Polio Eradication Remains a Public Health Emergency, WHO Committee Confirms

The international spread of poliovirus continues to pose a significant threat to global health, prompting the World Health Organization (WHO) to extend its Public Health Emergency of International Concern (PHEIC) designation for polio. A recent meeting of the Emergency Committee under the International Health Regulations (IHR) on January 14, 2026, reaffirmed this status, highlighting ongoing transmission in key regions and the risk of international spread.

Current Poliovirus Situation: Wild Poliovirus and Vaccine-Derived Poliovirus

The committee reviewed the latest epidemiological data concerning both wild poliovirus type 1 (WPV1) and circulating vaccine-derived polioviruses (cVDPV). While progress has been made, challenges remain in interrupting transmission and achieving eradication goals.

Wild Poliovirus (WPV1)

As of the meeting, nine new WPV1 cases had been reported since the last committee meeting on October 1, 2025, with five cases in Afghanistan and four in Pakistan. In 2025 to date, a total of 40 WPV1 cases have been reported – nine in Afghanistan and 31 in Pakistan, compared to 99 cases reported in all of 2024. Environmental surveillance also detected WPV1 in 673 samples in 2025 (64 from Afghanistan, 608 from Pakistan, and one from Germany), compared to 741 in 2024.

Land border closures between Afghanistan and Pakistan have created a backlog of untested samples, potentially impacting the accuracy of the current epidemiological assessment. Efforts are underway to resume testing and analyze the results.

Transmission remains concentrated in specific areas, including southern and eastern Afghanistan, and Khyber Pakhtunkhwa and Sindh provinces in Pakistan. The committee expressed concern about ongoing transmission along cross-border epidemiological corridors.

Circulating Vaccine-Derived Polioviruses (cVDPV)

Globally, 202 cVDPV cases and 218 environmental detections were reported in 27 countries in 2025 (as of December 31st). The vast majority of these cases (192) were cVDPV2. Nigeria, Ethiopia, and Yemen accounted for 64% of global cVDPV2 cases. New outbreaks of cVDPV1 were reported in Algeria, Djibouti, Lao People’s Democratic Republic, and Israel, while Cameroon, Chad, and Guinea experienced cVDPV3 outbreaks.

The introduction of the novel oral polio vaccine type 2 (nOPV2) has shown promise, with more than 80% of cVDPV2-affected countries interrupting outbreaks after using nOPV2 in vaccination campaigns.

Amendments to the International Health Regulations

Amendments to the IHR, adopted in June 2024 and entering into force on September 19, 2025, include broader poliovirus notification requirements, the introduction of a “pandemic emergency” designation (a higher level of alert for public health emergencies), measures to strengthen equitable access to health products, and recognition of health documents in both digital and non-digital formats. International Health Regulations

Challenges and Ongoing Efforts

Several challenges hinder polio eradication efforts, including insecurity, limited access to vaccination campaigns, vaccine hesitancy, and gaps in population immunity. In Afghanistan, security concerns have limited house-to-house campaigns, and the inclusion of women as vaccination health workers remains low. In Pakistan, while political commitment is strong, inconsistencies in campaign quality and access constraints persist, particularly in Khyber Pakhtunkhwa province.

Both Afghanistan and Pakistan are implementing intensive vaccination schedules, with a focus on high-risk areas. However, coordinated cross-border efforts are crucial, as the two countries constitute a single epidemiological bloc.

International Spread and Ongoing Risk

The detection of WPV1 in an environmental sample in Germany in October 2025, linked to a strain from Afghanistan, underscores the ongoing risk of international spread. This highlights the importance of maintaining high vaccination coverage, strong disease surveillance, and international cooperation.

Conclusion

The WHO Emergency Committee unanimously concluded that the risk of international spread of poliovirus continues to constitute a Public Health Emergency of International Concern, recommending an extension of the Temporary Recommendations for a further three months. While the event does not currently constitute a pandemic emergency, sustained vigilance and coordinated global efforts are essential to achieve polio eradication. Public Health Emergency status