Eastern Mediterranean leaders press harder on polio eradication as funding tightens
At the Seventy-third session of the WHO Regional Committee for the Eastern Mediterranean in Cairo, ministers and partners put polio eradication back at the center of regional health security. The message was unmistakable: ending transmission will depend not only on vaccination campaigns, but on political continuity, functioning surveillance, and health systems strong enough to reach children in areas where routine services are fragile or interrupted.
The timing matters because the campaign is being pushed forward under financial strain. WHO’s Officer-in-Charge for the Eastern Mediterranean, Dr Adham Ismail, said the organization had absorbed a 14% budget cut while still working to protect priority programmes, including polio, health emergencies and universal health coverage. In practice, that means fewer resources at the very moment when eradication work still requires repeated access, repeated follow-up, and steady field coordination. Polio does not disappear because a region is tired of chasing it.
Transmission remains concentrated in the hardest-to-reach places
Afghanistan and Pakistan remain the only two countries in the region where wild poliovirus is endemic, with transmission concentrated in high-risk areas, especially southern Afghanistan and southern Khyber Pakhtunkhwa in Pakistan. Circulating variant poliovirus continues to threaten other parts of the region, including Somalia, Sudan and Yemen. Those geographic patterns are not accidental. Poliovirus persists where immunization gaps overlap with insecurity, population movement, strained primary care systems and weak surveillance density.
High-risk transmission zones create a biological advantage for the virus. When children miss even a small number of vaccine contacts, herd protection thins, and the pathogen can continue moving silently through households and communities before paralysis reveals the damage. In that setting, environmental surveillance, case detection and rapid response become as important as the vaccine itself.
Wild poliovirus has no place to hide when immunity is high and surveillance is tight. It thrives when both fail at once.
Political support is doing part of the work health systems must still finish
Member States used the session to reaffirm a shared commitment to ending polio and to strengthening immunization systems more broadly. The region’s public health strategy is no longer only about campaign delivery; it is about building the infrastructure that keeps children protected between outbreaks. Countries including Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates continue to support eradication through political leadership, technical cooperation and financial backing.
That regional solidarity carries practical value because polio eradication is rarely solved inside national borders alone. Mobile populations cross frontiers, vaccine confidence can vary from district to district, and outbreaks in one fragile setting can quickly reappear in another. Coordinated financing and harmonized surveillance reduce those seams. Saudi Arabia’s delegation stressed the need for transboundary coordination that includes mobile populations and integrates vaccination into broader health services, alongside monitoring, surveillance and the empowerment of women in the workforce in the most affected areas.
The workforce point is clinically relevant. In many settings, female vaccinators and health workers improve access to households where cultural norms or security conditions limit contact with male staff, especially for mothers of young children. In eradication campaigns, access is not a social detail; it is a delivery mechanism.
Fragile and crisis-affected settings remain the decisive battleground
Qatar reiterated support for regional and international efforts to eradicate polio and strengthen partnerships that help protect children, with particular emphasis on fragile and crisis-affected settings. That emphasis reflects the reality on the ground: routine immunization is hardest to sustain where conflict, displacement or chronic underinvestment disrupt the normal rhythm of primary care. In those places, each missed vaccination visit widens the immunity gap and increases the chance that either wild poliovirus or circulating variant poliovirus will find a route forward.
The regional subcommittee for polio eradication and outbreaks reviewed progress and persistent obstacles at its 15th meeting. The discussion centered on the same structural barriers that have slowed eradication for years: limited access in some districts, uneven campaign quality, and the need to keep surveillance sensitive enough to detect every signal quickly. There is no shortcut around those problems. Eradication requires repeated high-quality immunization rounds and a surveillance system capable of finding the virus when circulation is still small.
Budget pressure is colliding with a long campaign that still needs stamina
WHO’s decision to protect core programmes despite a reduced budget shows how tightly the region is managing its response. A 14% cut is not a minor administrative inconvenience. It can affect field operations, supervisory reach, logistics, data review and the ability to sustain campaign quality in remote areas. When eradication efforts are underfunded, the risk is not only slower progress; it is the loss of hard-won gains that have already required years of mobilization.
The region’s challenge is now less about proving that polio can be driven down and more about keeping the machinery intact until transmission is stopped everywhere. Surveillance must remain aggressive in endemic countries and equally alert in countries where variant viruses can still emerge. Immunization systems must be strong enough to absorb shocks from conflict, displacement and financial constraint without dropping coverage in the very communities that can least afford to miss a dose.
No single campaign round ends polio. Sustained access, repeated vaccination and durable surveillance do.
As the Cairo meeting closed, regional leaders were effectively making a pledge to keep those systems in place despite fiscal pressure and humanitarian strain. The remaining burden is concentrated, but it is still dangerous. Until the last endemic transmission chains are broken and variant outbreaks are controlled across the region, the job is unfinished and the margin for complacency remains small.