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Ruchi Kumar is a Mumbai-based journalist who covers conflict, politics and gender. From 2014 to 2021, she reported out of Kabul.

Last week, international agencies and health workers across Afghanistan learned that the Taliban had suspended the direct, door-to-door polio vaccination campaign that was scheduled to begin.

The timing couldn’t have been worse. The decision to halt nationwide immunizations comes just days after the World Health Organization (WHO) reported 18 new cases of polio infection in the country this year, a significant rise from the six cases reported in 2023. Afghanistan and Pakistan are the only two countries in the world that have failed to eradicate polio virus transmission.

While there was no official reason provided for the suspension, health care workers familiar with the situation reported that the Taliban want to stop all door-to-door immunizations owing to a combination of security concerns and their restrictions on women. They now plan to shift vaccination efforts to local mosques, with the expectation that families will bring their children to get the doses.

The Taliban believe that the door-to-door campaigns could be used to identify and reveal their locations to foreign threats, claiming historic precedent that such campaigns were used by Western intelligence agencies in the past to locate and target terrorists such as Osama bin Laden. That has led to widespread mistrust of the immunization campaigns, including conspiracy theories spread by militants and religious leaders that the West uses vaccines to sterilize Muslim children, or that they contain taboo ingredients, or that they weaken one’s faith; these conspiracies have prompted deadly attacks on polio workers in Afghanistan and Pakistan. Even before they took over the country, the Taliban had restricted door-to-door campaigns in areas they controlled.

However, the Taliban’s fear of health care workers isn’t the only reason for the ban. Since taking over in 2021, the Taliban have introduced a number of restrictions on women’s rights and movement, barring them from participating in public and political life, while also limiting their employment opportunities. While women are still allowed to work in the health care sector, many Afghan women have reported that they have been forced to leave their jobs under pressure from local authorities.

But Afghan women workers have been crucial to the success of the door-to-door immunization efforts. In a society that is deeply conservative and gender-segregated, they have unique access to families and spaces where men would not be welcomed. Vaccination campaigns have employed thousands of Afghan women, who despite the risks and threats, travel into remote communities to administer doses and raise awareness on the risks.

As a result, Afghanistan was making significant progress in combatting polio in the recent years. Despite a setback in 2020 because of the COVID-19 pandemic, the WHO reported the lowest number of polio cases in 2021: just four, down from 56 in the prior year. The labour of Afghan women was key to this success.

When the Taliban seized power, many health care workers hoped that it would translate to better health care access into communities that had been isolated during the war. Unfortunately, that was not the case, as the Taliban actually expanded their restrictions in southern Afghanistan. In fact, several health workers in southern Afghanistan, particularly in Kandahar, the seat of the Taliban’s political power, shared that door-to-door campaigns have been banned for years in the region.

The results speak for themselves. Of the 18 cases of polio reported this year, 16 are from the southern provinces, and 11 of those are from Kandahar province alone.

A map of regions that have banned door-to-door vaccinations and a map locating the most recent cases of polio in Afghanistan would look nearly identical. Without women’s participation, it will be impossible for the country to achieve widespread immunization coverage.

Even the success of mosque vaccination campaigns, if and when they are resumed, will require women’s participation, as awareness efforts within communities will be imperative, and women will have better access to gendered spaces in conservative families.

Eliminating women from efforts to prevent the spread of the highly infectious virus could spell tragedy for not just Afghanistan, but also for the world’s broader eradication efforts. If polio is to be completely eliminated, it is crucial to achieve herd immunity, by ensuring that more than 95 per cent of the population receives the vaccine doses regularly. Instead, the Taliban’s commitment to their ideological and systemic repression of Afghan women – as well as the group’s enduring paranoia about the West – will only bring pain to their own people and threaten to undo decades of global efforts to contain the virus.

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