The meeting of the Technical Advisory Group (Tag) on Polio Eradication for Afghanistan and Pakistan, the last two countries where the poliovirus is endemic, concluded in Doha. Over the four-day meeting, decisive steps were taken to stop the transmission of the wild poliovirus in both countries.

This comes despite ongoing challenges such as the rise in detection of wild poliovirus type 1 in sewage in Afghanistan and Pakistan, ongoing issues of insecurity, vaccine hesitancy, community boycotts of polio vaccination campaigns, and low routine immunisation rates among high-risk populations. Under these circumstances, the Tag experts conducted an in-depth review of polio programmes in both countries, emphasising the urgent and diligent work required to eradicate polio throughout 2024.

After thorough analysis and evaluation, the Tag concluded that poliovirus transmission could be halted if their recommendations are fully and immediately implemented. Key among these recommendations is the need to reach unvaccinated children and provide them with polio vaccines to close the critical immunity gaps that allow virus transmission.

The Tag also recommended that Afghanistan and Pakistan coordinate their efforts in the border areas known as virus corridors. This is vital given the risk of transmission in historic polio-reservoirs being re-established. Joint efforts will also maintain a unified approach, supporting all polio workforce members.

The Tag experts reiterated that strong and consistent government leadership and engagement at all levels are essential for success. Eradicating polio will require improving the quality and performance of programmes and their coordination at all levels.

HE Dr Hanan Mohamed Al Kuwari, Minister of Public Health and Co-Chair of the Regional Subcommittee on Polio Eradication and Outbreaks at the WHO Eastern Mediterranean Regional Office reaffirmed Qatar's steadfast commitment to supporting regional efforts to ensure a polio-free world for future generations.

In a speech delivered on her behalf by Dr Hamad Eid Al Romaihi, Director of Health Protection and Communicable Disease Control at the Ministry of Public Health, Her Excellency, stated, "The eradication of polio is not merely a public health goal; it is a testament to our collective determination to safeguard the health and well-being of every child, irrespective of their geographical location or socioeconomic status."

Dr Hanan Balkhy, WHO Regional Director for the Eastern Mediterranean, addressed the meeting virtually. In her address, Dr Balkhy urged all stakeholders to dig deep to address the remaining challenges and identify optimal solutions with the guidance of the TAG members.

Dr Balkhy stated, "The key to success lies in reaching all children in Afghanistan and Pakistan during polio campaigns We know that the virus is tenacious and unsparing. Recent detections outside the endemic zone in both Afghanistan and Pakistan underscore the urgency needed to respond to this virus, particularly as it is now surviving largely in groups of migrant populations."

Dr Jean-Marc Olivé, Chair of the Tag, acknowledged that both programmes in Afghanistan and Pakistan have the human, technical, and financial resources to eradicate polio. He highlighted initiatives demonstrating that the programmes fully understand the complex challenges and are addressing them with innovation and renewed energy. However, he warned that inaction would be catastrophic for current eradication efforts, saying, "Interruption remains feasible; however, there is an imminent risk of historic reservoirs becoming endemic again. Both the Afghanistan and Pakistan polio programmes have to stay ahead of the virus if we are to succeed."

The Tag recommendations serve as a road map to reinforce polio eradication efforts in Afghanistan and Pakistan and guide international assistance and financing to achieve a polio-free world. Sustained collaboration, unwavering commitment and innovative solutions will be pivotal in overcoming the final barriers to polio eradication.

The Tag will prepare a full report detailing all its findings and recommendations. The group will meet again in November 2024 to review progress in both countries.
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