The 45^th meeting of the Emergency Committee under the International Health Regulations (IHR or Regulations) on the international spread of poliovirus was convened by the WHO Director-General on 14 May 2026 via video conference with affected countries, supported by the WHO Secretariat. The Emergency Committee reviewed the latest epidemiological data on wild poliovirus type 1 (WPV1) and circulating vaccine-derived polioviruses (cVDPV) in the context of the global targets to interrupt endemic WPV1 transmission in 2026 and to stop cVDPV2 outbreaks by 2028 with subsequent certification of WPV1 eradication and cVDPV2 elimination. Technical updates were received about the situation in the following countries: Afghanistan, Malawi, Nigeria, Pakistan, Somalia, and Togo.

Amendments to the IHR, adopted by the Seventy-seventh World Health Assembly, through resolution WHA77.17 in June 2024, entered into force, generally, on 19 September 2025.¹ Key amendments to the IHR include, inter alia, broader poliovirus notification requirements; the introduction of the determination of “pandemic emergency”², a higher level of global public health alert with respect to a public health emergency of international concern (PHEIC); measures to strengthen equitable access to relevant health products; and recognition of health documents in non-digital and digital formats.

Wild poliovirus

Since the last Emergency Committee meeting in January 2026, 16 new WPV1 cases have been reported from the two endemic countries, Afghanistan (14) and Pakistan (2). Of the 14 new WPV1 cases reported in Afghanistan, 11 had onset in 2025. The cases in Afghanistan were reported from the South and East Regions of the country, while in Pakistan the cases were reported from Khyber Pakhtunkhwa and Sindh provinces. In 2026 to date, four WPV1 cases have been reported: three in Afghanistan and one in Pakistan. In 2025, 52 WPV1 cases were reported: 21 in Afghanistan and 31 in Pakistan. For environmental surveillance, a total of 74 WPV1 positive samples have been reported so far in 2026 (17 from Afghanistan and 57 from Pakistan). In 2025, a total of 747 WPV1 positive samples were reported; 94 from Afghanistan, 651 from Pakistan and two from Germany. No further WPV1 detections were reported from Germany after the first half of October 2025.

Following the closure of the Afghanistan–Pakistan land border, which prevented shipment of AFP and environmental surveillance samples from Afghanistan to the Pakistan Regional Reference Laboratory (RRL) between 12 October 2025 and early January 2026, the programme was able to resume sample shipments during the second week of January 2026. All Afghanistan samples from 2025 have now been tested and finalized. While the land border between Afghanistan and Pakistan remains closed, the programme has established a regular aerial shipment mechanism to transport samples to the RRL in Islamabad. In addition, WHO is coordinating with other laboratories in the Region to establish contingency testing capacity for Afghanistan samples, should the need arise.

While the overall trajectory of WPV1 cases and environmental sample positivity is declining, the Committee noted with concern the continued WPV1 transmission in both endemic countries, which persisted throughout the most recent low transmission season (October 2025–April 2026), particularly along the southern (South Afghanistan–Quetta Block) and central (Northwest Pakistan/South Khyber Pakhtunkhwa–Southeast Afghanistan) cross-border epidemiological corridors, as well as in Karachi, Pakistan.

The Committee further noted that sustained local WPV1 transmission continues to be concentrated in three critical geographies: the South Region of Afghanistan, South Khyber Pakhtunkhwa (KP), and Karachi. The South Region of Afghanistan remains the area of greatest concern, with intense transmission and evidence of prolonged undetected circulation. Southern Khyber Pakhtunkhwa continues to present significant operational and security challenges that impede implementation of high-quality vaccination activities, while Karachi remains a significant reservoir for poliovirus transmission, with widespread environmental surveillance positivity indicating continued local transmission.

The Committee noted encouraging progress in the northern cross-border epidemiological corridor, encompassing Peshawar in Pakistan and the East Region of Afghanistan, where programme quality has improved. At the same time, the Committee noted that these gains remain at risk, highlighting the recent environmental detection in Peshawar, immunity gaps, surveillance sensitivity concerns, population movement and persistent refusal pockets. The Committee emphasized the need to sustain high quality surveillance and immunization activities to maintain the progress achieved. The Committee also noted encouraging progress in the Quetta Block, particularly the marked decline in positive environmental samples during the last 6 months. However, the Committee emphasized that these gains remain fragile because of continued intense WPV1 transmission in the adjoining South Region of Afghanistan, as well as uneven quality of vaccination campaigns and low routine immunization coverage. The Committee underscored the need for targeted measures to sustain and consolidate the progress achieved by boosting population immunity in areas with persistent immunity gaps.

Regarding molecular epidemiology, there has been an overall decrease in genetic biodiversity between 2020 and 2023. However, an increase in the genetic biodiversity was observed in 2024, necessitating a split of two genetic clusters into eight genetic clusters, three of which are active in 2025, and four are active in 2026. The remaining chains of transmission continue to circulate in populations and geographies with persistently low immunization coverage, including the bordering districts of the southern and northern epidemiological corridors across the two endemic countries. Evidence of shared cross-border transmission between the two WPV1-endemic countries was documented as recently as first quarter of 2026.

Afghanistan and Pakistan continue to implement an intensive and mostly synchronized campaign schedule, with a focus on achieving high vaccination coverage in core reservoirs and ensuring timely, effective response to WPV1 detections in other areas of each country. There have been two nationwide and five sub-national vaccination campaigns in 2025, and two sub-national and a national campaign in 2026 so far. Additionally, targeted fractional IPV campaigns were implemented in the high-risk areas of the East, South, and Southeast Regions between August and September 2025. Pakistan implemented five nationwide and one sub-national vaccination campaign in 2025 and nationwide campaigns in 2026 so far. Bivalent OPV was integrated into the measles campaign in high-risk areas of the country in December 2025, and targeted fractional dose IPV campaigns were implemented in Karachi, Quetta Bloc and Lahore.

In Afghanistan, campaigns are being conducted using the site-to-site strategy, with focused efforts to strengthen operational and communication approaches to maximize coverage of target children under this modality. House-to-house campaigns have not been implemented since October 2024 due to security concerns, limiting full campaign access to all children; at the same time, the overall inclusion of women as vaccination health workers remains very low, particularly in the South Region. The Committee expressed concern that, in the absence of house-to-house campaigns and with limited participation of women health workers, site-to-site campaigns often fail to reach all children, particularly younger children, which could contribute to further geographic spread within Afghanistan and beyond.

The Committee noted with appreciation the strong leadership and high-level commitment to polio eradication in Pakistan at all levels, including the direct engagement of the Prime Minister, the Federal Minister for Health, and the Prime Minister’s Focal Person for Polio Eradication. The Committee also acknowledged consistently high reported coverage and Lot Quality Assurance Sampling (LQAS) pass rates at the national and provincial levels. However, the Committee noted that the quality at district level remains variable and inconsistent, including in several critical areas such as Quetta Bloc, South KP and the Central Pakistan Bloc, attributed to operational challenges and prevailing insecurity, particularly in Khyber Pakhtunkhwa, and Balochistan provinces. The programme in Pakistan is facing substantial challenges in consistently and effectively reaching all target children in South KP, which is currently experiencing the most intense WPV1 transmission in the country, with an estimated 250 000 children reportedly unreached, primarily due to access constraints driven by insecurity. The Committee noted encouraging early signs of improvement following implementation of the Karachi Audit recommendations, including declining environmental surveillance detections and improving LQAS results. However, the Committee emphasized that these gains are still at an early stage and do not yet reflect eradication-level programme quality, as local transmission and evidence of undetected transmission persist in Karachi. The Committee underscored that full implementation of the audit recommendations will be critical to achieving the programme quality needed to interrupt WPV1 transmission.

In summary, available data indicate that global WPV1 transmission remains geographically confined to the two endemic countries. There is measurable progress achieved during the last 6 months in several key geographies, including the East Region of Afghanistan and the Peshawar, Quetta and Karachi Blocks of Pakistan. However, the decline in WPV1 cases and environmental detections, particularly following the low transmission season and a period of intensified programme activities, do not necessarily indicate that eradication-level programme quality has been achieved. The Committee noted that programme quality gaps persist across critical geographies and beyond, and that sustained efforts to strengthen surveillance, improve routine and supplementary immunization, fully implement programme improvement recommendations from TAG and Karachi audit, and ensure access to all children will be essential to interrupt WPV1 transmission and achieve eradication. The Committee reinforced that Afghanistan and Pakistan constitute a single epidemiological bloc for the purposes of polio eradication, with a continued risk of cross-border transmission. It therefore remains essential that both country programmes, with support from the GPEI, maintain strong cross-border coordination at the national and subnational levels and continue efforts towards synchronized programme implementation, particularly in border areas. Both countries should also maintain close coordination to reach and vaccinate populations moving across the border, including undocumented migrants returning from Pakistan to Afghanistan, whose movement continues to compound the programme's operational challenges.

Circulating vaccine derived polioviruses (cVDPV)

In 2026 (as of 30 April), a total of 32 cVDPV cases and 27 environmental detections were reported globally across 12 countries. Of the 32 cVDPV cases in 2026, 28 are cVDPV2, two are cVDPV3, and two are cVDPV1 cases. All the 27 positive environmental samples in 2026 tested positive for cVDPV2. In 2025, a total of 238 cVDPV cases and 247 confirmed cVDPV environmental detections were reported globally across 30 countries. Nigeria in the African Region reported the highest number of cVDPV2 cases in 2025 (66) and 2026 (14) so far, representing 30% and 50% of the global cVDPV2 case load, respectively. Nigeria reported co-circulation of cVDPV2 and cVDPV3 in 2026. In 2025, Algeria, DR Congo, Djibouti and Israel had reported co-circulation of cVDPV1 and cVDPV2 while Cameroon, Chad and Nigeria had reported co-circulation of cVDPV2 and cVDPV3.

As of 30 April, 13 unique cVDPV2 emergence groups have been detected in 2026, compared with 36 in 2025, 31 in 2024 and 28 in 2023. All the 13 cVDPV2 emergences detected in 2026 represent a continuation from 2025, with no new cVDPV2 emergence in 2026. Since its introduction in 2021, more than 2 billion doses of nOPV2 have been administered and a total of 42 cVDPV2 emergences have been associated with it. The Committee noted that nOPV2 continues to demonstrate significantly greater genetic stability and a substantially lower risk of reversion to neurovirulence compared to Sabin OPV2. More than 80% of cVDPV2-affected countries have interrupted outbreaks with three or fewer SIAs using nOPV2.

In 2026 (as of 30 April), two cVDPV1 cases have been reported, both from South Sudan. In 2025, three cVDPV1 cases were reported, one each from Algeria, the Democratic Republic of Congo, and Lao People’s Democratic Republic. In addition, cVDPV1 outbreaks were reported in Djibouti and Israel, based on environmental surveillance detections (ten detections each from Djibouti and Israel). Nigeria is the only country in 2026 that reported cVDPV3, hence it is now affected by cVDPV2 and cVDPV3 outbreaks. In 2025, four countries, Cameroon, Chad, Guinea, and Nigeria reported cVDPV3 outbreaks.

The Committee noted that although global transmission of cVDPV1 and cVDPV3 remains at lower levels compared to cVDPV2, the upward trend observed in 2025 is a concern. This underscores the critical importance of sustaining high population immunity against type 1 and type 3 polioviruses through robust routine immunization, as well as ensuring timely and high-quality response activities in the event of any detections.

The Committee noted that the risk of cVDPV outbreaks is largely driven by a combination of inaccessibility, insecurity, high concentrations of zero-dose and under-immunized children, and ongoing population displacement.

Conclusion

1. The Committee unanimously concluded that the risk of international spread of polioviruses continues to constitute a Public Health Emergency of International Concern (PHEIC) and recommended extending the Temporary Recommendations for a further three months.
2. The Committee, after a thorough review of the epidemiological and programmatic situation, unanimously concluded that the event does not constitute a pandemic emergency.

In reaching the conclusion that the risk of international spread of poliovirus continues to constitute a PHEIC, the Committee considered the following factors:

Ongoing risk of WPV1 international spread

The Committee noted that the risk of international spread of WPV1 persists due to the following factors:

• Ongoing WPV1 transmission in the core reservoirs, particularly in the southern region of Afghanistan and Karachi and South KP in Pakistan.
• Persistent inconsistencies in campaign quality and a substantial number of unimmunized and under-immunized children in some key areas, driven by access constraints due to insecurity (e.g. South KP, South Afghanistan), sub-optimal operational performance (e.g. site-to-site vaccination modality in Afghanistan and uneven quality in parts of Pakistan), and vaccine hesitancy in certain communities (e.g. South KP, Quetta Block, Southeast Afghanistan), all contributing to gaps in the population immunity.
• Ongoing population movement between the two endemic countries, including the returnees from Pakistan to Afghanistan, leading to continued risk of cross-border WPV1 transmission.
• Population movement from the two endemic countries to other neighbouring and distant countries, demonstrating risk of international spread (recent example from late 2025: Germany).

Ongoing risk of cVDPV international spread

Based on the following factors, the risk of international spread of cVDPV appears to remain high:

• Continued cVDPV2 transmission in Lake Chad Basin, particularly in high-risk areas of Nigeria, with continued potential for amplification of spread.
• Ongoing cVDPV2 transmission in the Horn of Africa, including Somalia, Ethiopia, and Yemen. The Horn of Africa countries continue to experience overlapping humanitarian and health emergencies, making it challenging to implement high-quality vaccination campaigns in a timely manner.
• A large pool of unimmunized and susceptible children in the northern governorates of Yemen (more than 4.5 million children aged less than five years), where a proper OPV response to the ongoing cVDPV2 outbreak has not yet been implemented due to insecurity and lack of access. Challenges also persist regarding timely shipment of AFP stool specimens from these areas. Full access to all children in Nigeria, southern and central Somalia also remains a significant challenge.
• A widening gap in intestinal mucosal immunity among young children since the global withdrawal of OPV2 in 2016, as well as high concentration of zero dose children in certain areas.
• Continued low routine immunization and IPV coverage in several countries, resulting in persistent immunity gaps, indicates an ongoing risk of cVDPV1 and cVDPV3 outbreaks. This is underscored by the cVDPV1 outbreaks reported in 2025 in Algeria, Djibouti, the Lao People's Democratic Republic, and Israel, and in 2026 in South Sudan, as well as the cVDPV3 outbreaks in Cameroon, Chad, Guinea, and Nigeria.
• Ongoing cross-border transmission, including spread into newly re-infected countries and territories.

Additional Contributing factors include:

• Sub-optimal routine immunization: Many countries have weak immunization systems that can be further impacted by humanitarian emergencies including conflict, protracted complex emergencies and lack of political commitment. This growing vulnerability leaves populations in fragile states at increased risk of polio outbreaks.
• Ongoing insecurity and conflict in several areas that serve as persistent source of cVDPV transmission.
• The current resource-constrained environment further challenges the full and effective implementation of critical eradication activities.

Risk categories

The Committee provided the Director-General with the following advice aimed at reducing the risk of international spread of WPV1 and cVDPVs, based on the risk stratification as follows:

1. States infected with WPV1, cVDPV1 or cVDPV3, with or without evidence of local transmission.
2. States infected with cVDPV2, with or without evidence of local transmission.
3. States previously infected by WPV1 or cVDPV within the last 24 months (last detection > 13 months)

Criteria to assess States as no longer infected by WPV1 or cVDPV:

• Poliovirus Case: 12 months after the date of onset of the most recent case PLUS one month to account for case detection, investigation, laboratory testing and reporting period OR when all reported AFP cases with onset within 12 months of last case have been tested for polio and excluded for WPV1 or cVDPV, and environmental or other samples collected within 12 months of the last case have also tested negative, whichever is the longer.
• Environmental or other isolation of WPV1 or cVDPV (no poliovirus case): 12 months after collection of the most recent positive environmental or other sample (such as from a healthy child) PLUS one month to account for the laboratory testing and reporting period.
• These criteria may be varied for the WPV1 endemic countries and countries with longstanding persistent polio outbreaks, where more rigorous assessment is needed in reference to surveillance quality.

Once a country meets these criteria as no longer infected, the country will remain on a ‘watch list’ for a further 12 months as a period of heightened monitoring.  After this period, the country will no longer be subject to Temporary Recommendations.

Temporary recommendations

States infected with WPV1, cVDPV1 or cVDPV3 with or without evidence of local transmission
(as of data available at WHO HQ on 30 April 2026)

States that have had an emergence or importation of cVDPV1 or cVDPV3, or importation of WPV1 but without evidence of local transmission should:

• Officially declare, if not already done, at the level of head of state or government, that the risk of poliovirus transmission is a national public health emergency and implement all required measures to support polio eradication. Where such declaration has already been made, this emergency status should be maintained as long as the response is required.
• Undertake urgent and intensive investigations and risk assessment to determine if there has been local transmission, requiring an immunization response.
• Further intensify efforts to increase routine immunization coverage, as high routine immunization coverage is an essential element of the polio eradication strategy, particularly as the world moves closer to eradication. Countries which have not yet introduced a second dose of IPV into their routine immunization schedules should urgently implement this. Once available, countries should also consider introducing the hexavalent vaccine, now approved by Gavi.
• Intensify surveillance for polioviruses and strengthen regional cooperation and cross-border coordination to ensure the timely detection of poliovirus.
• Ensure a high-quality surveillance network that provides equitable coverage of all populations, enabling timely detection of new poliovirus isolates and effective monitoring and response to evolving epidemiological trends.
• Ensure that both routine and supplementary immunization activities reach all geographies and populations equitably, aiming to achieve uniformly high population immunity. The GPEI and other relevant international health partners should support countries in ensuring fair and timely access to recommended polio vaccines through established global mechanisms.

States with local transmission of cVDPV1, cVDPV3 or WPV1 with risk of international spread, in addition to the above measures, should:

• Ensure that all residents and long­term visitors (> four weeks) of all ages, receive a dose of bivalent oral poliovirus vaccine (bOPV) or inactivated poliovirus vaccine (IPV) between four weeks and 12 months prior to international travel.
• Ensure that those undertaking urgent travel (within four weeks), who have not received a dose of bOPV or IPV in the previous four weeks to 12 months, receive a dose of polio vaccine at least by the time of departure as this will still provide benefit, particularly for frequent travelers.
• Ensure that such travelers are provided with an International Certificate of Vaccination or Prophylaxis in accordance with the Model International Certificate of Vaccination or Prophylaxis (ICVP), contained in Annex 6 of the IHR to record their polio vaccination and serve as proof of vaccination. It is noted that, in accordance with resolution WHA77.17, ICVP issued after 19 September 2025 (date of entry into force of the amendments) by States Parties to which the amendments apply shall conform to the amended Model ICVP contained in Annex 6.
• Restrict at the point of departure the international travel of any resident lacking documentation of appropriate polio vaccination. These recommendations apply to international travelers from all points of departure, irrespective of the means of transport (road, air and/or sea).
• Further enhance cross­border efforts by significantly improving coordination at the national, regional, and local levels to substantially increase vaccination coverage of travelers crossing the border and of high risk cross­border populations. Improved coordination of cross­border efforts should include closer supervision and monitoring of the quality of vaccination at border transit points, as well as tracking of the proportion of travelers that are identified as unvaccinated after they have crossed the border.

For both sub-categories

• Maintain these measures until the following criteria have been met: (i) at least six months have passed without new detections from any source and (ii) there is documentation of full application of high-quality eradication activities in all infected and high-risk areas; in the absence of such documentation these measures should be maintained until the state meets the criteria of a ‘state no longer infected’.
• Provide to the Director-General a regular report on the implementation of the Temporary Recommendations, including vaccination of international travelers, as appropriate.
• At the end of 12 months without evidence of transmission, provide a situational review report to the Director-General, including the measures taken to maintain high population immunity.

States infected with cVDPV2, with or without evidence of local transmission:
(as of data available at WHO HQ on 30 April 2026)

States that have had an importation of cVDPV2 but without evidence of local transmission should:

• Officially declare, if not already done, at the level of head of state or government, that the risk of poliovirus transmission is a national public health emergency.
• Undertake urgent and intensive investigations and risk assessment to determine if there has been local transmission of the imported cVDPV2, requiring an immunization response.
• Noting the existence of a separate mechanism for responding to type 2 poliovirus infections, States should ensure preparedness to request vaccines from the global novel OPV2 stockpile, as required.
• Further intensify efforts to increase routine immunization coverage, as high routine immunization coverage is an essential element of the polio eradication strategy, particularly as the world moves closer to eradication. Countries which have not yet introduced a second dose of IPV into their routine immunization schedules should urgently implement this. Once available, countries should also consider introducing the hexavalent vaccine, now approved by Gavi.
• Intensify surveillance for polioviruses and strengthen regional cooperation and cross-border coordination to ensure the timely detection of poliovirus.
• Ensure a high-quality surveillance network that provides equitable coverage of all populations, enabling timely detection of new poliovirus isolates and effective monitoring and response to evolving epidemiological trends.
• Ensure that both routine and supplementary immunization activities reach all geographies and populations equitably, aiming to achieve uniformly high population immunity. The GPEI and other relevant international health partners should support countries in ensuring fair and timely access to recommended polio vaccines through established global mechanisms.

States with local transmission of cVDPV2, with risk of international spread, in addition to the above measures, should:

• Encourage residents and long­term visitors (> four weeks) to receive a dose of IPV four weeks to 12 months prior to international travel.
• Ensure that travelers who receive such vaccination are provided with an International Certificate of Vaccination or Prophylaxis in accordance with the Model International Certificate of Vaccination or Prophylaxis (ICVP), contained in Annex 6 of the IHR to record their polio vaccination and serve as proof of vaccination. It is noted that, in accordance with resolution WHA77.17, ICVP issued after 19 September 2025 (date of entry into force of the amendments) by States Parties to which the amendments apply shall conform to the amended Model ICVP contained in Annex 6.
• Enhance regional cooperation and cross­border coordination to enhance surveillance for prompt detection of poliovirus, and vaccinate refugees, travelers and cross­border populations.

For both sub-categories:

• Maintain these measures until the following criteria have been met: (i) at least six months have passed without cVDPV2 detection from any source, and (ii) there is documentation of full application of high-quality eradication activities in all infected and high-risk areas; in the absence of such documentation these measures should be maintained until the state meets the criteria of a ‘state no longer infected’.
• Provide to the Director-General a regular report on the implementation of the Temporary Recommendations, including vaccination of international travelers, as appropriate.
• At the end of 12 months without evidence of transmission, provide a situational review report to the Director-General, including the measures taken to maintain high population immunity.

States no longer polio infected, but previously infected by WPV1 or cVDPV within the last 24 months(as of data available at WHO HQ on 30 April 2026)

WPV1

cVDPV

These countries should:

• Strengthen routine immunization to boost/maintain population immunity, particularly among high-risk and vulnerable populations.
• Ensure high quality surveillance, including considering introducing or expanding supplementary methods such as environmental surveillance, to reduce the risk of undetected WPV1 and cVDPV transmission, particularly among high-risk and vulnerable populations.
• Maintain efforts to ensure vaccination of mobile populations, including populations moving across national borders, internally displaced persons, refugees, and other vulnerable groups.
• Maintain regional cooperation and cross border coordination to ensure early detection of WPV1 or cVDPV, and vaccination of high-risk population groups.
• Maintain these measures with documentation of full application of high-quality surveillance and vaccination activities.

Additional considerations and recommendations

The Committee expressed its deepest condolences to the families, friends, and colleagues of the health workers who lost their lives while supporting polio vaccination activities. The Committee expressed its solidarity with those affected and condemned attacks on health workers, emphasizing that their safety and security are essential to achieving global polio eradication.

The Committee noted the overall decline in the number of WPV1 and cVDPV cases during the last 12 months. However, this trend is subject to some important considerations, noted below.

For WPV1, transmission has survived the low transmission season in some critical geographies of the two endemic countries, posing a risk to the achievements. These include the South Region of Afghanistan and South KP and Karachi in Pakistan. In Afghanistan, the absence of house-to-house vaccination campaigns since October 2024 has led to suboptimal campaign quality, especially in the South Region, where intense WPV1 transmission persists.

The Committee recognized the political commitment in Pakistan and that the current high-level momentum in the country programme, if translated into high quality operational implementation and access to all children, offers an opportunity to fast-track progress towards stopping WPV1 transmission, with success hinging on progress in South KP and Karachi. The Committee recognized the operational and social mobilization related adjustments made to maximize reach through site-to-site campaigns in Afghanistan, which have resulted in encouraging progress in the critical East Region of the country. However, the Committee urged the Afghanistan polio programme to explore feasible options for transitioning to house-to-house vaccination everywhere in the country, as site-to-site campaigns have generally not achieved the consistent high coverage and quality required for eradication, particularly in the South Region.

The Committee acknowledged the GPEI efforts to resume and regularize the sample shipment from Afghanistan to the Regional Reference Laboratory in Islamabad, and urged that this mechanism be maintained, with appropriate contingency planning to address any future disruptions. The Committee appreciated the ongoing coordination between the Afghanistan and Pakistan polio programmes for vaccination and surveillance activities, which is critical to success in this epidemiological bloc.

For cVDPV outbreaks, the Committee noted the continued transmission in the African Region, particularly in the Lake Chad Basin and the Horn of Africa. The Committee expressed deep concern about the situation in Nigeria and Yemen, where the access and the quality of response remain significantly sub-optimal over a long period of time. In Nigeria, both routine immunization and supplementary immunization activities have not been able to reach all children, particularly in the high-risk northern states, due to a mix of challenges related to operational quality and access, noting that essential resources have largely been made available to the country by the GPEI. The Committee urged that all necessary steps be considered at the national, state and local government levels to improve routine immunization and enhance the quality of vaccination campaigns to stop the cVDPV2 and cVDPV3 outbreaks in Nigeria. This is critical to success in the African Region and globally since Nigeria is the largest contributor to the global cVDPV caseload. Similarly, ongoing challenges have not allowed the implementation of any immunization response in the northern governorates of Yemen, where cVDPV2 transmission continues. Moreover, a significant backlog of AFP stool specimens from Yemen awaits testing. The Committee urged the GPEI to explore all feasible options and to intensify advocacy efforts to facilitate meaningful progress in Yemen. In Somalia, the ongoing cVDPV2 detections indicate uneven population immunity, with persistent access challenges in South and Central regions, leaving more than 450 000 children unreached during vaccination campaigns.

The Committee noted that conflict and insecurity continue to affect many countries and sub-national areas experiencing WPV1 and cVDPV outbreaks, disrupting both routine immunization services and supplementary polio vaccination campaigns. Moreover, concurrent health emergencies and other disease outbreaks in several of these countries compound the difficulties in mounting timely and effective vaccination responses. Recognizing the highly diverse and often complex operating environments at national and sub-national levels, the Committee emphasized the critical importance of tailoring operational strategies and social mobilization efforts to local contexts in order to achieve high-quality campaign implementation and ultimately interrupt transmission. The Committee also underscored the need for a ‘bloc approach’ and coordinated sub-regional approaches and strengthened cross-border collaboration to address the challenges arising from porous borders and shared operational constraints among polio-affected countries.

The Committee emphasized the urgent need for a comprehensive, ‘whole-of-government’ and ‘whole-of-society’ approach in both polio endemic countries as well as critical outbreak affected countries, extending to the district level, to deliver the high-quality activities required for success, and sustain global confidence and support for polio eradication.

The Committee remains concerned that the current financial shortfall estimated at nearly 30% poses a substantial risk to all programme components, including the maintenance of sensitive poliovirus surveillance. These risks are exacerbated by concurrent funding constraints affecting WHO, international partners, and national governments, reflecting broader fiscal pressures in the global health sector. The Committee also recognized that the increasingly complex geopolitical environment continues to affect programme implementation in several countries. The Committee noted that the resulting operational and financial pressures, including rising transportation and fuel costs and broader resource constraints, are placing additional strain on the delivery of essential programme activities. The Committee recommended that WHO and GPEI surveillance teams at global, regional, and national levels ensure robust mechanisms for monitoring surveillance quality, particularly in priority countries, in order to identify any emerging gaps promptly and facilitate timely remedial action. The Committee further urged donor countries and partner organizations to increase their financial support, underscoring that the consequences of under-funding could be substantial and far-reaching. The Committee urged national governments to prioritize polio eradication within their domestic financing frameworks to safeguard the gains made and sustain momentum towards global eradication.

The risk of international spread remains considerably lower for circulating vaccine-derived poliovirus types 1 and 3 (cVDPV1 and cVDPV3) than for cVDPV2. Nevertheless, the Committee expressed concern regarding the cVDPV1 and cVDPV3 outbreaks reported in 2025 and 2026, indicating the presence of population subgroups with suboptimal immunity to poliovirus types 1 and 3 and highlighting the importance of improving routine immunization. The Committee recommended that high-quality outbreak response measures be implemented to stop the cVDPV1 and cVDPV3 outbreaks and prevent further geographic spread. The Committee noted that, given the current financial limitations facing the GPEI, preventive vaccination campaigns using bOPV cannot be supported in countries that have no active transmission of poliovirus type 1 or type 3. The Committee encouraged countries where population immunity to types 1 and/or 3 is very low to consider conducting catch-up activities through routine immunization programmes and, where justified by a careful risk assessment, implementing supplementary immunization activities with bOPV using domestic resources.

The Committee recognized the critical role of mobile and migrant populations in sustaining WPV1 transmission in the two endemic countries, as well as cVDPV transmission in the African Region and elsewhere globally. The Committee urged that vaccination of populations on the move be accorded the highest priority. The Committee emphasized the need to identify and differentiate the various categories of mobile populations and to reach them through country-specific, tailored strategies, drawing on current guidance from WHO and the GPEI.

The Committee noted ongoing cross-border transmission of polioviruses, predominantly in the African and Eastern Mediterranean Regions. In-depth genetic analyses indicate at least 13 documented cVDPV global importation events from January 2025 to January 2026. Notable events include the detection of WPV1 in wastewater in Germany in October 2025, multiple detections of cVDPV2 in some countries of the European Region in 2025 and 2026, cVDPV2 in Papua New Guinea linked to the 2024 transmission in Indonesia, cVDPV2 in Namibia and Zambia associated with the outbreak in Angola, cVDPV2 in Togo, Benin, Burkina Faso, and Algeria associated with the outbreak in Nigeria, as well as shared cVDPV3 transmission between Chad and Cameroon. These events reaffirm that polio continues to pose a global threat until complete eradication is achieved. The Committee emphasized the vital importance of sustaining highly sensitive surveillance in all polio-affected and high-risk countries. The Committee further underscored the need to preserve the operational capacity of the Global Polio Laboratory Network to ensure timely and accurate poliovirus detection in support of eradication efforts. Strong surveillance remains essential for the early identification of and rapid response to both imported viruses and newly emerging outbreaks. The Committee recommended that communication and programme messaging concerning the international spread of polioviruses be carefully tailored to the specific epidemiological and socio-political context of each setting, including high-income countries, in order to promote greater understanding and sustained commitment to the global polio eradication effort.

The Committee noted that novel OPV2 continues to demonstrate greater genetic stability compared to Sabin OPV2. However, the risk of new cVDPV2 emergences increases when the interval between outbreak response campaigns exceeds four weeks or when vaccination quality is suboptimal, underscoring the need for timely and high-quality immunization efforts.

Based on the current situation regarding WPV1 and cVDPVs, and the reports provided by affected countries, the Director-General accepted the Committee’s assessment, and on 21 August 2026 determined that the poliovirus situation continues to constitute a public health emergency of international concern (PHEIC) with respect to WPV1 and cVDPV. He further followed the advice of the Committee that the poliovirus situation does not constitute a pandemic emergency.

The Director-General endorsed the Committee’s recommendations for countries meeting the definition for ‘States infected with WPV1, cVDPV1 or cVDPV3’, ‘States infected with cVDPV2’ and for ‘States previously infected by WPV1 or cVDPV within the last 24 months’ and extended the Temporary Recommendations under the IHR to reduce the risk of the international spread of polioviruses, effective, 21 August 2026.

¹ The text of the International Health Regulations (2005), as amended in 2014, 2022 and 2024 is available at https://apps.who.int/gb/bd/pdf_files/IHR_2014-2022-2024-en.pdf [accessed on 21 October 2025]

² Under amended Article 1 of the IHR, “pandemic emergency” is defined as “a public health emergency of international concern that is caused by a communicable disease and:
(i) has, or is at high risk of having, wide geographical spread to and within multiple States; and
(ii) is exceeding, or is at high risk of exceeding, the capacity of health systems to respond in those States; and
(iii) is causing, or is at high risk of causing, substantial social and/or economic disruption, including disruption to international traffic and trade; and
(iv) requires rapid, equitable and enhanced coordinated international action, with whole-of government and whole-of-society approaches.