The Kabul Times.
Health Opinion

Third of Afghan children go without polio drops thanks to Taliban’s door-to-door vaccination ban

A long-running Taliban ban on door-to-door polio vaccination teams means that one-in-three Afghan children are still not getting polio drops, creating a vulnerable pool of millions where the virus could run riot.
Three years after the militants banned house-to-house health teams operating in their territory, the edict remains in force and means around 3.4 million under-fives are missed in each vaccination drive.
The lack of access has become the biggest problem for the long-running global campaign to stamp out the crippling poliovirus. The campaign is also having to navigate a patchwork of territorial control and shifting front lines, as foreign troops leave Afghanistan and fighting intensifies.
Hopes that the Taliban would allow vaccinators to at least administer drops at central sites under their control, such as in local mosques, have so far not been realized.
The Taliban’s military leadership enacted the ban on door-to-door vaccination teams in May 2018 after alleging health workers were spies gathering intelligence for air strikes and special forces raids. The insurgents claimed commanders had been targeted shortly after their areas had been visited by vaccination teams.
The ban largely affects southern and eastern Afghanistan and means that while the campaign tries to reach 10 million children during every national vaccination sweep, currently some 3.4 million are being missed. Assurances that the Afghan polio campaign is purely medical have not changed the insurgents’ minds.
Godwin Mindra, acting polio chief for UNICEF in Afghanistan, said the door-to-door approach was the mainstay of polio vaccination and enabled teams to reach more children.
“The reason we do house-to-house campaigns is we can follow these kids very closely, we can go to homes with newborns, we can go to homes where there are sick kids who are not able to go to a health facility, we can go to homes where there are visiting children,” he told the Telegraph.
He went on: “Unfortunately, in areas where we have had bans by the Taliban, since May of 2018, these kids have repeatedly not received polio vaccine. That means their immunity to the virus has lowered. “For every three children we are targeting, we are missing one. That’s significant and if we continue with the critical mass of children who are missed, we have a risk that it will be hard for us to eliminate in terms of getting the virus circulation stopped,” he said.
Preliminary figures from the most recent campaign in March showed the number of children out of reach was rising, he said. Months of negotiation with the Taliban leadership have yet to remove the block. International bodies including the United Nations children’s body, UNICEF, have met leaders from the Taliban’s Doha political office.
Last year hopes were raised that the militants would allow teams to vaccinate at central points in Taliban territory, but the final go-ahead has not yet been given. Epidemiologists say such a campaign, where babies and toddlers would for example be taken to the local mosque, would reach more children, but still not enough to eradicate poliovirus.
An effective mosque-to-mosque campaign may reach around four-fifths of children, but levels must reach closer to 95 per cent to stamp out the poliovirus. A Taliban figure familiar with the negotiations told the Telegraph that they did not trust the polio vaccination teams, who were suspected of using smartphones to gather information and asking questions unrelated to polio.
Another senior Taliban figure said: “At the movement no decision has been made. The polio door to door campaign has been absolutely banded by top leadership.”
Dr Mohammad Rashidi, Afghanistan’s national polio coordinator, said: “The problem has been the same for three years, there has been a ban on house-to-house vaccinations in the south and east.
“Right now through our international partners we are trying to get in contact with them and with local community leaders that they should allow us. We are in negotiations.” Afghanistan and neighboring Pakistan are the only two countries where the wild strain of the poliovirus remains endemic. A three-decade-long worldwide campaign to stamp out the childhood scourge has come tantalizingly close to ending a disease which caused 350,000 cases per year in the late 1980s. Afghanistan suffered 56 cases in 2020 and Pakistan suffered 84.
The authors are Ben Farmer and Sami Yousafzai and this article previously appeared in the Telegraph.

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The Kabul Times.