Taliban restrictions on women increase risk of polio outbreak, health officials warn

Health officials are warning that a polio outbreak is looming in Afghanistan after the Taliban suspended its vaccination campaign over safety concerns and restrictions on women.

The World Health Organization (WHO) has confirmed 18 new cases polio infections in the country so far this year, a significant increase from the six cases reported in 2023. Local health workers say the numbers could be higher as many cases remain undetected.

The Taliban have “temporarily suspended” polio vaccinations in Afghanistan, a health official involved in the campaign confirmed to the Guardian, citing concerns about safety and the involvement of women in administering the vaccines.

Polio is a highly contagious viral disease that can cause paralysis and death, especially in infants and young children.

“The reason behind postponing the polio campaign is the problems with the implementation modalities,” the health official explained on condition of anonymity. “The leadership of the current government has ordered us not to conduct door-to-door campaigns.”

Instead, the Taliban government wants to shift vaccination efforts to local mosques, expecting families to bring their children there to get shots.

“This is very bad news for the polio program,” the official said. “For eradication to be successful, we need to treat more than 95 percent of children with two doses of the vaccine.

“But without door-to-door campaigns we will not be able to achieve (that target). It puts the whole country at risk, even the region.”

Afghanistan and Pakistan are the only two remaining countries in the world where the polio virus is endemic.

“One of the reasons for banning door-to-door campaigns was security. The south, particularly Kandahar, is where Taliban leaders live, and they are concerned that the campaigns could reveal their locations to foreign threats,” the official said.

Fake vaccination campaigns in Afghanistan and Pakistan have reportedly been used by US intelligence agencies to identify and confirm terrorist hideouts, including that of Osama bin Laden. This has led to widespread distrust of the campaigns in the region, with several attacks on polio workers over the past decade.

A local health worker in Kandahar said door-to-door vaccinations are already banned in southern Afghanistan.

“In Kandahar and even in parts of Uruzgan province, vaccinations have only taken place in local mosques for years,” one of them said.

While the Taliban has banned women from working in several sectors, women in health care have largely been allowed to keep their jobs.

However, the health worker said: “Women in the southern region face restrictions from local authorities in participating in the programme, especially in rural areas.”

The health official agreed. “Women have been crucial to the success of door-to-door campaigns and raising awareness of the vaccines among mothers and families, as men are not allowed in these spaces in a deeply conservative society,” they said.

Of the 18 cases reported this year, 11 are in Kandahar. “In the rest of Afghanistan, there are no problems with female polio workers, and in the areas where we have female workers, we have no cases of polio. They are directly responsible for eradicating polio in those parts,” the official added.

“When the Taliban took over, I was happy because I thought now we would have a chance to completely eradicate polio from Kandahar,” said a 23-year-old former female polio worker, who wanted to be identified only as Farhanaz.

“I was willing to travel to remote areas if necessary to administer the vaccines, but when I faced restrictions, I was devastated,” she said.

Farhanaz said she had been involved in the local vaccination campaign since she was a teenager, but was forced to resign shortly after the Taliban took power in 2021.

“Our work was crucial and effective. If we stop ourselves (women) from doing our work, it will harm the country and our children will suffer through no fault of their own,” she warned.

The WHO has been asked for comment.