Africa On Brink Of Eliminating Polio

Africa is on the verge of being declared polio-free, after three years without any recorded cases of the disease, according to the World Health Organization (WHO). Nigeria marked three years without a wild polio case on Wednesday, a “major milestone.” If no more incidences emerge in the next few months, Africa could officially be declared polio-free in 2020. The last case was recorded in Borno state in August 2016. Dr Matshidiso Moeti, the WHO regional director for Africa, said, “We are confident that soon we will be trumpeting the certification that countries have, once and for all, kicked polio out of Africa.” She added that stopping the disease has not been easy and praised the “monumental effort” of health workers “on an unprecedented scale.” She said exhaustive surveillance of people on the move was a significant factor in the progress.

In 2012, 200 children in Nigeria were affected by polio, which can cause paralysis and life-long health complications. The number made up more than half of all global cases. Those affected were particularly concentrated in the north-east of the country, where Boko Haram activity had made consistent access for health workers difficult. The group now controls far less territory. Renewed political commitment was evident from 2015 when President Buhari was shown personally giving one of his grandchildren vaccine drops, declaring that his administration would do “all within its powers to ensure that no Nigerian child is ever infected with polio again.” Nigeria and neighbouring countries have held multiple vaccination campaigns in locations from markets to border points to boost the immunity of the local population and prevent the virus from spreading. Dr Pascal Mkanda, head of polio for WHO Africa, highlighted the increased use of technology to gather accurate data on whether the target population was really being reached. Nigeria’s progress on polio has not been without setbacks. Having reduced cases to 202 in 2002, there was a spike of 1,122 by 2006 when immunisation campaigns in the north of the country had to be suspended following unfounded rumours about the safety of the oral polio vaccine. Having redoubled its campaign, progress against the disease was again threatened by insecurity in the north-east.

While WHO experts celebrated the achievements of the past three years, they underlined that political will and funding will need to be sustained, and all children under five protected. Moeti called on member states to sustain their vigilance in surveillance to maintain their wild-polio-free status. To reach full polio-free certification, a team of independent experts have to assess surveillance systems across the continent, ensuring no cases are missed and there are no gaps in monitoring. Despite the progress in halting outbreaks of wild poliovirus, several countries on the continent are still contending with the rarer vaccine-derived poliovirus, which can occur in communities without full immunisation coverage. The Democratic Republic of the Congo, currently dealing with an Ebola outbreak, is one of the countries in which this form of cases has risen in the last year. The virus is still endemic in Pakistan and Afghanistan and will need to be eradicated there before the world can be declared polio-free.

Credit: Lucy Lamble for The Guardian, 21 August 2019.