Health

Putting an end to polio globally

… as 370m children get immunised within five years

An outbreak of wild polio virus type 1 in Lilongwe, Malawi, last February raises serious concern for the global community. This is the first case of wild polio virus in Africa in more than five years after the continent was declared free of indigenous wild polio in August 2020. Laboratory analysis has linked the strain to the one circulating in Sindh Province of Pakistan. This has resulted in creating new strategies to tackle the infection which leads to one irreversible paralysis in 200, report APPOLONIA ADEYEMI and PRECIOUS YUSUF

Series of actions have been made all over the world to completely eradicate the polio virus and when this is finally achieved, it will be the second disease after smallpox to be completely erased. With the recent detection of a case of polio in in Lilongwe, the capital of Malawi, which is the first in three decades, more efforts have been put into making sure the disease is no longer endemic in any country all over the world. In February 2022, Malawi confirmed its first case of wild polio in three decades and the first on the African continent since 2016, linked to a virus originating in Pakistan, and in April 2022 Pakistan recorded its first wild polio case since January 2021. At present, polio is endemic in only two countries; Pakistan and Afghanistan and the Global Polio Eradication Initiative (GPEI) has intensified efforts to wipe out the disease in the world once and for all. One of the biggest barriers is to think that the job is now finished and that efforts can be relaxed and not integrate the vaccination programme into the health system. Recent outbreaks in Ukraine and Israel of the variant poliovirus circulating vaccine-derived poliovirus (cVDPV) that can emerge in under-immunised populations underscore the threat that polio anywhere poses to children everywhere. Stakeholders are however of the belief that GPEI leaders can speak to outbreak response efforts in these countries and across Africa, including the expanded use of a new tool, the novel oral polio vaccine type 2 (nOPV2), that may help to stop the outbreaks conclusively.

Distrupting polio transmission

According to the Director-General of the World Health Organisation (WHO), Dr. Tedros Adhanom Ghebreyesus, “The global effort to consign polio to the history books will not only help to spare future generations from this devastating disease, but serve to strengthen health systems and health security.” On Tuesday, the GPEI announced that it was seeking new commitments to fund its 2022-2026 strategy at a virtual event to launch its investment case. The strategy, if fully funded, will see the vaccination of 370 million children annually for the next five years and the continuation of global surveillance activities for polio and other diseases in 50 countries.

Adequate funding required

To find this strategy, GPEI will need about U.S$4.8 billion dollars to fund and implement these strategies and they are looking forward to getting donations from the necessary bodies. “A strong and fully funded polio programme will benefit health systems around the world. That is why it is so crucial that all stakeholders now commit to ensuring that the new eradication strategy can be implemented in full,” said Niels Annen, Parliamentary State Secretary to the Federal Minister for Economic Cooperation and Development, Germany.

Polio eradication, a shared responsibility

“The polio pledging moment at the World Health Summit this October is a critical opportunity for donors and partners to reiterate their support for a polio-free world. We can only succeed if we make polio eradication our shared priority,” he added that Germany will support all efforts to fight the disease in all countries of the world. Wild poliovirus cases are at a historic low and the disease is endemic in just Pakistan and Afghanistan now which is progress from the four countries- Nigeria, India, Pakistan and Afghanistan- that used to be the only polio endemic countries in the world. Nigeria and India were certified to be polio free and now the disease has to be stopped in all countries so that it does not end up spreading to other places like we have seen in the case of Malawi. The fact that it is at a low, presents a unique opportunity to interrupt transmission. However, recent developments, due in part to impacts of the COVID-19 pandemic, underscore the fragility of this progress. Meanwhile, outbreaks of cVDPV, variants of the poliovirus that can emerge in under-immunised communities, were recently detected in Israel and Ukraine and circulate in several countries in Africa and Asia. “Despite enormous progress, polio still paralyses far too many children around the world – and even one child is too many,” said UNICEF Executive Director, Catherine Russell. “We simply cannot allow another child to suffer from this devastating disease – not when we know how to prevent it. Not when we are so close. We must do whatever it takes to finish the fight – and achieve a polio-free world for every child,” she encouraged all health workers to keep up the good work in identifying and stopping the spread of the disease.

Polio re-emergence in Malawi

“The re-emergence of polio in Malawi after three decades was a tragic reminder that until polio is wiped off the face of the earth, it can spread globally and harm children anywhere. I urge all countries to unite behind the GPEI and ensure it has the support and resources it needs to end polio for everyone everywhere,” said Hon. Khumbize Kandodo Chiponda MP, Minister of Health, Malawi. He urged all countries to continue to intensify and scale up their efforts in wiping out the disease. The new eradication strategy centres on integrating polio activities with other essential health programmes in affected countries, better reaching children in the highest risk communities who have never been vaccinated and strengthening engagement with local leaders and influencers to build trust and vaccine acceptance. It will also help to improve the vaccinations for other diseases as it will reach a lot of children in hard to reach places. “The children of Pakistan and Afghanistan deserve to live a life free of an incurable, paralysing disease. With continued global support, we can make polio a disease of the past,” said Dr. Shahzad Baig, National Coordinator, Pakistan Polio Eradication Programme. “The polio programme is also working to increase overall health equity in the highest-risk communities by addressing area needs holistically, including by strengthening routine immunisation, improving health facilities, and organising health camps.” Since 2020, GPEI infrastructure and staff have provided critical support to governments as they respond to the COVID-19 pandemic, including by promoting COVID-safe practices, leveraging polio surveillance and lab networks to detect the virus, and assisting COVID-19 vaccination efforts through health worker trainings, community mobilisation, data management and other activities.

 

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