Update on Polio Eradication in Afghanistan

Najibullah Safi, MD, MSc. HPMDirector General, Preventive MedicinesMinistry of Public Health, Afghanistan

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

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Risk categorization of districts, 2016

2

Confirmed Polio cases 2016

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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

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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)

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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

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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

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Thanks

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