efforts began in 1998, when the WHO regional director for Africa appointed 16 people to the Africa Regional Certification Commission (ARCC). Based in Yaoundé, Cameroon, and led by Rose Leke as chairperson as of 2020, the group was tasked with overseeing the eradication effort in the Africa WHO region. The independent body is the only organisation recognized to certify that polio has been eradicated from the region. On 25 August 2020, the ARCC declared that wild poliovirus has been eliminated in its region which includes 47 countries spanning most of Africa. The last reported case of polio in the region was on 21 August 2016, in Borno, Nigeria. Among the conditions for certification of the region was a requirement that 95% of the population be immunised. The Eastern Mediterranean Region is the only WHO region remaining region that has not certified wild poliovirus eradication. The region includes 22 countries spanning from Morocco to Pakistan, several of which have individually eradicated the disease. This region experiences significant political unrest, humanitarian crises, forced displacement, and deterioration of health care systems, which hinder eradication efforts. Syria, Yemen, and Somalia are categorized as very-high-risk, and Iraq, Sudan, and Libya are categorized as high-risk, while Pakistan and Afghanistan are the only countries in which the disease remains endemic as of 2019. Since 2007, people administering polio vaccines have been the target of violence in Pakistan. A 2011 US Central Intelligence Agency operation used a hepatitis vaccination program as a cover to search DNA evidence to confirm the location of Osama bin Laden. Following his killing the same year, Islamist insurgents in the region have become more hostile to vaccination efforts. More recently, the hostility has been exasperated by the United States' expansion of the use of drone strikes in northwest Pakistan; in June 2012, Mullah Nazir, leader of the Federally Administered Tribal Agencies, distributed leaflets calling for a ban on polio vaccination with the goal of persuading the US to stop drone strikes in the area. Support from modeling Building on modeling used to support regional polio certification in the Americas, additional modeling explored how different characteristics of the three serotypes of wild poliovirus and the specific conditions in the countries with the last reported regional and global cases could impact changes in confidence about no circulation with increasing time since the last reported case. Specific modeling studies for Nigeria, which reported the last wild