When Afghanistan instituted a door-to-door polio vaccination policy in 2000, the complete eradication of the disease seemed within reach. Between 1999 and 2004, the number of new cases fell from 63 to 4.
However, with the escalation of violence in the country in 2005, hopes for complete elimination diminished as vaccinating became more difficult. Figures just released by the Afghanistan Ministry of Health indicate that between 2010 and 2011 the number of new infections tripled, from 25 to 76 cases.
The disease remains endemic in only three countries — Nigeria, Pakistan and Afghanistan — and has recently re-emerged in Chad, Angola, and the Democratic Republic of Congo. It’s no coincidence that each of these countries is also a region of ongoing conflict. Political insecurity, violence and poor infrastructure each have a major role in the persistence of the last 1% of the disease.
I became personally aware of this risk in west Africa when it was recommended to me by Kaiser Permanente here in Southern California that I receive a booster vaccination before I left for Ghana a couple of weeks ago. I readily agreed.