Vaccinating the Pak-Afghan Border — Towards a Polio-Free Region

Pakistan and Afghanistan are the last two countries with wild poliovirus, and the eradication partnership treats them as a single epidemiological block. Genetic sequencing regularly shows virus strains travelling in both directions. Vaccinating at the border is therefore not a supplementary activity — it is central to both programmes.

Why household campaigns are not enough here

The populations that matter most in the border regions are the ones least likely to be at home. Traders, labourers, seasonal migrants and families visiting relatives cross continuously through Torkham in the north and Chaman in the south, along with large movements of displaced and returning families.

A microplan built on fixed households does not describe this population. A child counted in a settlement last round may be thirty kilometres away — or in another country — this round.

Permanent transit points

Pakistan operates around 500 permanent transit points nationwide: at the border crossings themselves, along the highways leading to them, and at bus terminals and railway stations. Teams there vaccinate children while families are in motion.

The work is relentless and repetitive — long shifts at a crossing, checking every vehicle, vaccinating children who may have had drops a week earlier somewhere else. Repeat doses are harmless and the alternative is a missed child, so teams vaccinate rather than ask.

Coordination with Afghanistan

• Synchronised campaign timing, so a family crossing mid-round is reached on one side or the other rather than falling between two schedules.
• Shared surveillance data, including sequencing results, so both programmes can see the actual routes the virus uses.
• Coordinated response to large population movements, including repatriation of Afghan families from Pakistan — moments when very large numbers of children move at once.

See joint Pak-Afghan operations.

The two corridors

In the north, Torkham links eastern Afghanistan to the Peshawar corridor and onward to southern Khyber Pakhtunkhwa — the region that produced three of Pakistan's four cases in 2026 up to September. In the south, Chaman links Kandahar to the Quetta block, one of the world's longest-standing poliovirus reservoirs.

Why it matters for everyone

Neither country can be certified polio-free while the other is transmitting, and either can reinfect the other indefinitely. The teams at these crossings are working on the last remaining transmission of a virus that once paralysed 350,000 children a year worldwide.

Related: joint anti-polio strategy · global polio and Pakistan