The Forty-fourth Meeting of the Polio International Health Regulations (IHR) Emergency Committee took place on January 14, 2026, convened by the Director-General of the World Health Organization (WHO). During this crucial meeting, eight out of nine committee members participated via video conference, discussing the latest epidemiological data regarding wild poliovirus type 1 (WPV1) and circulating vaccine-derived polioviruses (cVDPV). The committee focused on the global targets aiming to interrupt endemic WPV1 transmission by 2026 and stop cVDPV2 outbreaks by 2028, with subsequent plans for certification of WPV1 eradication and cVDPV2 elimination.
The committee received technical updates about the polio situation in several countries, including Afghanistan, Angola, Germany, the Lao People’s Democratic Republic, Namibia, Pakistan and Papua New Guinea. Amendments to the IHR, adopted by the Seventy-seventh World Health Assembly through resolution WHA77.17 in June 2024, became effective on September 19, 2025. These amendments introduced broader poliovirus notification requirements and established a new classification for “pandemic emergency,” enhancing global public health alerts for public health emergencies of international concern (PHEIC).
Current Status of Wild Poliovirus
Since the last Emergency Committee meeting held on October 1, 2025, a total of nine new WPV1 cases have been reported in the endemic countries of Afghanistan (5 cases) and Pakistan (4 cases). As of now, 40 WPV1 cases have been documented in 2025, compared to 99 cases reported throughout 2024. Notably, environmental surveillance has yielded 673 positive WPV1 samples in 2025, including 608 from Pakistan and 64 from Afghanistan, along with one case from Germany. This data indicates a concerning trend, as land border closures between Afghanistan and Pakistan have disrupted the shipment of samples necessary for monitoring and testing, leading to a backlog of untested samples.
The committee expressed alarm regarding the ongoing WPV1 transmission, particularly in southern Afghanistan and across the Khyber Pakhtunkhwa region in Pakistan. Despite the absence of reported cases in Karachi for 2025, environmental samples still indicate active transmission within the city. In Afghanistan, intense transmission is ongoing in the southern region, detected through both acute flaccid paralysis (AFP) cases and environmental surveillance. Encouragingly, WPV1 transmission in the eastern region of Afghanistan has decreased significantly this year, suggesting improvements in population immunity.
Vaccination Campaigns and Challenges
Both Afghanistan and Pakistan are currently implementing synchronized vaccination campaigns aimed at achieving high coverage in core areas. Afghanistan has conducted two nationwide and five sub-national polio vaccination rounds in 2025, while Pakistan has executed five nationwide and one sub-national vaccination campaign within the same timeframe. However, security concerns have hindered house-to-house campaigns in Afghanistan since October 2024, limiting access to many children, particularly younger ones.
The committee noted Pakistan’s strong leadership and commitment to polio eradication, highlighted by the active engagement of the Prime Minister and other high-level officials. Despite reported vaccination coverage being high, the quality of these campaigns at the district level remains inconsistent, especially in critical areas like Quetta Bloc and South Khyber Pakhtunkhwa, where the most intense WPV1 transmission occurs. The committee identified a significant number of unimmunized and under-immunized children, particularly in South KP, where over 250,000 children remain unreached.
International Spread and Future Risks
On November 10, 2025, the Global Polio Eradication Initiative (GPEI) confirmed WPV1 detection in an environmental sample collected in Hamburg, Germany. Genetic sequencing linked this detection to WPV1 identified in Kandahar, Afghanistan, suggesting potential international spread. This incident underscores the necessity of maintaining high vaccination coverage and robust disease surveillance globally.
The committee unanimously concluded that the international spread of polioviruses continues to pose a PHEIC, necessitating the extension of Temporary Recommendations for an additional three months. Factors contributing to this ongoing risk include:
- Ongoing WPV1 transmission in core reservoirs, particularly in southern Afghanistan and Karachi, Pakistan.
- Geographical expansion and established transmission in critical areas, including parts of Punjab Province.
- Persistent inconsistencies in vaccination campaign quality, leading to significant populations remaining unimmunized.
- Cross-border movement between Afghanistan and Pakistan, increasing the risk of shared transmission.
Conclusion and Next Steps
The committee emphasized the importance of high-quality vaccination campaigns, especially during the low transmission season from December 2025 to May 2026. Full access to all children, particularly in high-risk areas, is crucial for stopping WPV1 transmission in both Afghanistan and Pakistan. Coordinated efforts are necessary to ensure that populations, including undocumented migrants, are reached and vaccinated effectively.
Moving forward, the international community must remain vigilant and committed to eradicating polio globally. The risk of resurgence in polio transmission highlights the necessitate for sustained public health efforts, including vaccination and surveillance. Stakeholders are encouraged to participate in discussions regarding polio eradication strategies and share insights on effective practices.
This article is for informational purposes only and does not constitute medical advice.
