February 24, 2025 – Kabul
Afghanistan remains one of only two countries—alongside Pakistan—where polio, a crippling and potentially fatal disease, has never been fully eradicated. The nation’s battle against polio has been shaped by decades of conflict, political upheaval, and shifting policies under Taliban influence, presenting a stark contrast between periods of progress and significant setbacks.
Early Efforts and Pre-Taliban Progress
Polio vaccination campaigns in Afghanistan began in earnest in the late 1970s, following the global push sparked by the World Health Organization (WHO). By the 1980s, despite the Soviet-Afghan War, vaccination efforts managed to reduce cases from nearly 2,000 annually to hundreds by the early 1990s. The introduction of the Global Polio Eradication Initiative (GPEI) in 1988 further bolstered these efforts with mass immunization campaigns. However, conflict and poor infrastructure limited reach, particularly in rural areas where 74% of Afghans live.
The First Taliban Era (1996–2001)
When the Taliban first seized power in 1996, polio vaccination faced new challenges. Initially, the group did not outright ban immunization efforts, and the first national supplementary campaigns were conducted in the late 1990s under their rule. However, their strict interpretation of Islamic law and suspicion of Western initiatives led to uneven implementation. In some regions, local commanders allowed vaccinations, while others resisted, viewing health workers with distrust. Despite this, polio cases dropped to fewer than 50 annually by 2001, aided by international coordination and limited Taliban interference at the time.
Post-2001: A Window of Opportunity
After the U.S.-led invasion toppled the Taliban in 2001, Afghanistan saw a surge in polio vaccination efforts. International organizations like UNICEF and WHO, alongside the Afghan government, launched aggressive house-to-house campaigns, vaccinating millions of children under five. By the early 2000s, cases fell to single digits in some years, raising hopes of eradication. Yet, lingering instability and the Taliban’s insurgency in rural strongholds disrupted access, leaving pockets of unvaccinated children vulnerable.
Taliban Insurgency and Vaccination Bans (2018–2021)
As the Taliban regained control over swathes of territory by 2018, their stance hardened. In May of that year, they banned house-to-house polio vaccinations in areas they controlled, citing security concerns and alleging campaigns were a cover for espionage—a narrative fueled by the CIA’s fake vaccination ruse to locate Osama bin Laden in 2011. This ban left approximately 3.4 million children unvaccinated per campaign, causing a spike in cases from 21 in 2018 to 56 in 2020. Southern provinces like Kandahar, a Taliban stronghold, became polio hotspots, with mosque-to-mosque vaccinations proving less effective than door-to-door efforts.
Taliban Rule Returns (2021–Present)
Since reclaiming power in August 2021, the Taliban’s approach to polio vaccination has been inconsistent. Initially, a breakthrough came in November 2021 when they lifted the ban, allowing nationwide house-to-house campaigns for the first time in years. Over six million children were targeted annually, and cases dropped to four in 2021. The Taliban even permitted women to serve as vaccinators, a move seen as pragmatic amid their broader restrictions on female participation in public life. By 2023, however, only two cases were reported, hinting at progress.
Yet, this momentum faltered in 2024. In September, the Taliban abruptly suspended campaigns, citing security fears and discomfort with women vaccinators, shifting efforts to site-to-site models like mosques. This decision, centered in Kandahar—home to supreme leader Hibatullah Akhundzada—coincided with a rise to 23 cases in 2024, up from six in 2023. Health experts warn that without consistent, widespread vaccination, Afghanistan risks reversing decades of gains, threatening not just its own children but also neighboring Pakistan, where 41 cases were reported this year due to cross-border movement.
A Tale of Two Eras
Under the first Taliban regime, polio efforts were hampered but not halted, with cases declining despite limited cooperation. Today’s Taliban rule shows a more complex picture: early cooperation gave way to renewed restrictions, driven by paranoia and ideology. While pre-2021 campaigns under a Western-backed government reached more children, they too struggled with insurgency-related access issues. The common thread across all eras is clear—conflict and mistrust have kept polio alive in Afghanistan, making eradication an elusive goal.
As of February 2025, the latest campaign, launched this week in 16 provinces, aims to vaccinate 6.2 million children. Yet, with the Taliban’s fluctuating policies and Kandahar’s ongoing limitations, experts remain cautious. “Eradication requires every child to be reached,” said a WHO official. “Anything less, and polio persists.” For Afghanistan, the fight continues—one drop of vaccine at a time.
