low literacy rates, poor hygiene practices and low awareness of the benefits of vaccination.
“From 2001, we shifted from a centre-based strategy to house-to-house campaigns with well-defined service delivery structures. Since then, there has been success… Experts believe that Afghanistan is on the brink of eradication,” Quddus said in Kabul.
But in May, thousands of children missed out on vaccination in the southern region, especially Zabul Province, because anti-government elements refused to allow the campaign, according to WHO’s National Surveillance Cell.
In June, another 101,085 children under five could not be reached in the same region due to “insecurity and prevention of Taliban in the areas they control”, according to the Surveillance Cell.
Despite the setbacks, officials are upbeat ahead of another nationwide campaign to be launched on 17 September by President Hamid Karzai. Targeting 7.8 million children, the campaign has enlisted 55,000 personnel and volunteers.
“It is a community-based approach because of security and difficult terrain,” Quddus explained. “Mullahs, teachers and community elders are all involved. We also maintain a highly sensitive surveillance system that can detect children with paralysis even in places where we cannot reach.”
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