KABUL (Reuters) – Afghanistan has launched its annual polio inoculation campaign aimed at reaching 9 million children, the health ministry said on Monday, the second year in a row the vaccination drive has taken place under Taliban rule.

Afghanistan and neighbouring Pakistan are the last countries with endemic polio, an incurable and highly infectious disease that can cause crippling paralysis in young children.

Polio has been virtually eliminated globally through a decades-long inoculation drive. But insecurity, inaccessible terrain, mass displacement and suspicion of outside interference have hampered mass vaccination in Afghanistan and some areas of Pakistan.

Nek Wali Shah Momin, director of Afghanistan’s National Emergency Operation Center (EOC) for Polio Eradication, said many more areas could now be reached since the Taliban took over and fighting stopped. The EOC is led by the health ministry and includes international agencies including the World Health Orgnization and the U.N. children’s agency.

While the Taliban have in recent months banned many female NGO workers and stopped women attending universities and most high schools, the doctor said female vaccinators were working on the campaign.

He said women were crucial to accessing children who were often at home with their female caregivers who were usually not comfortable interacting with male vaccinators.

In areas where vaccination teams had to travel longer distances, Momin said authorities had required female staff to have a male chaperone. He said they had recruited and trained male family members of the female vaccinators to join the teams’ vaccination efforts.

Some militant factions have targeted vaccination efforts in the past. In 2022, eight workers were killed in attacks in northern Afghanistan.

“The support of all Afghans, including parents, community leaders, ethnic elders, and religious leaders, is critical to eradicate polio and we want them to take part in the fight,” the Taliban’s acting health minister Qalandar Ebad said.

Some health experts said the role of the Taliban, whose stated goal is to impose their strict interpretation of Islamic law, could help encourage acceptance of vaccination in conservative areas around the region.

“Religious leaders’ role in the polio elimination drive in both Pakistan and Afghanistan is crucial … the active participation of the Taliban in polio campaigns is a very positive and major development,” said Rana Jawad Asghar, an epidemiology expert and CEO of Pakistan-based consultancy Global Health Strategists and Implementers.