Current Countries Reporting Wild Poliovirus and Circulating Vaccine-Derived Poliovirus
As of the latest World Health Organization and Global Polio Eradication Initiative situation reports, wild poliovirus type 1 remains endemic in only two countries, Pakistan and Afghanistan, while circulating vaccine-derived poliovirus outbreaks continue in several other nations, mainly in parts of sub-Saharan Africa and Southeast Asia. These countries with polio are identified through acute flaccid paralysis surveillance and environmental sewage sampling, which together form the backbone of global polio monitoring systems designed to detect every possible case. The Global Polio Eradication Initiative, a partnership led by WHO, UNICEF, the U.S. Centers for Disease Control and Prevention, Rotary International, and the Bill and Melinda Gates Foundation, coordinates outbreak response in these settings, with technical guidance and funding reviewed by the Global Polio Oversight Board and reported in public situation updates available at https://www.who.int/health-topics/poliomyelitis.
In 2024, WHO and UNICEF reported that wild poliovirus cases in Pakistan and Afghanistan fell to historically low levels, yet the risk of international spread remains due to population movement, subnational surveillance gaps, and persistent under-vaccinated communities. Circulating vaccine-derived poliovirus type 2 outbreaks, which emerge in under-immunized populations where oral polio vaccine is used, have been documented in countries including the Democratic Republic of the Congo, Nigeria, Somalia, and Yemen, with outbreak response campaigns using novel oral polio vaccine type 2 deployed in line with WHO Emergency Use Listing guidance. Independent monitoring boards and technical advisory groups evaluate these data quarterly, and their findings inform country-level vaccination strategies and donor funding allocations discussed in reports accessible at https://www.polioeradication.org/.
Vaccination Coverage, Campaigns, and Funding in Polio-Affected Countries
Routine immunization coverage with inactivated polio vaccine and supplemental immunization activities remain the primary tools to stop transmission in countries with polio, with national and subnational coverage estimates published annually by WHO and UNICEF in the Global Immunization Coverage and Polio Elimination reports. In high-risk districts of Pakistan and Afghanistan, door-to-door vaccination campaigns and mobile teams target zero-dose children, while independent monitoring teams and community-based surveillance networks measure campaign quality, with results published in WHO position papers and joint monitoring frameworks that donors reference when allocating funds to the Global Polio Eradication Initiative.
International financing for polio eradication comes primarily from Gavi, the Vaccine Alliance, the Gates Foundation, and bilateral donors, with the Global Polio Eradication Initiative budget and country-level expenditure plans made public through financial reports and the WHO polio programme financial documents. In 2024, Gavi approved new support packages for polio vaccine procurement and health system strengthening in eligible countries, while the U.S. government, through the U.S. Agency for International Development and the Centers for Disease Control and Prevention, continues to fund technical assistance and outbreak response in high-risk settings, with program data and funding allocations summarized in public reports available at https://www.cdc.gov/polio/.
Certification, Risk of Reintroduction, and Global Eradication Timeline
WHO certifies regions as polio-free only after three years of zero wild poliovirus cases and robust surveillance, a process currently applied to the African Region and other regions where transmission has been interrupted, while countries with polio remain under enhanced surveillance and must meet strict criteria for outbreak response and vaccination coverage before certification can proceed. The Global Commission for the Certification of Poliomyelitis Eradication reviews surveillance data annually and issues recommendations on the timing of regional and global certification, with decisions informed by independent technical reviews and risk assessments published in WHO weekly epidemiological records and position papers.
Even after wild poliovirus transmission is stopped, countries must maintain high immunity and sensitive surveillance to prevent