The ambitious goal of eradicating wild-type poliovirus type-1 (WPV1) by 2026 appears to have become tougher
WPV1, which is endemic only in Pakistan and Afghanistan, is showing signs of a resurgence since 2023.
The concern about WPV1 is not limited to the number of cases in children.
The circulation of the virus in the environment is seen to be rising, and, positive environmental samples have been increasingly collected in Pakistan, in 2023 and till early June this year, from cities which have been historical reservoirs for the virus.
According to the World Health Organization, the presence of positive environmental samples in “epidemiologically critical areas and historical reservoirs” represents a significant risk to the gains made in the past.
Rising positive environmental samples are a reflection of polio campaigns not really achieving their desired coverage; fake finger marking sans vaccination is a persisting problem
The situation in Pakistan appears worse than it is in Afghanistan with the actual spread of WPV1 seen “predominantly in Afghanistan in 2022 now being detected in Pakistan in 2023 and 2024”.
There is also the grave risk of international spread from Pakistan, particularly to Afghanistan.
With over 0.5 million Afghan refugees forced to leave Pakistan, and an estimated 0.8 million to be evicted soon, there is an increased risk of cross-border spread of the virus.
There is a large pool of unvaccinated and under-immunised children in southern Afghanistan, increasing the risk that returning refugees can pose
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