Pakistan and neighboring Afghanistan simultaneously launched fresh vaccination campaigns against polio Monday amid a resurgence in cases in the only two countries globally where the virus continues to be endemic and paralyze children.

The World Health Organization reported 64 polio infections this year: 41 from Pakistan and 23 from Afghanistan, up from six each in both countries in 2023.

Pakistani officials said the weeklong house-to-house nationwide campaign that was rolled out Monday enlists 400,000 polio workers, who aim to vaccinate over 45 million children under five against the paralytic disease.

“This is Pakistan’s third nationwide campaign this year, launched in response to the alarming increase in polio cases across 71 districts,” said Ayesha Raza Farooq, the prime minister’s point-person for polio eradication.

More than half the infections in 2024 are located in southwestern Balochistan province, which sits on the Afghan border and is “facing an intense transmission” of the poliovirus. The southern province of Sindh has recorded 12 cases this year, while other regions in Pakistan, a country of more than 240 million, have reported the remaining cases, according to Pakistan’s polio eradication program.

Anwarul Haq, the coordinator of the National Emergency Operations Center for Polio Eradication, urged parents to cooperate with health teams in protecting their children against the crippling disease, stressing that there is no cure for polio. “With the threat at an all-time high, we must act as one nation to keep our children safe through vaccination,” he stated.

Local and WHO officials attribute the resurgence of poliovirus in Pakistan to vaccine boycotts in rural areas stemming from the false propaganda that these initiatives are a Western plot to sterilize Muslim children.

Additionally, anti-state militants in violence-hit districts bordering Afghanistan occasionally attack vaccinators and their police escorts, suspecting them of spying for the government. The violence has resulted in the deaths of dozens of polio workers and police personnel, including at least two vaccinators and seven police members killed this year.

Afghanistan

Meanwhile, health officials in Taliban-led Afghanistan announced Monday the opening of a three-day polio-vaccination campaign, saying it aims to reach 6.2 million children under five in 16 of the country’s 34 provinces. The target areas are primarily located close to the border with Pakistan.

The latest round of this year’s anti-polio campaign in Afghanistan began after nearly a two-month delay because Taliban authorities abruptly halted house-to-house vaccine deliveries in the southern province of Kandahar without publicly stating any reason. Instead, de facto Afghan authorities stressed the need to conduct vaccinations for children from site to site and mosque to mosque.

In a report released last month, an independent monitoring board of the Global Polio Eradication Initiative believed that the Taliban’s action had stemmed from their “administration’s concerns about covert surveillance activities.” The report quoted Taliban officials as explaining that their leadership is living in Kandahar and has concerns about their security.

Kandahar, regarded as the unofficial capital of Afghanistan under Taliban rule, is where the militant group’s reclusive supreme leader, Hibatullah Akhundzada, resides and governs the country through his decrees based on his strict interpretation of Islam.

The Taliban chief has banned most Afghan women from public and private sector workplaces and barred girls from receiving an education beyond the sixth grade.

WHO officials say eradicating polio in Afghanistan requires comprehensive integration of large migrant populations into the vaccination program. They say it is also crucial to reach out to groups that refuse vaccination and establish a female public health workforce dedicated to the polio initiative to tackle multiple challenges facing polio-eradication efforts in the impoverished country.