POLIO TRANSMISSION • One new wild poliovirus (WPV1) case was reported in May from Shahwalikot district of Kandahar province. • 4 WPV1 positive environmental samples were reported in May 2018: 2 from Nan- garhar, 1 from Kunar and 1 from kandahar province, bringing the total number of positive samples to 19 to date in 2018. AFGHANISTAN MAY 2018 AFP AND ENVIRONMENTAL POLIO SNAPSHOT SURVEILLANCE • 231 acute flaccid paralysis (AFP) cases (108 girls and 123 boys) were reported in May. Overall in 2018, 1,420 AFP cases have been reported, of which 1,247 have been discarded as “non-polio AFP” and 165 cases are pending classification. 1 8 WPV CASES IN TOTAL WPV • Non-polio AFP rate is 17, stool adequacy APRIL CASES IN 2018 Jawzjan Balkh Kunduz Takhar above 95%, and non-polio enterovirus Badakhshan rate is above 14% at the national level. In all regions non-polio AFP rate is above 13, Samangan stool adequacy above 89%, and non-polio Faryab Baghlan GAZIABAD district 4 Sar-e-Pul Panjsher enterovirus rate is ranging from 9 to 20%. POSITIVE ENVIRONMENT Nuristan Badghis 2 WPV Bamyan Parwan SAMPLES IN APRIL Kunar SUPPLEMENTARY IMMUNIZATION Kabul Wardak Hirat Ghor Nangarhar KAMA district ACTIVITIES Logar 1 WPV Daykundi Paktya • A National immunization days campaign Ghazni 9,9 m Khost was conducted on 7-11 May. It targeted CHILDREN VACCINATED DURING around 9.9 million children under the age Uruzgan NATIONAL IMMUNIZATION DAYS of 5 years with OPV in 399 districts of 34 Farah Paktika provinces. Zabul SHAHWALIKOT district COMPLEMENTARY 457 3 WPV VACCINATION ACTIVITIES PERMANENT TRANSIT TEAMS Hilmand Kandahar Nimroz • 14 cross-border vaccination points, 39 SPIN BOLDAK district cross-border teams and 457 permanent 1 WPV transit teams (PTTs) were operational 14 across Afghanistan during May 2018. CROSS-BORDER VACCINATION POINTS • Permanent transit teams vaccinated KHAKREZ district 1,108,591 children against polio and cross- 1 WPV border teams vaccinated 78,075 children in May. 4 78,000 4.0 FRONTLINE WORKERS Cases in 2018 • A total of 2,594 children under age of 3.5 33 10 were vaccinated with OPV and 1,562 (Overall 13.2% female: 42.7% of urban work- 3.0 Cases in May with IPV by teams in UNHCR repatriation ers,4.5% of rural) 2.5 2 22 centers and IOM sites receiving returnees 2.0 and refugees from Pakistan and Iran. 1 1.5 1 11 11

• In compliance with International Health 1.0 0 0 0 Regulations (IHR), 10,172 international 0.5 2017 00 0 2018 travelers were vaccinated during May. 11,9 m 0.0 DOSES OF VACCINE GIVEN Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar April May Data as of 31 May 2018 WILD POLIOVIRUS CASE COUNT 2017-2018 New study looks at reasons behind refusals

Despite overall progress, refusals remain a risk for polio eradication. In April and May, UNICEF studied the reasons behind refusing the polio vaccine in southern refusals Afghanistan. The data shows that key reasons for most were misperceptions, including the vaccine making children behave badly or even killing them, making them sick, and the vaccine being an American conspiracy in addition to objection by influencers. The findings will lead to changes in the content Influential scholar supports polio of frontline worker training, tailored delivery channels and eradication messages for mass communications.

Molvi Yaseen Fahim, one of the most influential religious scholars in Afghanistan, has a large following in high-risk areas and on the Afghanistan/Pakistan border, where the polio virus continues to be a threat. Previously, he did not even vaccinate his own children, but after several high-level meetings, he has agreed to become an ambassador for the programme and to promote polio eradication on radio and TV. This is a major achievement, and will help the programme in building trust around vaccination. 26 21,198 7,000 medical doctors children were full-time social trained on polio in vaccinated by social mobilisers 346 PIECES OF NATIONAL May. mobilizers after the reached families EARNED MEDIA COVERAGE campaign, out of a total with life-saving 30% 42,780 missed children. information about are women TOP HEADLINES IN MEDIA: polio. • Paktika: Media having positive effect in polio awareness campaigns • Aryana Saeed’s message on polio vaccine • Fresh positive polio case registered in Kandahar

/WHOAfghanistan UNICEF WHO @UNICEFAfg www.unicef.org/afghanistan Melissa Corkum Dr. Hemant Shukla /poliofreeafghanistan Polio-Free Afghanistan poliofreeafghanistan @WHOAfghanistan www.emro.who.int/afg [email protected] [email protected] /afghanistanunicef