The thirty-seventh meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) on the international spread of poliovirus was convened by the WHO Director-General on 12 December 2023 with Committee members and advisers meeting face to face, and via video conference with affected countries, supported by the WHO Secretariat.  The Emergency Committee reviewed the data on wild poliovirus (WPV1) and circulating vaccine derived polioviruses (cVDPV) in the context of the global target of eradication of WPV and cessation of outbreaks of cVDPV2.  Technical updates were received about the situation in the following countries: Afghanistan, Egypt, Guinea, Mauritania, Nigeria, Pakistan and Zimbabwe.

Wild poliovirus

There have been four new cases of WPV1 in Pakistan since the last meeting, bringing the total to six in 2023. Furthermore, there has been a large increase in environmental detections, with 60 positive samples found in the three months from September to November, bringing the total in 2023 to 82.  After a period of non-detection, new transmission is occurring in the Quetta Block in Balochistan, in Karachi in Sindh, Islamabad / Rawalpindi and in Peshawar in Khyber Pakhtunkhwa (KP) province. Although implementation of a polio action plan in southern KP has resulted in 160,000 more children being vaccinated, the context remains challenging: political instability, insecurity in some areas, with front line workers requiring police patrols to accompany them, and vaccination boycotts where communities make demands for other services in exchange for allowing polio vaccination. The programme continues to miss a significant number of children in Pakistan.