KABUL, 25 January 2009 (IRIN) - Over 650,000 children under five have missed the first nationwide polio immunisation drive in 2009 because of access restrictions due to insecurity and heavy snow in various parts of Afghanistan, the Ministry of Public Health (MoPH) said.

A three-day national polio immunisation campaign launched on 3 January had reached about seven million children.

Roads blocked by snow in Ghor, Badghis, Daykundi, Farah and Bamiyan provinces prevented access to over 440,000 children, Abdullh Fahim, MoPH's spokesman in Kabul, told IRIN on 22 January.

Over 215,000 children were also missed in the volatile southern provinces of Kandahar, Helmand, Uruzgan and Zabul where aid workers and health centres have been repeatedly attacked by insurgents over the past few months, according to Fahim.

"We will launch another campaign for the children that we could not reach because of bad weather," said Fahim, adding that efforts were also under way to access children in insecure areas in the south.

Afghanistan, with a population of some 27 million, is one of four countries in the world where poliomyelitis is still endemic. The MoPH confirmed 31 polio cases, mostly in insecure southern and eastern areas, in 2008.

Six nationwide anti-polio drives in 2009

Despite constant rounds of immunisation, poliovirus has left many Afghan children crippled over the past four years.

Afghanistan was expected to wipe out polio in 2006 but returning refugees, conflict and resistance to the immunisations by some sceptical groups have repeatedly delayed the target.

The MoPH, backed by UN agencies and several other donors, will conduct six nationwide and 12 regional polio immunisation drives in 2009, Fahim said. The exercise will cost about US$30 million, all of which will be paid by donors such as the UN Children's Fund (UNICEF) and the World Health Organization (WHO).

MoPH officials say access to children, rather than lack of money, is their main concern. "We could eradicate poliovirus in three years if we had access to all children," Fahim said.

In 2008 health workers engaged in direct and indirect access negotiations with Taliban insurgents and managed to immunise children in some volatile regions. The effort has potential for success but is in need of strong follow-up measures, enhanced awareness, local support and extended efforts by all actors, experts say.

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