Polio IHR Emergency Committee Convenes 42nd Meeting

The Forty-second meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) on the international spread of poliovirus was convened by the WHO Director-General on 18 June 2025 with committee members and advisers meeting via video conference with affected countries, supported by the WHO Secretariat. The Emergency Committee reviewed the data on wild poliovirus (WPV1) and circulating vaccine derived polioviruses (cVDPV) in the context of the global target of interruption and certification of WPV1 eradication by 2027 and interruption and certification of cVDPV2 elimination by 2029. Technical updates were received about the situation in the following countries: Afghanistan, Angola, Burkina Faso, Guinea, Nigeria, Pakistan, and Papua New Guinea.

Wild poliovirus

Since the last Emergency Committee meeting, nine new WPV1 cases were reported, one from Afghanistan and eight from Pakistan bringing the total to 13 WPV1 cases in 2025. In 2024, 99 WPV1 cases were reported during the whole year, including 25 from Afghanistan and 74 from Pakistan. A total of 275 WPV1 positive environmental samples have been reported in 2025 so far (as of 04 June), 30 from Afghanistan and 245 from Pakistan. In 2024, 741 WPV1 positive environmental samples were reported during the whole year, including 113 from Afghanistan and 628 from Pakistan.

The upward trend in WPV1 cases and environmental detections has persisted in both endemic countries throughout 2024. In Pakistan, this increase has been evident since mid-2023, initially in environmental samples and later in paralytic polio cases, primarily in Khyber Pakhtunkhwa (KP), Sindh, and Balochistan. In Afghanistan, the rise in WPV1 detections, both in environmental samples and cases during 2024 and 2025 has been concentrated primarily in the South Region. WPV1 transmission in Afghanistan's East Region has significantly declined during the first half of 2025, indicating enhanced population immunity. The Committee noted with concern the geographic expansion of WPV1 to new provinces and districts in both endemic countries during 2024 and 2025. Notably, Gilgit-Baltistan province in Pakistan reported its first WPV1 case in over eight years, underscoring the continued risk posed by persistent transmission in core reservoir areas. Currently, the most intense WPV1 transmission is occurring in the southern cross-border epidemiological corridor, encompassing Quetta Block (Pakistan) and the South Region (Afghanistan). The Committee also noted the ongoing WPV1 transmission in the epidemiologically critical blocks of Karachi, South KP and Central Pakistan.

Recent review of the molecular epidemiology shows an increase in the genetic biodiversity in 2024, necessitating a split of two genetic clusters into eight genetic clusters. Three genetic clusters are active in 2025. The remaining chains of transmission continue to circulate in populations and geographic areas with persistently low immunization coverage, including the bordering districts of the southern and northern epidemiological corridors across the two endemic countries. The genetic data analysis also indicates that WPV1 persisted through the low transmission season (October 2024 to April 2025) within the core reservoirs of Southern Afghanistan, Karachi, Peshawar, and the Quetta Block - posing a risk to achieving Goal 1 of the GPEI strategy by end-2025.

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. Afghanistan implemented two nationwide and two sub-national vaccination rounds while Pakistan implemented three nationwide and one sub-national vaccination round in 2025, so far.

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. The Committee expressed concern that site-to-site campaigns often fail to reach all children, particularly younger children and girls, which could contribute to a resurgence of WPV1 and its 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 the consistently high reported coverage and Lot Quality Assurance Sampling (LQAS) pass rates at the national and provincial levels. However, the Committee observed variability in campaign quality at the district and sub-district levels, attributed to operational challenges and prevailing insecurity, particularly in Khyber Pakhtunkhwa and Balochistan provinces.

In addition to seasonal population movements within and between the two endemic countries, the continued return of undocumented migrants from Pakistan to Afghanistan further compounds the challenges faced by the programme. This ongoing displacement heightens the risk of cross-border poliovirus transmission, as well as transmission within both countries. The Committee noted that this risk is being addressed through vaccination at border crossing points and the revision of micro-plans in districts of origin and return. The programme continues to coordinate closely with IOM and UNHCR. The Committee also acknowledged the ongoing coordination between the Afghanistan and Pakistan programmes at both national and sub-national levels and encouraged the continuation of these collaborative efforts.

In summary, available data indicate that global WPV1 transmission remains geographically confined to the two endemic countries. However, during 2024 and 2025, there has been geographic spread alongside continued transmission within core reservoir areas in both the endemic countries.

Circulating vaccine derived polioviruses (cVDPV)

In 2025, a total of 67 cVDPV cases have been reported to date, 65 of which are cVDPV2 and two are cVDPV3. No cVDPV1 cases have been reported in 2025. Additionally, 69 environmental samples have tested positive for cVDPV, all of which are type 2. In 2024, a total of 319 cVDPV cases were reported, including 304 cVDPV2, 11 cVDPV1, and 4 cVDPV3 cases. During the same year, 276 environmental samples tested positive for cVDPV, 273 cVDPV2 and three cVDPV3. Since the last meeting of the Emergency Committee, a cVDPV2 outbreak has been reported from Papua New Guinea in the WHO Western Pacific Region.

In 2025, a total of 15 circulating cVDPV2 emergence groups have been detected to date, compared to 30 in 2024, 27 in 2023, 22 in 2022, 29 in 2021, 36 in 2020, and 44 in 2019. Of the 15 emergence groups identified in 2025, two are newly detected this year and are derived from the novel OPV2 (nOPV2) vaccine. Since its introduction in 2021, approximately 1.65 billion doses of nOPV2 have been administered and a total of 30 cVDPV2 emergences have been associated with nOPV2. 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.

No cVDPV1 cases or positive environmental samples have been reported so far in 2025 (as of 4 June). In 2024, a total of 11 cVDPV1 cases were reported, 10 in the Democratic Republic of the Congo and one in Mozambique. The Committee noted the encouraging development of the closure of the cVDPV1 outbreak in Madagascar, following more than 18 months without detection, and supported by vigorous response efforts.

Guinea is the only country to report cVDPV3 cases in 2025 to date, with two cases confirmed. In 2024, cVDPV3 outbreaks were reported in two countries: French Guiana (a French territory in South America) and Guinea. Both outbreaks were attributed to new emergences, resulting in three positive environmental samples in French Guiana (May to August 2024) and four cVDPV3 cases in Guinea (July to November 2024). The Committee noted with concern the continuation of the cVDPV3 outbreak in Guinea from 2024 into 2025, as well as the co-circulation of both cVDPV2 and cVDPV3 in the country.

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

The Committee unanimously agreed that the risk of international spread of poliovirus continues to constitute a Public Health Emergency of International Concern (PHEIC) and recommended extending the Temporary Recommendations for a further three months. In reaching this conclusion, the Committee considered the following factors:

Ongoing risk of WPV1 international spread

Based on the following factors, there remains the risk of international spread of WPV1:

• Re-established WPV1 transmission in the core reservoirs, namely: south region of Afghanistan and Karachi, Peshawar and Quetta Block of Pakistan.
• WPV1 geographical spread to epidemiologically critical areas like Central Pakistan, and parts of Punjab province in Pakistan that were without any WPV1 detection for prolonged periods of time.
• This survival of WPV1 transmission through the low transmission season (Nov 2024 – Apr 2025) in both endemic countries indicates sizeable cohort of unimmunized and under-immunized children.
• A substantial number of WPV1-positive environmental samples have been reported in Pakistan in 2025; 275 to date, compared to 741 in all of 2024. This high environmental surveillance positivity during the low transmission season indicates intense WPV1 transmission and significant gaps in population immunity.
• Lack of house-to-house vaccination campaigns in Afghanistan represents a major risk of further WPV1 spread and intensification of its transmission.
• Certain geographies and population pockets in the epidemiologically critical areas of Pakistan continue to have inconsistent campaign quality and substantial number of unimmunized and under-immunized children due to insecurity, operational gaps, and vaccine hesitancy.
• Ongoing population movement between the two endemic countries, including the returnees from Pakistan to Afghanistan, leading to cross-border WPV1 transmission.
• Ongoing population movement from the two endemic countries to other countries, neighbouring and distant.

Ongoing risk of cVDPV international spread

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

• Ongoing cross border spread including into newly re-infected countries and territories.
• Continued cVDPV2 transmission in Lake Chad Basin particularly the critical areas of Nigeria, and its potential to amplify the transmission.
• The cVDPV2 transmission in the Horn of Africa seems to be intensifying, particularly in Ethiopia. The Horn of Africa countries continue to face humanitarian and health emergencies making it challenging to implement high-quality vaccination campaigns in a timely manner.
• There is a large pool of unimmunized susceptible children in the Northern Governorates of Yemen. There are challenges regarding timely shipping of AFP stool specimens from northern Yemen.
• The widening gap in population intestinal mucosal immunity in young children since the withdrawal of OPV2 in 2016, as well as high concentration of zero dose children in certain areas.
• Despite no cVDPV1 detection for the last nine months, continued low routine immunization and IPV coverage in several countries and associated immunity gap, indicates continued risk of cVDPV1 emergence.
• Continued cVDPV3 transmission in Guinea and risk of its spread, especially to the areas and populations with low immunity against type-3 poliovirus

Contributing factors include:

• Sub-optimal routine immunization: Many countries have weak immunization systems that can be further impacted by humanitarian emergencies including conflict and protracted complex emergencies. This poses a growing risk, leaving populations in these fragile states vulnerable to polio outbreaks.
• Ongoing insecurity and conflict in many areas that are the source of cVDPV transmission.
• Lack of access: Inaccessibility continues to be a major risk, particularly in northern Yemen and Somalia which have sizable populations that have been unreached with polio vaccine for extended periods of more than a year.
• 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.
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 endemic countries, where more rigorous assessment is needed in reference to surveillance gaps.

Once a country meets these criteria as no longer infected, the country will remain on a 'watch list' for a further 12 months for 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 potential risk of international spread

(as of data available at WHO HQ on 04 June 2025)

WPV1

Afghanistan most recent detection 26 April 2025

Pakistan most recent detection 7 May 2025

cVDPV1

Mozambique most recent detection 17 May 2024

DR Congo most recent detection 19 September 2024

cVDPV3

French Guiana (France) most recent detection 6 August 2024

Guinea most recent detection 7 March 2025

These countries should:

• Officially declare, if not already done, at the level of head of state or government, that the interruption 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.
• 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 the form specified in Annex 6 of the IHR to record their polio vaccination and serve as proof of vaccination.
• 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.
• Further intensify efforts to increase routine immunization coverage, including sharing coverage data, 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.
• Maintain these measures until the following criteria have been met: (i) at least six months have passed without new infections 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 above assessment criteria for being no longer infected.
• Provide to the Director-General a regular report on the implementation of the Temporary Recommendations on international travel.

States infected with cVDPV2, with or without evidence of local transmission:

(as of data available at WHO HQ on 4 June 2025)

1. Algeria most recent detection 28 April 2025
2. Angola most recent detection 17 April 2025
3. Benin most recent detection 19 November 2024
4. Burkina Faso most recent detection 30 March 2025
5. Cameroon most recent detection 7 April 2025
6. Central African Republic most recent detection 25 March 2025
7. Chad most recent detection 12 April 2025
8. Côte d'Ivoire most recent detection 06 February 2025
9. Democratic Republic of the Congo most recent detection 22 November 2024
10. Djibouti most recent detection 20 April 2025
11. Egypt most recent detection 1 August 2024
12. Ethiopia most recent detection 24 March 2025
13. Finland most recent detection 19 November 2024
14. Germany most recent detection 21 April 2025
15. Ghana most recent detection 20 August 2024
16. Guinea most recent detection 12 June 2024
17. Indonesia most recent detection 27 June 2024
18. Israel most recent detection 11 February 2025
19. Kenya most recent detection 31 July 2024
20. Liberia most recent detection 8 June 2024
21. Niger most recent detection 1 March 2025
22. Nigeria most recent detection 14 April 2025
23. occupied Palestinian territory (oPt) most recent detection 5 March 2025
24. Papua New Guinea most recent detection 22 April 2025
25. Poland most recent detection 21 January 2025
26. Senegal most recent detection 5 March 2025
27. Sierra Leone most recent detection 28 May 2024
28. Somalia most recent detection 28 April 2025
29. South Sudan most recent detection 3 December 2024
30. Spain most recent detection 16 September 2024
31. Sudan most recent detection 8 February 2025
32. The United Kingdom of Great Britain and Northern Ireland most recent detection 20 January 2025
33. Uganda most recent detection 7 May 2024
34. United Republic of Tanzania most recent detection 17 February 2025
35. Yemen most recent detection 14 February 2025
36. Zimbabwe most recent detection 25 June 2024

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 prevention or interruption 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, Members States should request vaccines from the global novel OPV2 stockpile.
• 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.

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 have access to an appropriate document to record their polio vaccination status.
• Intensify 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 the detection of circulation of VDPV2 in the country 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'.

• At the end of 12 months without evidence of transmission, provide a report to the Director-General on measures taken to implement the Temporary Recommendations.

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 4 June 2025)

WPV1

country last virus date

cVDPV

country last virus date

1. Botswana cVDPV2 25 July 2023
2. Burundi cVDPV2 15 June 2023
3. Equatorial Guinea cVDPV2 26 March 2024
4. Gambia cVDPV2 15 February 2024
5. Madagascar cVDPV1 16 September 2023
6. Mali cVDPV2 2 January 2024
7. Mauritania cVDPV2 13 December 2023
8. Mozambique cVDPV2 5 March 2024
9. Republic of Congo cVDPV2 7 December 2023
10. Zambia cVDPV2 6 June 2023

These countries should:

• Urgently strengthen routine immunization to boost/maintain population immunity.
• Enhance surveillance quality, 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.
• Intensify efforts to ensure vaccination of mobile and cross­border populations, Internally Displaced Persons, refugees, and other vulnerable groups.
• Enhance regional cooperation and cross border coordination to ensure prompt detection of WPV1 and 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 noted with concern that the Global Polio Eradication Initiative is revisiting its priorities and reprogramming its operations considering current fiscal constraints. The financial shortfall, estimated at nearly 40%, represents a serious risk to the achievement of eradication goals. All components of the programme, including the capacity to sustain sensitive surveillance for polioviruses, are at considerable risk due to reduced funding levels. These risks are further amplified by the parallel funding constraints faced by WHO, other international health partners, and individual countries, reflecting broader fiscal pressures across the global health landscape. The Committee therefore urged donor countries and partner organizations to strengthen their financial support, stressing that the consequences of falling short would be significant and far-reaching. The Committee further called on national governments to prioritize polio eradication within their domestic funding frameworks to safeguard progress and maintain momentum toward the goal of global polio eradication.

The Committee expressed concern over the continued transmission of wild poliovirus type 1 (WPV1) in the core reservoirs of Afghanistan and Pakistan, as well as its spread to additional areas within both countries, including locations that had not reported WPV1 for extended periods, such as the recent case in Gilgit-Baltistan after an eight-year absence. The Committee noted that WPV1 transmission persisted through the low transmission season, underscoring the risk of further intensification during the ongoing high transmission season if high-quality vaccination activities are not effectively implemented. The persistence of WPV1 transmission despite ongoing vaccination campaigns highlights gaps in immunization quality.

The Committee remains concerned about the continued inability to conduct house-to-house vaccination campaigns in Afghanistan. This challenge places infants and young children at a heightened risk of missing polio vaccination. The Committee urged the Afghanistan polio programme to explore options for transitioning to house-to-house vaccination, noting that site-to-site campaigns do not achieve the level of coverage and quality required to reach eradication. The Committee also recommended recruitment of additional female vaccinators to enhance community acceptance and improve coverage, especially in the South Region of Afghanistan.

The Committee acknowledged the strong political commitment to polio eradication demonstrated at the national and provincial levels in Pakistan. The Committee emphasized, however, that this commitment must be translated into concrete operational measures to strengthen community engagement and ensure the implementation of high-quality vaccination campaigns, especially in the core reservoirs and epidemiologically critical areas. These efforts are critical to interrupt ongoing intense WPV1 transmission and to reduce the risk of further national and international spread.

The Committee is encouraged by the improving cVDPV1 situation in the African Region, including the closure of the cVDPV1 outbreak in Madagascar. The Committee noted the continued detection of cVDPV3 in Guinea in 2025 following its emergence in 2024, highlighting the risk of further spread if not contained through high-quality vaccination activities.

The Committee noted the continued transmission of cVDPV2 in the African Region, particularly in the Lake Chad Basin and the Horn of Africa. While there has been an overall decline in cVDPV2 cases over the past two years, the Committee expressed concern over the increase in reported cases from Angola, Chad, Ethiopia, Niger, Nigeria, South Sudan, and Yemen during the past 12 months. The Committee also noted the concerning cVDPV2 epidemiological situation in Algeria (African Region) and Papua New Guinea (Western Pacific Region) and recommended the immediate implementation of high-quality vaccination campaigns to strengthen population immunity. Additionally, the Committee acknowledged the persistent challenges in conducting effective immunization responses in critical areas of the African Region and northern Yemen.

The Committee expressed concern over the epidemiological situation in Papua New Guinea, particularly in areas and populations with very low immunity to type 2 poliovirus and sub-optimal surveillance quality. The situation in Papua New Guinea requires urgent surveillance strengthening measures including addressing silent areas for acute flaccid paralysis (AFP) surveillance to minimize the risk of undetected cVDPV2 circulation, alongside rapid implementation of high-quality immunization activities to build immunity in populations with historically low type 2 poliovirus protection.

The Committee noted that several countries affected by cVDPV continue to face conflict and insecurity, which disrupt both routine immunization services and polio vaccination campaigns. The Committee further observed that ongoing health emergencies and concurrent disease outbreaks in multiple countries are compounding the challenges for timely and effective implementation of polio vaccination campaigns. Recognizing the diverse and complex operating environments at national and sub-national levels, the Committee emphasized the need for context-specific, tailored interventions to ensure high-quality vaccination activities and ultimately interrupt cVDPV transmission. The Committee underscored the importance of synchronized sub-regional strategies and robust cross-border coordination to address issues related to porous borders and shared operational constraints across affected countries.

The Committee noted the continued cross-border spread of cVDPV2 within the African and Eastern Mediterranean Regions, the detection of cVDPV2 in multiple countries of the European Region, and the recent detection of cVDPV2 in Papua New Guinea, linked to the 2024 transmission in Indonesia. These developments underscore that polio remains a global threat until eradication is fully achieved. The Committee emphasized the critical importance of maintaining sensitive surveillance systems in polio-affected and high-risk countries and recommended that the GPEI provide all necessary support under the Global Polio Surveillance Action Plan. The Committee also underscored the need for high-income countries to sustain high-quality poliovirus surveillance, given the persistent risk of importation, as recently demonstrated by detections in the European Region. Robust surveillance remains essential for early detection and timely response to both importations and newly emerging outbreaks.

The Committee recognized the critical role that mobile and migrant populations play in sustaining WPV1 transmission in endemic countries, as well as cVDPV transmission in the African Region and globally. The Committee urged that vaccinating populations on the move be treated as a top priority, emphasizing the importance of identifying different categories of mobile populations such as seasonal, economic, and agricultural migrants, and reaching them through country-specific, tailored strategies and approaches.

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.

The Committee expressed concern that several countries are not initiating outbreak response campaigns in a timely manner, as recommended by SAGE and other technical advisory bodies. Such delays increase the risk of prolonged cVDPV outbreaks and the emergence of new ones. The Committee recommended that all countries ensure the prompt initiation of outbreak response campaigns and maintain an interval of no more than four weeks between the two rounds of response campaigns.

The Committee noted that the amendments to the International Health Regulations (2005) (IHR) through resolution WHA77.17 (2024), were notified to States Parties on 19 September 2024 and that they would come into effect on 19 September 2025 for 192 States Parties. Regarding any potential effects of these amendments on the Committee, the Secretariat informed the Committee that it would be premature to assess any such effects at this time but would brief the Committee ahead of their entry into force in September 2025, should the Committee continue to be convened under the IHR at this time.

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 11 July 2025 determined that the poliovirus situation continues to constitute a Public Health Emergency of International Concern (PHEIC) with respect to WPV1 and cVDPV. The Director-General endorsed the Committee's recommendations for countries meeting the definition for 'States infected with WPV1, cVDPV1 or cVDPV3 with potential risk for international spread', 'States infected with cVDPV2 with potential risk for international spread' 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 poliovirus, effective, 11 July 2025.