Progress towards eradicating poliomyelitis in Afghanistan and Pakistan, 2009
Afghanistan, India, Nigeria and Pakistan are the 4 countries where transmission of indigenous wild poliovirus (WPV) has never been interrupted. Afghanistan and Pakistan, which form a single epidemiological block, continued intense eradication efforts during 2009. Most of Afghanistan remained free of WPV, and large parts of Pakistan did not report cases; however, WPV transmission persisted in known virus reservoirs in both countries.
In Afghanistan, endemic WPV continued to circulate in 2009 in the conflict-affected Southern Region. More than half of all cases in Pakistan were reported from the main endemic reservoir in conflict-affected parts of the North-West Frontier Province (NWFP) and the Federally Administered Tribal Areas (FATA). Not only did reservoirs persist in both countries owing to limitations in access imposed by a lack of security, but WPV also continued to circulate in accessible areas of Pakistan where managerial and operational problems again affected the quality of supplementary immunization activities (SIAs).
These areas included parts of southern Punjab Province, the Quetta area of Balochistan Province, and parts of Sindh Province and Karachi city.