A high-level meeting on the sidelines of the Seventy-ninth World Health Assembly in May 2026 brought together health leaders from the Horn of Africa and Yemen with a renewed, urgent commitment: to stamp out variant poliovirus transmission in their region by the end of 2027. Representatives from Djibouti, Ethiopia, Kenya, Somalia, South Sudan, and Yemen, along with key partners from the Global Polio Eradication Initiative (GPEI), reaffirmed their dedication to crucial strategies like stronger cross-border coordination, enhanced surveillance, and more robust routine immunization programs. This gathering, jointly organized by the World Health Organization's Regional Offices for Africa (AFRO) and the Eastern Mediterranean (EMRO), highlighted the collective determination needed to tackle polio in what is recognized as one of the most interconnected and complex regions for disease control. While facing significant hurdles like population movements across borders, ongoing humanitarian crises, and insecurity, the spirit of collaboration remains strong, aiming to safeguard every child from this preventable, debilitating disease. ## Understanding the Polio Threat: What is Variant Poliovirus? Polio is a highly infectious disease caused by the poliovirus, which primarily attacks the nervous system and can lead to irreversible paralysis, especially in children. While wild poliovirus is now confined to only a few countries globally, variant polioviruses (known as circulating vaccine-derived polioviruses or cVDPVs) pose a significant challenge in areas with low vaccination rates. These variant viruses emerge when the weakened live virus in the oral polio vaccine (OPV) circulates in under-immunized populations for an extended period, mutating to a form that can cause paralysis, similar to wild polio. The existence of cVDPVs underscores the critical need for comprehensive vaccination coverage. When too few children are vaccinated, these circulating viruses can find susceptible hosts, multiply, and regain their ability to cause disease. The fight against polio, therefore, is not just about eradicating the wild virus but also ensuring that robust immunization systems prevent the emergence and spread of these dangerous variants.