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April 2023, Volume 73, Issue 4

Student's Corner

The Challenge of Eradicating Polio from Afghanistan

Mati Ur Rehman  ( 4th Year MBBS Student, Dow Medical College, Karachi, Pakistan. )

Dear Madam, Polio, a crippling disease that attacks the spinal cord and brain of the infected individual and may result in paralysis remains endemic in Afghanistan. To avoid polio outbreaks, we need mass polio vaccination campaigns that over the years have resulted in a >99% decrease in the total number of cases reported worldwide from an estimated 350,000 in 1988 to 33 reported in 2018.1 However, Afghanistan and parts of Pakistan, like North Waziristan, which borders Afghanistan continue to report positive cases. In 2022, eight new cases were reported in North Waziristan.2

Due to the circumstances surrounding Afghanistan, particularly the political instability, many children younger than five years could not acquire the polio vaccination and this was particularly significant in districts that were already under the influence of the then anti-government forces,3 which now have complete nationwide control.

With their anti-vaccination sentiment, the then antigovernment forces have always spread myths, something that most people in their controlled areas used to trust that vaccines are a conspiracy by the west to sterilize Muslim children.4 Now, after their takeover of Kabul, they’re ruling the entire country. Therefore, the vaccine refusal rates may go high - resulting in polio outbreaks. The fear of an outbreak has become more critical because of the recent earthquake that has left people to scramble for clean water and food.4 because polio spreads via highly contaminated water or food.

For Afghanistan and for the region, if we are to curb the spread of the virus and if we are to eradicate the virus, resumption of a nationwide vaccination programme with a close eye on fake markings because fake markings along with refusals to get vaccinated were the two most important reasons of recent outbreaks.2

Moreover, the government in Afghanistan, now in power, must ensure the safety of the polio workers because, in the past, so many vaccinators have been assassinated and kidnapped in order to stop the polio campaign.5

Lastly, because of conflicts and myths, eradication of polio remains a challenge in Afghanistan, and the Taliban as a government has a huge responsibility to play. They need to issue fatwas in favor of vaccines and educate people. They must ensure the safety of polio workers and from here to make sure that they reign in horses of their imagination before opening an anti-vaccine front.


Disclaimer: None.


Conflict of interest: None.


Funding disclosure: None.




Submission completion date: 29-07-2022


Acceptance date: 09-11-2022




1.      “Poliomyelitis.” [Online] [Cited 2022 Oct 20]. Available from: URL: sheets/detail/poliomyelitis.

2.      “Polio outbreak in Pakistan worsens as eighth child reported paralysed | Global development The Guardian.” [Online] [Cited 2020 Oct 20]. Available from: URL: development/2022/jun/07/polio-outbreak-in-Pakistan-worsens-as- eighth-child-reported-paralysed?s=08

3.      Sadigh KS, Akbar IE, Wadood MZ, Shukla H, Jorba J, Chaudhury S, et al. Progress Toward Poliomyelitis Eradication - Afghanistan, January 2020-November 2021. MMWR Morb Mortal Wkly Rep 2022; 71: 85-9.

4.      “Afghan earthquake survivors lack food, shelter as aid trickles in | Earthquakes News AlJazeera.”[Online] [Cited 2020 Oct 20]. Available from: URL:

5.      “Afghanistan Hit by New Wave of Polio Cases Amid Coronavirus Pandemic.” [Online] [Cited 2020 Oct 20]. Available from: URL:

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: