Seventh meeting of the Regional Subcommittee for Polio Eradication and Outbreaks
28 February 2023

Noting the progress achieved globally in eradicating wild poliovirus transmission since 1988, with virus transmission at the start of 2022 restricted to just two countries – Pakistan and Afghanistan; 

Noting that detection of wild poliovirus cases in both countries is at the lowest levels in history, with five cases reported in Afghanistan and one in Pakistan since January 2021, which presents a unique epidemiological window of opportunity to eradicate wild poliovirus once and for all;

Underscoring that the recent isolation of wild poliovirus from environmental samples in Pakistan and children in Afghanistan confirms continued poliovirus circulation in this joint, cross-border epidemiological block; 

Highlighting that the current favourable epidemiological situation is thanks to sustained commitment by leaders at all levels, notably by political leaders, community and religious leaders, civil society (especially Rotary International and individual Rotarians) and health workers at the forefront; 

Underscoring the resumption of nationwide polio immunization campaigns in Afghanistan in late 2021 after a gap of  more than three years; 

Noting ongoing vaccination coverage gaps in key high-risk areas and among high-risk population groups in both countries, and concerned about the lack of house-to house-vaccination in key polio endemic areas of Afghanistan; 

Recalling that the spread of poliovirus constitutes a Public Health Emergency of International Concern under the International Health Regulations (2005); 

Noting with concern the increasing humanitarian needs, economic crisis, risk of disruption of primary health services through the Sehatmandi Programme and limited hospital care in Afghanistan, all of which can jeopardize the integrity of childhood immunization and polio eradication in the country; 

Noting that UNICEF and WHO have restored Sehatmandi programme and have received financing to sustain delivery of health services through June 2022; 

We, the Eastern Mediterranean Regional Subcommittee on Polio Eradication and Outbreaks:

DECLARE:

1. The ongoing circulation of wild poliovirus in Afghanistan and Pakistan to be a Regional Public Health Emergency; and, 

COMMIT TO: 

2. Enhancing engagement and support by all political, community and civil society leaders and sectors at all levels, needed to fully resolve the afore-declared Regional Public Health Emergency; 

3. Supporting the coordination of activities across borders to ensure synchronized and cross-border response activities, including in Pakistan and Afghanistan. 

REQUEST:  

4. The international donor and development community to provide the much-needed humanitarian relief and financing to sustain and expand health services to the people of Afghanistan; 

5. The sustained and strengthened commitment by all leaders at all levels in Afghanistan and Pakistan, to capitalise on the current epidemiological window of opportunity through intensified eradication efforts, including by continuing to increase access to all children in previously inaccessible areas, implementing area-specific emergency action plans in known under-performing areas and responding to the detection of any new viruses from any source (be it from an acute flaccid paralysis case or environmental sample) as an emergency; 

6. All authorities in Afghanistan to facilitate resumption of house-to-house vaccination in all areas to ensure delivery of vaccine to the youngest and most vulnerable children who are not being reached by mosque-to-mosque only vaccination and who must be vaccinated to capitalize on the current opportunity across both countries, and 

7. The Regional Director to continue his tremendous leadership and support to Afghanistan and Pakistan in their efforts to eradicate polio, including by advocating for all necessary financial and technical support, reviewing progress, plan corrective actions as necessary, and regularly informing Member States of the afore-mentioned and of any eventual further action required, through the World Health Organization Executive Board, World Health Assembly and Regional Committee mechanisms.