Global Polio Eradication InitiativeMost think of polio as a disease of the past, eliminated from the world through scientific advancement. However, the disease remains present in some countries and runs the risk of spreading again if it is not contained. In the words of Ban Ki-moon in 2012, former Secretary-General of the United Nations, “Wild viruses and wildfires have two things in common. If neglected, they can spread out of control. If handled properly, they can be stamped out for good. Today, the flame of polio is near extinction — but sparks in three countries threaten to ignite a global blaze.” The Global Polio Eradication Initiative (GPEI) seeks to finally eradicate polio throughout the world.

The Global Polio Eradication Initiative

It is a truly global project, led by a partnership between the World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention, UNICEF, Rotary International, the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance. Furthermore, the Initiative involves 200 countries around the world. The Initiative started “in 1988 after the World Health Assembly passed a resolution to eliminate polio.” Over 33 years, the Initiative has secured more than $17 million worth of contributions from donors and financing.

The Global Polio Eradication Initiative has a well-developed and comprehensive plan which has produced numerous successes and lays out a roadmap to completely eradicate polio. One goal is integration. The GPEI seeks to integrate national governments’ vaccination plans with the polio vaccine, allowing children to get the polio vaccine as part of national immunization schedules. Enhanced integration also includes joint delivery of the polio vaccine with other vaccines, integration of polio surveillance with surveillance of other diseases and harmonizing data systems.

Routine vaccination of children is the crucial part of the plan, along with supplementary vaccination when needed. Areas that are most susceptible to an outbreak often receive supplementary vaccinations in targeted campaigns or through National Immunization Days.

Polio Success Stories

The success of the Global Polio Eradication Initiative since its founding is undeniable. The GPEI estimates that the global incidence of polio has decreased 99.9% since its inception. Polio efforts saved more than 1.5 million lives and prevented 16 million people from polio-induced paralysis. In addition to this, the GPEI administered more than 2.5 billion polio vaccines to children across the world.

Africa is a shining example of the GPEI’s success in eradicating polio. Even after the development of the polio vaccine in 1954, the disease remained endemic for decades and the continent struggled to track cases and vaccinate children. Around 1996, wild polio paralyzed 75,000 African children a year. The GPEI helped to coordinate cooperation between African national leaders and multinational NGOs, leading to greater tracking and quick responses to outbreaks.

As part of the Kick Polio Out of Africa campaign, the GPEI and other contributors provided nine billion doses of the oral polio vaccine and vaccinated 220 million children every year. Thanks to this work, Nigeria became the only country where polio was still endemic by 2016. In 2020, after four years without a polio case, the GPEI declared Africa polio-free. The elimination of a highly contagious and dangerous disease is a remarkable success story.

Remaining Countries and At-Risk Countries

While it is near eradication, polio remains endemic in Afghanistan and Pakistan. While concerning, there were less than 30 reported cases of the disease in these countries in 2018. Children miss out on coverage for polio in Afghanistan and Pakistan for various reasons, including a lack of infrastructure and an unstable political situation. Still, the Global Polio Eradication Initiative continues to vaccinate children, provide surveillance of the disease and work to develop new vaccines, diagnostic tools and antiviral drugs.

The failure to eliminate or contain polio completely could lead to a resurgence. If not contained, this could lead to 200,000 or more global cases a year within 10 years. The GPEI, in support of the governments of Afghanistan and Pakistan, works extensively with leaders in the countries to vaccinate children and provide teams of volunteers.

Children need multiple doses of the vaccine for effective prevention and vaccinations must be widespread in order to prevent any community transmission. For this reason, the GPEI has identified five main at-risk countries that are vulnerable to outbreaks and require greater surveillance:

  1. China
  2. Indonesia
  3. Mozambique
  4. Myanmar
  5. Papua New Guinea

Approaching the Finish Line

The Global Polio Eradication Initiative has had major successes so far and is nearly at the finish line of eradicating polio from all nations of the world. Unprecedented global cooperation and collaboration have been the driving forces behind its achievements. Global collaboration is integral for addressing all aspects of global poverty.

Clay Hallee
Photo: Flickr

Dangers of non-vaccination
Polio survivor, Richard Elaka, 60, has made it his mission for the last 20 years to educate his community in Kinshasa, Democratic Republic of the Congo (DRC) on the benefits of vaccinating. At 7 years old, Mr. Elaka suddenly lost the use of his legs. His family initially believed this was the result of a curse that his uncle put on him. It was not until later that Richard understood that the poliomyelitis virus had infected him due to him not having received the polio vaccine. Unable to walk without the use of crutches from the age of 7, Mr. Elaka has not taken his survival for granted. He spends his free time doing community outreach. He roams the streets attempting to teach his neighbors about the dangers of non-vaccination.

The Under-Vaccination Problem in the DRC

Only 35% of children in the DRC, between the ages of 12-23 months, have complete vaccination records by the time they turn 1 year old. The COVID-19 pandemic has perpetuated this issue; the DRC has steadily watched vaccination numbers decline since the start of the pandemic. The primary reasons for the declining numbers are:

  1. Vaccinators lacking the personal protective equipment required for dispensing injections.
  2. Parental concerns of exposure to COVID-19 when traveling to vaccination facilities.
  3. Insufficient funds to buy the vaccines.
  4. Conflict and insecurity.

Number three on this list is one of the biggest barriers the DRC has faced.

The Plan

The DRC’s government is working to remedy the issue of under vaccination. The dangers of non-vaccination, particularly within the population of a developing country like the DRC, are a very real and present danger. In June 2020, the DRC  doubled the immunization funding budget it had in 2019. In fact, about $16.4 million went towards the purchase of vaccines.

Along with the financing that UNICEF contributed, the money that the DRC government provided has made it possible for the Emergency Plan for Revitalization of Routine Immunizations’ work in the DRC to continue. Some formally know the Emergency Plan for Revitalization of Routine Immunizations as The Mashako Plan, named for the late DRC Minister of Health Professor, Leonard Mashako Mamba. Its creation in 2018 was a direct response to the issue of incomplete immunizations. Initiated with the hope of targeting several under-vaccinated areas of the DRC, the Mashako plan implemented five key components in creating a sustainable immunization practice:

  1. Dispensing Immunizations – The 2018 goal was to increase the number of completed vaccination sessions by 20%.
  2. Stockout Reduction – Reduce incidents of local health care centers experiencing stockout by 80%.
  3. Observation and Assessment – Closely monitoring data results of vital factors.
  4. Supervision – Routine inspections of immunization storehouse and vaccine dispensing facilities.
  5. Funding and Strategy – Monthly meetings to discuss finance and implementation.

The Good News

From its inception to 2019, the Mashako Plan has contributed to a 50% increase in completed vaccination sessions. The impact COVID-19 is having on the DRC and its mission to vaccinate has been challenging. In 2020, the DRC contended not only with COVID but with Ebola and measles outbreaks as well. Despite these arduous circumstances, volunteer vaccinators, DRC public health officials and community members, like Richard Elaka, remain undeterred in the commitment to protecting the citizens of the DRC from the dangers of non-vaccination.

– Rachel Proctor
Photo: Flickr

dual outbreaksThe impact of COVID-19 has resulted in fractured economies and health care systems all around the world. While some countries are trying to recover, others just cannot catch a break. Papua New Guinea is a country that finds itself in a unique and desperate situation. With the onset of COVID-19, the country was also hit with a resurgence of polio. Dual outbreaks are a cause of significant concern for Papua New Guinea. Australia is coming to the aid of its neighbors with a substantial financial assistance plan.

Resurgence of Polio

Papua New Guinea is one of the most poverty-stricken countries in the pacific region. The country was declared officially polio-free 18 years ago, but in 2018, the virus was rediscovered in a 6-year-old child. Shortly after, the virus also emerged in multiple other children from the same general area. Polio is especially harmful to children under 5 years old and can lead to lifelong paralysis.

A few months after the polio outbreak, the Australian Government stepped in and responded by giving $10 million to Papua New Guinea’s polio immunization crusade. A few weeks later, the Global Polio Eradication Initiative (GPEI) received another $6 million, which an additional $15 million dedication followed in November 2018. Rachel Mason Nunn, an experienced social development worker in Papua New Guinea, stated that “We have a window right now to invest heavily in infectious diseases in Papua New Guinea. Australia should continue to invest in health care in Papua New Guinea, if not just because it is the right thing to do, but because helping our region acquire strong health systems is a vital element of Australia’s own health security.” Australia is the largest contributor to the development of Papua New Guineas’ struggling health care system.

COVID-19 in Papua New Guinea

In an extreme case of bad luck, Papua New Guinea experienced two disease outbreaks within two years of each other. In a frantic request for aid, the government reached out to the World Health Organization (WHO) in an effort to take some weight off its already overburdened health care system.  When COVID-19 hit the county, there was a limited number of testing kits available and a shortage of medical staff as well as medical supplies and protective gear. The WHO responded by deploying emergency medical teams and supplying necessary resources to upscale testing in Papua New Guinea.

The Road Ahead

Due to the support of contributors like the WHO and Australia, millions of child polio vaccinations have been administered and a sufficient number of COVID-19 testing kits are available in the country. For a country that is still dealing with diseases like malaria and polio, the people of Papua New Guinea are pushing ahead. This unique situation serves as a global reminder that the prevention and treatment of other diseases should not be neglected during the COVID-19 pandemic and that inter-country support is essential in addressing dual outbreaks.

– Brandon Baham
Photo: Flickr

Polio Program in SomaliaSomalia is one of the few countries remaining with a risk of poliovirus transmission. The polio program in Somalia was established as a way to eradicate the virus completely as part of the global immunization effort. However, with the arrival of SARS-CoV-2, the polio program in Somalia has been stifled. Somalia ranks 194 out of 195 on the Global Health Security Index. The international recommendation for healthcare workers is 25 per 100,000 people; however, Somalia only has two per 100,000 people. The country also has only 15 intensive care beds for a population of 15 million. It is considered to be among the least prepared countries in the world to detect and execute a quick response to COVID-19.

Effects of the Pandemic on the Polio Program in Somalia

Many of the workers that are part of the polio program in Somalia have suspended all door-to-door immunization due to the ongoing coronavirus pandemic. With travel kept to a minimum, polio samples cannot be flown abroad to external medical labs for testing. In addition to this, millions of polio vaccines will expire in a matter of months.

The global polio immunization program paused at the end of March 2020, leaving more than 20 million workers and medical practitioners without work. The World Health Organization (WHO) estimates that the number of unvaccinated children could reach 60 million by June in the Mediterranean region.

The Polio Program Fights COVID-19

Polio surveillance systems are developed disease surveillance systems. This network of disease surveillance has been able to track the poliovirus and deploy medical teams throughout the world. Now, the polio program in Somalia has shifted its efforts to combat the COVID-19 pandemic. The system’s infrastructure, its capacity and the experience of its medical staff make it prepared to deal with the novel coronavirus. As of July 2020, Somalia had approximately 3,000 confirmed cases of COVID-19 with 930 recovered cases and 90 deaths. The number of actual cases is likely significantly larger, but many cases go undetected due to a lack of testing.

Thousands of frontline workers for the polio program in Somalia started curbing the spread of the coronavirus. These workers form rapid response teams trained to detect COVID-19 cases as well as to educate and raise awareness about the ongoing pandemic in Somalia. WHO’s national staff and local community healthcare workers have joined theses polio response teams, utilizing their resources and skills to tackle the virus.

WHO Support

These teams have traveled to remote areas in Somalia, providing critical information regarding physical distancing, hand-washing, detection of symptoms and prevention. With WHO’s aid, the program has acquired testing kits and equipment to evaluate potential cases of the virus. The surveillance teams have adopted the same procedures that they used for the polio program in Somalia for COVID-19. After collecting potential COVID-19 samples from suspected cases, the rapid response teams transport the samples to external laboratories for testing. Outside humanitarian agencies use the same protocols and operations that they used for the poliovirus.

Furthermore, the response teams continue polio immunization simultaneously with the COVID-19 response. It is essential for the polio program to continue immunization, as Somalia experienced a polio outbreak earlier this year.

How Other Countries Have Adapted

Other countries in the same region have realized the practicality of the polio network. They have accordingly redeployed their own immunization programs to fight COVID-19. For example, South Sudan has converted approximately 80% of its polio workforce to track coronavirus cases in the country. It has trained polio contact tracers to evaluate people for symptoms of COVID-19. Mali has also been engaging its own polio program in response to the ongoing pandemic.

Even though polio and COVID-19 do not have much in common, the polio program is an important tool to fight the pandemic. The Bill and Melinda Gates Foundation, in partnership with the WHO, has been working to equip these polio networks to help countries deal with the pandemic. The suddenness of the pandemic has left no time for countries such as Somalia to prepare. As such, the global polio immunization campaign is a valuable resource for this unprecedented emergency.

Abbas Raza
Photo: Flickr

Africa Polio Resources
Africa is using its polio resources to find creative solutions to the new pandemic. COVID-19 halted employment for many Africans and placed strains on international polio laboratories. These laboratories are members of the Global Polio Laboratory Network. Therefore, health organizations are now using polio resources to tackle COVID-19 in African countries. Already facing many challenges, these groups must balance fighting COVID-19 with continued administration of polio vaccinations.

Polio Eradication in Africa

Vast amounts of global research aid polio eradication in Africa. It is appropriate to alter these successful strategies now to fight COVID-19. In fact, expectations determined that Nigeria would be officially void of the disease between March and June 2020. The World Health Organization (WHO) announced in July 2020 that Nigeria was the last African country where polio was endemic, but that polio is no longer in African countries.

WHO’s Method of COVID-19 Mitigation

WHO is fighting COVID-19 through 16 polio testing facilities across 15 countries. To do so, it reconfigured machines that it originally used to display polio symptoms with COVID-19 data. These cell phone devices have the contact information of outreach teams, making data tracking easier. Another example of Africa’s use of polio resources is an outreach center developed in Brazzaville (2017). The research center assists countries with data-keeping technology to fight COVID-19.

COVID-19 Eradication in Sudan and Somalia

The WHO Polio Eradication Program provides training across 14 states of The Republic of Sudan. This training allows citizens of all seven localities of The Republic of Sudan (Khartoum, Ombada, Omdurman, Karary, Bahri, Sharq Elnil and Jabal Awliya) to assist potential COVID-19 victims. Recipients of the training are front line essential workers trained in healthy behaviors, COVID surveillance and COVID data interpretation. The training sessions empowered over 300 rapid response individuals, all of whom tested satisfactorily while demonstrating their competency.

Current difficulties such as social distancing and the minimal availability of face masks and gasoline make it difficult to continue to serve patients who need polio vaccinations. The short supply of resources also makes it difficult to provide diagnoses to individuals potentially affected by COVID-19. With Africa using polio resources to control COVID-19, polio vaccinations themselves had to take a back seat. These programs will re-obtain regular importance when possible. Many children still need vaccinations regularly to maintain Africa’s ‘eradicated’ polio status or they could be susceptible to the disease.

WHO training in Somalia empowers workers and allows staff to educate the community. Polio teams train and educate Somalians on the techniques and importance of reporting suspected COVID-19 cases. Polio Eradication Program associates can then continue sending feces samples labs for testing. These same techniques used for polio eradication allowed teams to hit the ground running in April of 2020.

The Reason Africa Must Continue to Monitor Polio and COVID-19

While techniques for testing polio and COVID-19 are similar, the diseases are not. Africa, while recently declared free of polio, must continue to monitor both diseases and refocus its attention on polio following the pandemic. Polio has numerous dangers: it attacks children, is highly contagious and leaves individuals paralyzed, all with a high risk of death. Continued vaccinations are the only hope of keeping Africa polio-free.

Polio laboratories need to increase efforts against COVID-19 to regain a singular focus on polio vaccinations. Nigerian President Mohammadu Buhari increased polio funding in 2016. His efforts highlight how ending disease allows a country to continue leveraging those resources. The COVID-19 pandemic is a major obstacle to Africa’s safety from polio.

DeAndre’ Robinson
Photo: Flickr

Healthcare in TunisiaThe North African country of Tunisia is sandwiched by two relatively unstable nations, Algeria and Libya. However, Tunisia has had consistent development in human wellbeing for the past couple of decades, ranking among the best nations in Africa. In part, this success can be attributed to Tunisia’s relatively strong healthcare system. According to a World Health Organization report, Tunisia possesses a “national health strategic plan” as well as a relatively high life expectancy at 75 years. Healthcare in Tunisia is a promising sign that the country can adequately support its population and promote longer, healthier lives for its citizens. Here are six facts about healthcare in Tunisia.

6 Facts About Healthcare in Tunisia

  1. More than 90% of the population is covered by health insurance. While some citizens use private insurance, others are covered by programs in place to assist the most disadvantaged in society. However, Tunisia still lacks truly universal coverage. One of the top complaints about healthcare in Tunisia is gaps in payment for important medical procedures, which can burden families.
  2. Tunisia’s 2014 constitution granted healthcare as a human right. The government is still working to make this a reality and provide universal, effective healthcare in Tunisia. Specifically, the government is trying to improve the dilapidated health infrastructure in the south of the country. This manifested in a 9% increase in the healthcare budget in 2016, which went toward improving infrastructure in remote areas.
  3. Private healthcare in Tunisia is booming. In recent years, before the COVID-19 pandemic, the number of private clinics built in the country was expected to surge. Seventy-five new facilities are set to be completed by 2025, doubling the number of hospital beds in the country. These improvements should help make access to quality healthcare more readily accessible to the general population.
  4. Tunisia successfully combated many diseases in the past. Most importantly, Tunisia has been able to eradicate and control many deadly diseases that put a strain on its healthcare system. Malaria, polio and schistosomiasis are well under control. In addition, Tunisia’s healthcare system has worked to address HIV/AIDS.
  5. During the COVID-19 pandemic, Tunisia has done relatively well. Sitting at 1,327 confirmed cases and 50 deaths as of July 2020, the country is positioned to recover economically from the virus, which is devastating in other parts of the world. Though it is still early in the pandemic, it appears that the healthcare system in Tunisia was able to absorb the influx of cases in order to slow the death rate.
  6. Robust preventative measures enabled Tunisia’s positive response to COVID-19. Seeing the potential for a rise in cases early on, the government, as advised by healthcare experts, quickly went into a rigorous lockdown that lasted for months. This was especially difficult considering that tourism accounts for 10% of the country’s GDP. According to a WHO spokesman, a strong sense of community and respect for the lockdown measures eased the country’s caseload and death toll. Because the Tunisian population was willing to make sacrifices for the broader community, they are now in a comparatively better place than some other nations around the world.

Healthcare is a critical issue for any nation. While there is always room for improvement, Tunisia has succeeded in using its available resources to ensure medical coverage for its people.

Zak Schneider
Photo: Pixabay

Although there is a vaccine, Polio is still a global problem. Here are some facts on eradicating Polio in developing countries.
People often think of polio as a disease of the past; but for many in Pakistan, Afghanistan and Nigeria, it is still a very real threat. Poliomyelitis, more commonly known as Polio, is an infectious disease that can result in base level symptoms similar to the flu, or on the more extreme end, it can invade an individual’s spinal cord or brain causing paralysis. Paralysis is the symptom people most commonly associate with Polio because of how deadly it can be. As the disease progresses slowly, the individual eventually loses function across their body and requires outside assistance to do even the most basic task of breathing. Without medical assistance, the individual will asphyxiate. Here is some information about eradicating Polio in developing countries.

Eliminating Polio

Vaccination is the only way to eradicate Polio. Children’s bodies become prepared to fight the disease more effectively with vaccination. Almost all children or 99 out of 100 will have protection from Polio as long as they receive all recommended courses of the vaccination.

However, sanitation also plays a key role in preventing the spread of Polio in the interim. The virus lives in individuals’ throats and intestines, so open sewage systems can leave a community more vulnerable to the spreading virus. The virus can thrive in feces for weeks before dying, leaving plenty of opportunities for people to come into contact with the virus and spread it.

Eradicating Polio is highly dependent on herd immunization, so it is integral that mass vaccination initiatives go to all corners of a country. By immunizing everyone who can take the vaccine, the risk of the disease spreading and those unable to take the vaccine contracting it reduces.

The Reasons Polio Still Exists in Pakistan, Afghanistan and Nigeria

Though there have been major advancements in eradicating Polio in Pakistan, Afghanistan and Nigeria, they still remain vulnerable due to the fear that the vaccine may cause fainting spells and death in children, which are false claims. Additionally, open sewage systems in rural areas and the difficulty to dispense full courses of vaccination to individuals in rural areas play a role in the continued life of Polio.

There is also the issue of spreading. In Afghanistan and Pakistan, the majority of new cases of Polio are often in the tribal areas surrounding the shared border of the two countries. The unchecked border often has people traveling back and forth so they are hard to pin down to receive their full course of vaccinations. This also allows for the virus to spread faster and makes it more difficult to isolate the infected.

Nigeria is doing relatively well with the fight towards eradicating Polio. The country no longer has an active outbreak, but it is at high risk of having an outbreak. This is due to active initiatives within the country to assure widespread vaccination and hygiene education to prevent the spread of the virus.

Mutations

Another massive issue these countries and doctors are having with eradicating Polio is that the virus is mutating. In June 2017, there were 21 cases of vaccine-derived Polio in the world. This has been caused by remnants of the oral vaccine getting loose in the environment where it is regaining strength and infecting people. The oral vaccine is from a weak form of the Poliovirus that allows the recipient’s immune system to fight off the virus and become more adept at fighting the active virus if it ever enters their body.

Many also consider the mutated and strengthened strain of the vaccine-derived disease to be more deadly as it has a higher risk of causing paralysis in those infected.

Solutions

The organization, Global Polio Eradication Initiative, is a public-private partnership working in tandem with national governments and private partners including the World Health Organization (WHO), Rotary International, the U.S. Centers for Disease Control and Prevention (CDC), the United Nations Children’s Fund (UNICEF) and the Bill & Melinda Gates Foundation. Together, they are attempting to roll out vaccines and education programs to aid in eradicating Polio internationally. The organization works with 200 countries and 20 million volunteers to ensure that everyone has the opportunity to live a life free of the pain Polio brings upon individuals and communities.

As of 2019, it has vaccinated over 2.5 billion children, and the number is only growing. This is an incredibly important program, as the alleviation of the threat of infection for every reduces the stress on government health programs. There is also a reduction in the personal and financial burden of contracting and surviving Polio from the shoulders of millions of families.

Through vigilant vaccination distribution and educational programs, the hope is that in the near future, people will be able to live in a world free from the crippling implications of the Poliovirus.

– Emma Hodge
Photo: Flickr

Nigeria Beat Polio
Like many countries in Africa, Nigeria has historically had to deal with serious diseases. One such disease that has been a prominent issue for the country is polio. Polio is an infectious disease that the poliovirus causes. The most common symptoms of polio are fevers, sore throats and nausea, among others. In more severe cases, polio can induce paralysis and meningitis, an infection that affects the spinal cord and brain. Recently, Nigeria beat polio by increasing vaccinations.

Polio Vaccines in Nigeria

The Nigerian government banned vaccinations for the poliovirus in 2003 amid fears they caused Muslim girls to become sterile and helped spread AIDS throughout the region. Around this time, reports stated an outbreak of polio cases throughout Nigeria, as well as many other parts of Africa. Afterward, United Nations officials convinced the then governor of Kano that the vaccinations were safe, although the virus continued to plague Nigeria.

In 2007, reports stated that many new cases of polio in Nigeria came as a result of a mutated vaccine. Normally the polio vaccine involves an injection with a more mild version of the poliovirus. Around this time, however, the vaccines appeared to have helped induce polio instead. This increased people’s concern over vaccinations and many did not perceive them to be a good idea, although it the United Nation’s World Health Organization (WHO) stressed the rarity of these mutations.

According to WHO, Nigeria accounted for more than half of all polio cases in 2012. However, WHO also reported that the country made great efforts since then to reduce the incidents of polio, including “increased community involvement and the establishment of Emergency Operations Centers at the national and state-level.” These efforts have allowed the Nigerian government to respond to outbreaks more efficiently and carry out vaccinations accordingly.

A Reduction in Polio Cases

According to WHO, Nigeria went two years from 2014 to 2016 without any cases of polio. WHO has attributed this to the Nigerian government’s efforts to combat the disease. However, this period quickly came to an end on August 2016, when reports indicated that polio paralyzed two children in the northern Borno state.

As of August 20, 2019, Nigeria achieved three years without any cases of polio. The liberation of the Borno State area in northeastern Nigeria from the Islamist military group, Boko Haram, may be a cause. This military group’s stated purpose was to forbid Muslim citizens in Nigeria from taking part in any activities associated with Western society. As a result of the liberation from Boko Haram, more children have been able to receive treatment for polio, including vaccinations.

Compared to the 600,000 children under the age of 5 who missed out on vaccinations in 2016, only 60,000 children under the age of 5 missed out on receiving vaccinations as of August 20, 2019. This is thanks to factors such as increased surveillance in various islands on Lake Chad, thus allowing them to see which ones people inhabit, thus allowing them to perform vaccinations on more people.

Nigeria Free of the Poliovirus

Nigeria is the last country in Africa to have had any records of the wild poliovirus, and WHO has announced that polio is no longer endemic on the African continent. In other words, thanks to the fact that vaccines have become more advanced and widespread, and the Nigerian government’s increased efforts to respond to these cases, many believe that not only has Nigeria beat polio, it is also virtually nonexistent in Africa as a whole.

While Nigeria beat polio and the virus’ presence in Africa may have faded, the disease has not completely disappeared. Several projects have formed to put an end to it once and for all, though. One such project is the Global Polio Eradication Initiative (GPEI). GPEI partners with organizations such as the World Health Organization and Rotary International. According to the GPEI website, it has helped ensure over 2.5 billion vaccinations for children all across the world in over 200 countries. This is a clear example of what the average person can do to help eliminate this disease.

– Adam Abuelheiga
Photo: Flickr

polio eradication in Nigeria
For the last three years, Nigeria has not had one case of polio. As the last country in Africa to still record the wild polio disease, this new health milestone of the eradication of polio in Nigeria has proven the success of public health campaigns for the entire continent of Africa.

The Decline of Polio

Back in 1988, polio paralyzed more than 350,000 children in over 125 countries around the world. Although the devastating disease infected children in almost every country, cases of wild polio decreased by 99 percent after 1988. While the wild polio disease exists in nature, several vaccine-derived outbreaks have occurred in six African countries. In 2012, the World Health Organization (WHO) reported that Nigeria held more than half of polio cases worldwide. Total immunization then became the primary goal for the eradication of polio in Nigeria to ensure that the population has protection from the vaccine-derived and wild virus. Persistent efforts of immunization have helped immunize over 45 million children under the age of 5 in Nigeria. An estimated 200,000 volunteers in Nigeria have aided in giving polio vaccines in the last five years.

Children and Polio

At the start of the polio epidemic in Nigeria, 600,000 children did not have the polio vaccine and an estimated 90 percent of polio cases were within northeast Nigeria. Due to this area encompassing largely scattered communities, satellite imaging has aided volunteers with finding unvaccinated children. Vaccinators will also frequently set up clinics within local markets to find all the unvaccinated children.

Dr. Pascal Mkanda, the leader of the eradication of polio in Nigeria for WHO, set out to eradicate the disease within three years by first vaccinating children under 5 years of age. The poliovirus remains highly infectious and mostly affects children. In the worst cases, polio causes irreversible paralysis. No cure for polio exists, but the eradication of the disease through immunization has prevented outbreaks. Estimates determine that the eradication of polio in Nigeria has saved 16 million children from paralysis.

Women and Vaccinations

Many Nigerian women are at the forefront of the battle against polio. UNICEF and the Bill & Melinda Gates Foundation hire mostly young Nigerian women as vaccinator volunteers because Islam is the most prominent religion in northern Nigeria, and it prohibits men that are not family members from entering a Muslim home. The women volunteers go door-to-door to educate families about the vaccine and receive clinical training to give vaccinations.

Today, more than 30 million Nigerian children have received the polio vaccine. The volunteers are also in a continuous battle with skeptical anti-vaccination parents and the militant group Boko Haram. Boko Haram intentionally spreads misinformation about the vaccine and violently targets volunteers in order to keep Islam pure in Northern Africa. Some Nigerian people still have doubts about the vaccine, but now only 1 percent of people refuse the vaccination.

Overall, the eradication of polio in Nigeria represents an achievement for global health. The commitment of global health organizations and neighboring communities to the eradication of polio proves that investing in foreign aid can have a worldwide benefit.

– Nia Coleman
Photo: Wikimedia Commons

Curing Polio in Pakistan and Afghanistan
In 1988, polio existed in more than 100 countries and infected close to 1,000 children daily. Due to advocacy efforts and the implementation of preventable vaccinations, cases of polio have significantly dropped at a rate of 99 percent. In 1988, about 350,000 children had polio while statistics indicated that in 2017, only 22 documented illnesses existed. However, children are still struggling as Pakistan and Afghanistan attempt to eliminate polio their countries.

Children are most vulnerable to contracting polio between birth and age five. One in 200 contagions result in irreparable paralysis, most commonly in the legs; five to 10 percent of those infected die from this disease due to the disabling of their breathing muscles.

Most children that are living with polio do not experience manifestations; however, polluted water and food can still spread the disease. Polio is preventable through several doses of vaccinations, but there is no treatment.

Modernized Vaccines to Prevent Polio

In 2013, all countries began to implement one dose of the new vaccines and terminate the use of the oral vaccines by 2018, which the Polio Eradication & Endgame Strategic Plan instructed.

In order to eliminate polio in Pakistan and Afghanistan, the Polio Eradication and Endgame Strategic Plan is terminating the administrations of oral vaccines which only protected against type 2 of the virus; instead, Afghanistan and Pakistan are implementing doses of the inactivated polio vaccine, which should be more effective in preventing the disease as it prevents all three types of polio. The modern vaccine can also enhance immunity and inhibit further epidemics of polio.

Efforts to Eliminate Polio in Pakistan and Afghanistan

In 2018, The Ministry of Public Health in Afghanistan partnered with UNICEF and The World Health Organization to initiate the country’s third nation-wide polio vaccination campaign. Nearly 9.9 million children below age five received the vaccination.

Regions such as Kandahar, Helmand, Uruzgan and Zabul contained nearly 1.2 million children who did not have access to the vaccine. However, this past program and future programs will ensure that these children can also receive the necessary dosages.

Vaccinated children also received Vitamin A capsules to strengthen their immunity and decrease diarrhea. This also strengthened their immune systems from respiratory infections. Immunity can increase their chances of survival by nearly 24 percent. Nearly 70,000 health workers visited every household to administer vaccinations. This was to ensure that other children received the preventable medication as well. Because polio is contagious, each family’s chances of surpassing the disease increases if every child receives a vaccination.

In Pakistan, the number of polio infections is at a low rate. Further, improved immunity has also begun to increase. While this country has made progress in battling polio, many children have not received the preventable vaccines in high-risk areas. Therefore, Pakistan has begun to implement various solutions such as customized vaccines. Additionally, the country has partnered with the Emergency Operations Centers to administer effective prevention techniques.

Polio is most common in Karachi as well as the federally administered tribal areas, the Quetta block and the Khyber-Peshawar corridor. While the disease is highly present in these areas, other areas nationwide are susceptible to contracting the virus due to travel and migration.

The Partnership Between Pakistan and Afghanistan

To eliminate polio in Pakistan and Afghanistan, the two nations plan on partnering to identify children who are vulnerable to the disease and provide vaccinations, while also administering health campaigns to promote advocacy about the prevention of polio. Environmental surveillance has discovered the presence of polio. This serves as evidence that children with weaker immune systems are present in these areas. Consequently, this enables the disease to grow and infect other children.

– Diana Dopheide

Photo: Flickr