Some information in this report came from Reuters.

More than 1 million Afghan children, particularly in conflict-stricken regions of the country, were deprived of polio vaccinations in 2018 because of actions taken by Taliban and Islamic State militants, Afghanistan health officials tell VOA.

"Overall, 1.2 million children were deprived of vaccinations in the country," Dr. Gula Khan Ayoubi, public affairs director of the mass immunization program at the Afghan Ministry of Public Health, told VOA. "And the hope this year is to bring down the number to about 200,000 children. The remaining 200,000 children are living in areas where the Islamic State terror group has a strong presence and does not allow any vaccinations."



"To a large extent, the southern provinces of Zabul, Kandahar, Helmand, Uruzgan, and in the east, Kunar, have been affected the most due to the Taliban's opposition," Ayoubi added.



Afghanistan, Pakistan and Nigeria are the only three countries in the world where polio is still not eliminated and continues to threaten the lives of millions of children.



In 2018, Afghanistan had the most cases of polio among the three, with 21 cases reported across the country.



Afghan officials charge that contentious fighting, unrest, and the Taliban, IS and other armed groups are the main obstacles in the hard-to-reach areas in southern, southeastern and eastern Afghanistan.

A health worker administers the polio vaccine to a FILE - An Afghan health worker administers the polio vaccine to a child during a vaccination campaign on the outskirts of Jalalabad on March 12, 2018. FILE - An Afghan health worker administers the polio vaccine to a child during a vaccination campaign on the outskirts of Jalalabad on March 12, 2018.

?Immunization ban



The Afghan Taliban last week told Reuters the group had banned the activities of World Health Organization and the International Committee of the Red Cross in areas under their influence until further notice.



"They [vaccinators] have not stuck to the commitments they had with Islamic emirates, and they are acting suspiciously during vaccination campaigns," Taliban spokesman Zabihullah Mujahid said.



Polio vaccinators often go house to house to vaccinate children, and they mark the doors of houses where members are not present at the time to ensure the residents are vaccinated at a later date.



The Taliban consider these vaccinators spies for the government and foreign forces, and are sensitive to their presence in areas under their influence.



Conditional agreement



Afghan health officials told VOA this month that they had reached a conditional agreement with the Taliban to continue their vaccination campaign in Taliban-controlled areas.



"With the help of religious leaders and local influential elders, local Taliban commanders have agreed to allow the children under their controlled areas to be vaccinated," Ayoubi said at the time. "Their condition, however, is that the mass vaccinations take place at a mosque or a similar place. Our vaccinators would not be allowed to go house by house and mark the doors."



WHO reaction



In a statement issued last week, WHO said the Taliban's ban would negatively affect its operations across the war-torn country.



"We are deeply concerned that the temporary ban will negatively impact delivery of health services to affected populations," the organization said. "WHO has been supporting health activities in all parts of Afghanistan, including primary health care, response to health emergencies, vaccination and polio eradication."

An Afghan health worker vaccinates a child as part FILE - An Afghan health worker vaccinates a child as part of a campaign to eliminate polio, on the outskirts of Kabul, Afghanistan, April 18, 2017. FILE - An Afghan health worker vaccinates a child as part of a campaign to eliminate polio, on the outskirts of Kabul, Afghanistan, April 18, 2017.

Sanela Bajrambasic, spokesperson for the International Committee of the Red Cross in Geneva, also said her organization was seeking clarification from the Taliban and that it would work with the group to find a solution to the issue.



"What we can say at this point is that we have seen the same statement on their website, and we will be seeking to engage bilaterally with the Taliban on it," she told Reuters.



Negative campaign



Some experts charge that in addition to militant groups, negative campaigns and rumors that swine are used to prepare the polio vaccine or that it has dangerous side effects have also made it difficult for vaccination campaigns to succeed in rural areas, which contribute to the spread of polio.



"The groups that spread these rumors are those opposing the mass immunization programs," said Dr. Najib Safi, WHO program manager of health system development. "These groups have always been trying to confuse people. In 2016, Afghan religious scholars decreed that it is permissible to use the polio vaccine. In addition to that, there are Islamic decrees from Egypt's al-Azhar University, [Saudi Arabia's] Jeddah and India's Deobandi Islamic school that the polio vaccine is permissible to administer."



"Polio, and all other immunizing vaccines that are being administered to children, have no side effects. There are no links between the polio vaccine and impotency," Safi added, making a reference to rumors.



Dr. Alam Shinwari, a medical expert who follows health-related developments, including polio in Afghanistan, charges that public awareness is the key to overcoming this issue.



"Polio is mainly endemic in areas around the border between Pakistan and Afghanistan, where traditional conservative religious tribes are residing, who have been influenced by their local religious scholars and local traditions beliefs that have negatively impacted their perceptions toward polio vaccination," Shinwari said.



"To overcome such barriers, we need to increase the level of public awareness by involving local religious scholars and imams, local educational experts, and finally, local leaders and elders. They have significant influence among people in tribal areas between Afghanistan and Pakistan and can help overcome this problem," he said.