The World Health Organization (WHO) convened the 44th meeting of the Emergency Committee on January 14, 2026, to address the escalating cases of poliovirus, specifically wild poliovirus type 1 (WPV1) and circulating vaccine-derived polioviruses (cVDPV), in Afghanistan and Pakistan. The meeting, conducted via video conference, included eight out of nine committee members and an adviser, discussing critical epidemiological data as well as global targets for eradicating polio.
Current Epidemiological Landscape
The committee reviewed data indicating a concerning rise in polio cases. In 2025, a total of 40 WPV1 cases were reported: nine in Afghanistan and 31 in Pakistan, compared to 99 cases in 2024. Since the last meeting on October 1, 2025, nine new WPV1 cases emerged, with five in Afghanistan and four in Pakistan. The regions most affected include southern Afghanistan and various provinces in Pakistan, particularly Khyber Pakhtunkhwa and Sindh.
Environmental surveillance also raised alarms, with 673 WPV1 positive samples reported in 2025, primarily from Pakistan. This highlights the ongoing transmission of poliovirus despite substantial vaccination efforts. The committee noted that border closures between Afghanistan and Pakistan disrupted the transportation of critical surveillance samples, resulting in a backlog and further complicating the epidemiological assessment.
Challenges in Vaccination Campaigns
Both countries have implemented synchronized vaccination campaigns targeting high-risk areas. In 2025, Afghanistan executed two nationwide and five sub-national vaccination rounds. Similarly, Pakistan executed five nationwide campaigns, yet challenges remain. The absence of house-to-house vaccination campaigns since October 2024 due to security concerns has hindered efforts to reach all children. The committee expressed concern that this limitation could lead to further geographic spread of the virus.
Specific operational challenges have also been observed in Pakistan, where an estimated 250,000 children remain unreached in South Khyber Pakhtunkhwa, where WPV1 transmission is most intense. Additionally, recent audits in Karachi revealed discrepancies in campaign data, suggesting that more children are missed than previously reported.
Despite these setbacks, strong political commitment in Pakistan, including direct involvement from the Prime Minister and health officials, has been observed. However, the committee underscored the need for consistent quality in vaccination coverage across districts, particularly in areas experiencing high transmission.
Global Implications and Future Strategies
The committee’s findings resonate beyond the immediate regions of concern. Following a detection of WPV1 in an environmental sample in Hamburg, Germany, the implications of cross-border transmission are now more apparent. Genetic sequencing indicates a direct link to WPV1 found in Afghanistan, emphasizing the global risk of poliovirus importation.
In light of these developments, the committee reiterated that the risk of international spread of both WPV1 and cVDPV remains high. They have advised the WHO Director-General to maintain the designation of a public health emergency of international concern (PHEIC) for the poliovirus situation. This designation underscores the critical importance of maintaining high vaccination coverage and robust disease surveillance globally.
Looking ahead, the committee recommended that both Afghanistan and Pakistan focus on improving vaccination strategies, particularly through house-to-house campaigns where feasible. They also called for enhanced cross-border coordination to address shared epidemiological challenges, especially in light of recent border restrictions.
In conclusion, the ongoing transmission of poliovirus in Afghanistan and Pakistan necessitates immediate and sustained action to avert further spread. The committee’s recommendations highlight the urgent need for high-quality vaccination campaigns and improved access to immunization for vulnerable populations. Failure to address these issues could have far-reaching consequences for global health security.
