Afghanistan - Pakistan Cross Border Coordination

This PowerPoint was one of the communication presentations made at a technical consultation on polio eradication in Afghanistan and Pakistan, held in Egypt from February 3-4, 2008. The objectives of the meeting included:

1. Reviewing progress towards polio eradication in the two countries, with a focus on 2007.
2. Discussing planned activities for 2008.
3. Making recommendations to enable the programme to address constraints facing the two national programmes.

The two-day meeting consisted of a programme of presentations and discussion looking at the epidemiological situation and programme activities in both countries, with a strong emphasis on programme communication.

The presentation begins with an overview of the epidemiological and genetic data that confirm both Pakistan and Afghanistan form a single epidemiological block with extensive population movement between both countries. It also points out that both countries share many issues including the ongoing sharing of the wild virus and access problems that underline the mutual benefits of sharing best practise. The Ministries of Health have led in providing support to cross-border collaboration. The main focus of this presentation was on reaching highly mobile populations and looking ahead to address future challenges and plans.

A number of activities are being implemented to reach these populations:

1. Permanent cross-border vaccination posts have been increased from 2 in 2006 to 11 in Pakistan and 13 in Afghanistan in 2007 resulting in the immunisation of 1.1 million children in 2007 (0.6 Pakistan/0.5 Afghanistan).
2. Special vaccination activities outside supplementary immunisation activities (SIAs) have included seasonal vaccination posts offering other antigens such as measles at 'choke points' resulting in 16,514 children vaccinated in Balochistan in 2007.
3. Special emphasis on mapping nomadic movements during campaigns and developing special microplans resulted in 0.2 million nomadic children receiving oral polio vaccine (OPV) in October 2007 national immunisation days (NIDs) in Pakistan and 0.08 million during the summer in Afghanistan.

The impact of this work is reflected in the reduction of polio cases in nomadic populations from 5 in 2006 to zero in 2007.

Challenges and plans for the future include:

1. Continued and strengthened cross-border coordination is needed more now than ever before.
2. Maintaining and improving existing levels of activity is critical for the programme.
3. Appreciating and encouraging the joint planning and implementation work of bordering provinces/regional teams has to remain a high priority.
4. Coordinated plans for accessing children in areas with serious security situations have been useful and need to be strengthened - for example, the letter of support from anti-government elements (AGE) in Afghanistan was helpful to the border areas of Pakistan.
5. More work needs to be done to build demand and awareness for vaccination among bordering populations such as the Spinboldak radio announcements which helped raise awareness of campaign dates in Pakistan.
6. Regular data exchange needs to continue and sharing information about polio and HOT cases in the border areas has to be improved.

Click here to download the full PowerPoint presentation.