regional vaccination campaigns are to ensure that all children under five in Afghanistan (some 5.7 million children) are protected against infection with poliovirus. In particular, children in high-risk areas, in inaccessible regions and in regions along the border to Pakistan are to be vaccinated.

Measures and Results

The Afghan government has included the eradication of polio in the national Health for All Afghans programme and has embedded it in a national emergency plan. The Ministry of Public Health regularly updates and implements this plan in conjunction with WHO and UNICEF. The polio programme aims to use nationwide and regional vaccination campaigns to immunise every child in the country using the oral polio vaccine, thus halting the transmission of the virus. Special efforts are made to identify those who have missed vaccinations and to carry out immunisations in high-risk areas, inaccessible regions and in areas along the border to Pakistan. Germany is supporting implementation of the national emergency plan with a contribu-tion of 50 million euros over four programme phases.

Context

Since 1988, the Global Polio Eradication Initiative (GPEI) has managed to reduce the number of reported new cases of polio by 99 per cent, from 350,000. In 2018, only 33 new infections were reported around the world, 21 in Afghanistan and 12 in Pakistan. During the first half of 2019, 42 new cases were reported worldwide: 32 in Pakistan and 10 in Afghanistan. Afghanistan and Pakistan thus remain the only two countries where the poliovirus has not yet been eradicated. The tense security situation in Afghanistan and its topography are signi-ficant obstacles to winning the fight against polio.

Objective

The programme supports the World Health Organization (WHO) und the United Nations International Children’s Fund (UNICEF) in eradicating polio in Afghanistan. Large-scale nationwide and

The Fight Against Polio

German Cooperation with Afghanistan

www.gc-afg.de

OverviewProgramme Polio Control Programme

Commissioned by

German Federal Ministry for Economic Cooperation and Development (BMZ)

Partners Afghan Ministry of Finance (MoF), Afghan Ministry of Public Health (MoPH), World Health Organization (WHO), United Nations International Children’s Fund (UNICEF)

Implementing organisation

KfW Development Bank

Provinces Nationwide

Programme objective

To eradicate the poliovirus in Afghanistan

Overall, more than 130 million doses of oral polio vaccine were administered to children under the age of five in 2015 and 2016

Overall, around 60 million doses of vaccine were administered to children under the age of five in 2016. In addition to these, eleven million doses were administered at border stations and, for the first time, half a million doses in 34 high-risk districts.

Programme phases III and IV (2017–2020)

The third and fourth phases of the Polio Control Programme in Afghanistan are running from 2017 to 2020. Reaching the ‘missed’ children – those who could not be immunised dur-ing the annual rounds of immunisation – remains a challenge, especially in the border region close to Pakistan. The main reason for this is the fragile security situation in the eastern and north-eastern provinces.

An integral part of all programme phases is the monitoring of live polio infections. All cases of polio are recorded, and samples from their environment are collected and tested in order to identify the sources of infection.

Employment for the local population

The Polio Control Programme provides extensive employment opportunities for the local population. An average of around 70,000 relief workers are employed across Afghanistan to carry out vaccinations, to monitor the cases of disease and to collect wastewater samples. In addition, the UNICEF social mobilisa-tion campaigns employ up to 7,000 social mobilisers and 7,000 other staff, almost a third of whom are women.

Programme phase I (2015)

In 2015 the programme supported WHO in carrying out mass vaccination campaigns. In addition to four national and nine regional vaccination campaigns, eleven so-called case-response campaigns were carried out in regions where the virus was sus-pected to be endemic. Other measures targeted nomadic groups and people living in previously inaccessible regions. Support for WHO was also provided with respect to case monitoring and testing wastewater samples.

Overall, around 60 million doses of the oral polio vaccine were administered to children, some eight million of these at border stations. During each of the nationwide vaccination campaigns up to 9.1 million children under the age of five were immunised, while up to 3.7 million children were immunised during each of the regional campaigns, with some children receiving more than one dose.

Programme phase II (2016/17)

The vaccination campaigns and monitoring activities were continued in 2016 and 2017. UNICEF provided the funds for the procurement of vaccines and cold-chain appliances in particular. Besides several nationwide and regional vaccination campaigns, including campaigns in high-risk areas, so-called mop-up cam-paigns were carried out from house to house in order to immu-nise children who had previously not been reached. In addition, vaccination campaigns at border points to inaccessible areas were stepped up and emergency operation centres established in order to improve the coordination of the campaigns.

July 2019

Contact:

Dr Ronald SteyerDirector KfW Office Kabul kfw.kabul@kfw.de

Published by:Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbHRegistered offices Bonn and Eschborn, Germanywww.giz.dewww.gc-afg.dePhoto credits: © PEI Afghanistan WHO/Tuuli Hongisto page 1 left | © PEI Afghanistan UNICEF/Celeste Hibbert page 1 right | © PEI Afghanistan WHO/Rada Akbar page 2

Imlemented by:

A volunteer vaccinates a baby | © PEI Afghanistan WHO

An average of around 70,000 relief workers are employed to carry out vaccinations. The UNICEF mobilisation campaigns employ an additional 14,000 people, almost one third of whom are women