Of the 541 children affected by polio globally in 2023, 85 per cent live in the 31 fragile, conflict-affected, and vulnerable countries, according to a new UNICEF analysis on World Polio Day.

Polio cases in these settings have more than doubled in the past five years, while routine childhood immunization has dropped from 75 to 70 per cent – well below the 95 per cent needed for community immunity.

The data issue a stark warning that the life-threatening disease continues to thrive in areas where life is most precarious, and where conflict, natural disasters, humanitarian crises, other destabilizing factors make it difficult to deliver critical healthcare.

“In conflict, children face more than bombs and bullets; they are at risk of deadly diseases that should no longer exist,” said UNICEF Executive Director Catherine Russell. “In many countries, we are witnessing the collapse of healthcare systems, destruction of water and sanitation infrastructure, and the displacement of families, triggering a resurgence of diseases like polio. Children are being left paralyzed, unable to walk, play, or attend school."

A global decline in childhood immunization has also led to an increase in polio outbreaks, including in countries that had been polio-free for decades. Nowhere is this more evident than in conflict-affected areas, with 15 out of 21 such countries – including Afghanistan, Democratic Republic of Congo, Somalia, South Sudan, and Yemen – currently battling polio.