Progress toward poliomyelitis eradication--Afghanistan and Pakistan, January 2010-September 2011

Indigenous transmission of wild poliovirus (WPV) has never been interrupted in Afghanistan, Pakistan, India, and Nigeria. Among those countries, Afghanistan and Pakistan represent a common epidemiologic reservoir. This report updates previous reports (1,4) and describes polio eradication activities and progress in Afghanistan and Pakistan during January 2010--September 2011, as of October 31, 2011, and planned activities during 2011--2012 to address challenges to polio eradication. In Afghanistan, WPV transmission during 2010--2011 predominantly occurred in the conflict-affected South Region and the adjacent Farah Province of the West Region. During 2010, 25 WPV cases were confirmed in Afghanistan, compared with 38 in 2009; 42 WPV cases were confirmed during January--September 2011, compared with 19 for the same period in 2010. In Pakistan, WPV transmission during 2010--2011occurred both in conflict-affected, inaccessible areas along the common border with Afghanistan and in accessible areas; 144 WPV cases were confirmed in 2010, compared with 89 in 2009, and 120 WPV cases were confirmed during January--September 2011, compared with 93 during the same period in 2010. In Pakistan, the president launched a National Emergency Action Plan for polio eradication in January 2011, emphasizing the key role and responsibility of political and health-care leaders at the district and subdistrict (union council) levels. Enhanced commitment, management, and oversight by provincial and district authorities will be needed to achieve further progress toward interruption of WPV transmission in Pakistan. Continued efforts also will be needed to enhance the safety of vaccination teams within insecure areas of both countries.