Key figures (as of October 2026)
| Wild poliovirus cases in 2026, as of 25 October | 49: Afghanistan 42, Pakistan 7 |
| Wild poliovirus cases in 2025 | 52: Afghanistan 21, Pakistan 31 |
| Wild poliovirus cases in 2024 | 99: Afghanistan 25, Pakistan 74 |
| Positive wastewater samples in 2026, as of 25 October | 230: Afghanistan 93, Pakistan 137 |
| Positive wastewater samples in 2025 | 747, including 2 in Europe |
| Programme target | Wild poliovirus eradicated by the end of 2027; type 2 variant poliovirus by the end of 2029 |
| Programme operating budget for 2027 | About US$778 million, roughly US$65 million below 2026 |
Six years of wild poliovirus cases
| Year | Global cases | Afghanistan | Pakistan | Elsewhere |
|---|---|---|---|---|
| 2020 | 140 | 56 | 84 | 0 |
| 2021 | 6 | 4 | 1 | 1 (south-east Africa) |
| 2022 | 30 | 2 | 20 | 8 (south-east Africa) |
| 2023 | 12 | 6 | 6 | 0 |
| 2024 | 99 | 25 | 74 | 0 |
| 2025 | 52 | 21 | 31 | 0 |
| 2026 (to 25 October) | 49 | 42 | 7 | 0 |
The series swings sharply. Cases fell by about 96% from 2020 to 2021, then rose eightfold from 2023 to 2024. Low years have often been followed by rebounds, so a single good season is weak evidence that transmission has stopped.
Counts cover wild poliovirus only. Cases of paralysis caused by circulating vaccine-derived poliovirus, which arises in under-immunised communities, are reported separately and are not part of this forecast.
Where the virus is now
Pakistan has made clear progress in 2026. Seven cases have been confirmed so far, against 31 in all of 2025. Five were in Khyber Pakhtunkhwa and two in Sindh, including a case in Karachi with paralysis onset in September. Positive wastewater samples have fallen from 651 in all of 2025 to 137 so far this year, and the programme reports a 75% fall in wild poliovirus detection in Pakistan this year. There have been no cases in Punjab this year, and recent wastewater samples from Lahore and Rawalpindi were negative.
Afghanistan has moved the other way. It has 42 cases so far in 2026, against 21 in all of 2025, with recent cases from Kandahar, Nangarhar and Kabul and onsets as late as September. Transmission continues in the shared southern and northern corridors along the border, where the virus was still passing from one country to the other in early 2026. The virus also persisted through the most recent low-transmission season, from October 2025 to April 2026.
Reporting lag matters. Samples can take weeks to be tested and classified. In 2025, a pause in sample shipments from October 2025 to January 2026 meant the 2025 total kept rising long after the year ended: from 40 confirmed cases in early 2026 to 52 by August 2026. Shipments now travel by air, but a lag of several months should still be expected.
Vaccination and strategy
Both countries run an intensive, largely synchronised schedule of vaccination campaigns that aims for high coverage in the core reservoirs. In 2025 Afghanistan held two nationwide and five sub-national campaigns and Pakistan five nationwide and one sub-national, alongside targeted injectable-vaccine campaigns in high-risk areas. Pakistan held two nationwide campaigns in 2026, in February and April, each reaching more than 44 million children. A week-long sub-national campaign is scheduled to start on 2 November, targeting more than 23.9 million children in 97 districts.
The programme's extended strategy runs to 2029. It sets the end of 2027 for wild poliovirus and the end of 2029 for type 2 variant poliovirus. The 2027 budget protects the work most critical to interrupting transmission in Pakistan and Afghanistan. Funding is lower, however: some outbreak responses will be limited or delayed, and surveillance funding stays at its reduced 2026 level.
Scenarios: wild poliovirus cases with onset in 2027
Resolution rule: the total number of wild poliovirus cases of all types, in all countries, with paralysis onset from 1 January to 31 December 2027, as shown in the global programme's official weekly count. The first count published on or after 31 March 2028 decides; later revisions do not count. Bands use whole numbers, and a value on an edge belongs to the band whose range includes it: 9 is in band 1, 10 is in band 2, 30 is in band 3, 60 is in band 4 and 100 is in band 5. If no official 2027 count has been published by 30 June 2028, the forecast is withdrawn. Probabilities are the Centre's analytical estimates. The forecast is scored with a multi-category Brier score and a ranked probability score across the five ordered bands.
0 to 9 cases
This band would mean near-interruption, as in 2021, when cases fell to 6. Pakistan's 75% fall in wild poliovirus detection makes progress there plausible. But Afghanistan has 42 cases so far in 2026, and the virus kept circulating through the last low season. Reaching single figures across both countries within one year would take a fall faster than any since 2020–21.
10 to 29 cases
This band would see the improvement in Pakistan continue and Afghanistan's 2026 rise reverse. In 2023 the global total was 12, so counts this low have happened recently. The weight reflects a credible path to a lower year with sustained campaigns. It is held back by Afghanistan's current numbers and the lower 2027 budget.
30 to 59 cases
This band holds the central estimate. Two of the last six years fell here (30 in 2022 and 52 in 2025), and 2026 has already reached 49 with onsets still being confirmed. A year similar to 2025 or 2026, with Pakistan low and Afghanistan level or modestly down, lands here. The first count after 31 March 2028 may also miss some late-confirmed cases, which pulls the published figure down slightly.
60 to 99 cases
This band covers a rebound or continued growth in Afghanistan, or a return of higher transmission in Pakistan, which rose from 6 cases in 2023 to 74 in 2024. The 2026 count is likely to finish in or near this band once lagged cases are added. The weight reflects that momentum and the reduced surveillance and outbreak-response budget.
100 cases or more
This band has happened once in the past six years (140 in 2020), and 2024 came close with 99. It would need a broad resurgence across both corridors. The persistent cross-border transmission, Afghanistan's sharp 2026 rise and funding constraints keep this tail meaningful. Pakistan's falling wastewater positivity argues against a larger weight.
What to watch
- The 2026 final count: how far the 49 cases rise as samples from late 2026 are classified.
- The low season, October 2026 to April 2027: whether wastewater positivity in both countries keeps falling and whether chains of transmission end.
- Afghanistan's southern and eastern regions: whether case growth in Kandahar and Nangarhar slows after campaigns.
- Karachi and southern Khyber Pakhtunkhwa: the main remaining reservoirs in Pakistan.
- Campaign reach and funding: the quality of synchronised campaigns, and whether more resources restore surveillance and outbreak response.
- Detections beyond the two countries: wastewater findings elsewhere, which would signal spread of the virus.
Figures as of October 2026. Probabilities are analytical estimates by the Ghaf Centre for Studies & Research.