U.N. agencies will launch a nationwide effort next month to vaccinate children in Afghanistan against polio with the permission of the Taliban, the United Nations announced Monday.
The U.N. said that the Taliban leadership had also agreed to a second nationwide polio vaccination campaign, to be synchronized with neighboring Pakistan’s immunization drive in December.
Multiple doses of the oral vaccine “offer the best protection,” Dapeng Luo, the World Health Organization’s representative in Afghanistan, said in the statement. He called the development “an extremely important step in the right direction.”
“This decision will allow us to make a giant stride in the efforts to eradicate polio,” said Hervé Ludovic De Lys, UNICEF’s representative in Afghanistan. “To eliminate polio completely, every child in every household across Afghanistan must be vaccinated, and with our partners, this is what we are setting out to do.”
Polio is a contagious viral illness that can cause paralysis or death in the most serious cases. It affects mainly young children. The virus has been nearly eradicated worldwide in recent decades, and Africa was declared free of wild polio last year — leaving Afghanistan and Pakistan as the only remaining places with the wild virus.
Poor roads and infrastructure have posed challenges to vaccine delivery in Afghanistan in the past. The ravages of war and vaccine hesitancy, exacerbated by the Taliban’s intimidation tactics, also hampered the ability of public health workers to immunize millions of Afghan children.
U.N. agencies launched childhood immunization campaigns across Afghanistan after the Taliban was overthrown in 2001. As the group regained control of parts of Afghanistan in recent years, it banned door-to-door visits by polio workers, in part because it feared that these visits were being used for intelligence gathering and military operations.
In 2011, the CIA used a fake hepatitis B vaccination project in Pakistan to collect information about al-Qaeda leader Osama bin Laden ahead of his killing. Public health experts argued that this significantly set back public trust in vaccination drives.
The coronavirus pandemic also fueled a rise in polio cases in Afghanistan as accessing remote areas became more difficult. The Afghan Health Ministry recorded 56 polio cases in 2020, up from 29 in 2019, the New York Times reported.
Meanwhile, polio vaccination workers faced violence from armed groups. Three female polio workers were fatally shot in March in eastern Afghanistan in a killing that went unclaimed. (The Taliban denied carrying out the attack.) Several more health workers carrying out polio vaccinations in Nangahar province were killed in attacks in June.
Only one case of the wild virus has been reported in 2021, according to UNICEF, so “Afghanistan has an extraordinary opportunity to eradicate polio.”
A critical boon: In the coronavirus era, the Taliban seems to have changed its tune on vaccination drives. The group announced in January that it would support the U.N.-backed coronavirus vaccination campaign in Afghanistan, which began in February. Monday’s announcement about its backing of the polio vaccination drive marks another sign that the group is easing its opposition to vaccination campaigns.
The Taliban has agreed to provide security for health workers and “expressed their commitment for the inclusion of female frontline workers,” UNICEF said.
With the cessation of fighting in Afghanistan and greater cooperation from the Taliban, U.N. agencies will be able to reach more than 3.3 million children who were previously inaccessible, UNICEF said.
The Taliban has also signed off in recent weeks on measles and coronavirus vaccination campaigns. Coronavirus vaccinations dropped precipitously after the Taliban’s takeover of Kabul in August.
Still, major challenges to the polio vaccination effort remain, including hesitancy among the general public, the threat of attacks by the Islamic State militant group and a health system weakened since the Taliban takeover.
Gaps between the promises of Taliban leadership and implementation on the ground could pose another obstacle, said Karl Blanchet, a University of Geneva professor and director of the Geneva Center of Humanitarian Studies.
“Even if the government is talking with one voice, I do think locally the vaccinators are going to meet Taliban leaders who have different views on vaccination,” he said.
Blanchet added that the WHO and UNICEF, which have run immunization campaigns in Afghanistan for years and have a history of negotiating with the Taliban, are uniquely positioned to carry out the vaccination drive. If it succeeds, he said, the campaign could provide a new model for health-care delivery in Afghanistan.
“They have a lot of legitimacy in the country,” he said of the U.N. agencies.