The number of polio cases reported in Afghanistan so far this year is up sharply over figures tallied for the whole of 2005. As VOA's George Dwyer reports, nearly all of the new cases occurred in the country's southern provinces, scene of some of the fiercest armed violence the country has witnessed in years.
Speaking before the United Nations General Assembly earlier this month (in September 2006), Afghanistan's President Hamid Karzai addressed many of the challenges facing his country - including a troubling new development. "It is also sobering to know that polio - the children's disease - increased from 4 cases in 2005 to 27 cases this year."
That disturbing trend is being linked to the fact that many Afghan children have not received scheduled vaccinations in recent months. Widespread disruption of medical service - particularly in the country's war torn south - is considered the most likely cause.
U.S. Agency for International Development Polio Eradication Director Ellyn Ogden says that, except for a single case reported in Western Afghanistan, all the others were found in the southern provinces where violence has disrupted communications, transportation, and the flow of supplies needed to prevent the disease. "Actually the number of cases has gone up 6 times what it was in 2005.
It is really not a question of availability of supply. It is more how do we access children, how do we have safe passage for vaccinators, and how do we make sure that the people on the ground can reach every child under age 5 repeatedly with vaccine so that we can stop transmission."
Delivering needed vaccine to children in developing nations is challenging under the best of circumstances says UNICEF Immunization Officer Francois Gasse.
"They live too far away from any immunization sites, they cannot get access to the immunization services and they cannot get access to immunization services because there are minority groups living in remote areas with very limited road infrastructure."
Twenty-seven cases of polio in a nation of nearly 30 million people - is that a serious problem? Ogden says it is serious. "It is serious because at this point in the eradication program any ongoing transmission is a threat to the global program. It is also a threat to the surrounding countries, most immediately around Afghanistan, who have been polio free for quite a while. Nobody wants to see an importation."
Ogden says that in order to halt the spread of polio routine early age immunization is essential. To support that effort, the Untied States contributes about $2 million a year to funding polio eradication activities in Afghanistan. Among those activities are so-called "Days of Tranquility."
Ogden adds, "President Karzai has set up a panel to try to work with local governors and to come up with local solutions. We feel that it is in the best interest of everybody to negotiate days of tranquility, or ceasefires, to immunize kids."
Polio typically spreads when unvaccinated children consume food or water tainted by virus contaminated fecal matter. After attacking the nervous system, polio can cause irreversible paralysis, or even death. Nearly 1900 people were stricken with polio worldwide in 2005, down from more than 350,000 before 1988 when the World Health Organization launched a global anti-polio campaign. Today only six countries remain endemic: Niger, Nigeria, Egypt, India, Pakistan, and Afghanistan.