Polio Outbreak in BurundiHealth authorities declared a polio outbreak in Burundi after confirming three cases and finding the virus after wastewater surveillance in the country. After three decades of no documented cases, in the Isale district in western Burundi, a four-year-old boy and two children he was in contact with tested positive for poliovirus type 2. In places where poverty rates are high, polio tends to spread easily due to sanitary water scarcity and limited access to health care. Unfortunately, those with polio frequently find themselves in a vicious cycle of poverty with no social or financial support. With the most recent statistics showing Burundi having a poverty rate greater than 65%, the polio outbreak in Burundi presents major concerns.

Public Health Emergency

The polio outbreak in Burundi constitutes a national health emergency, as poliovirus is extremely contagious. Since its first detection, health authorities have also confirmed five environmental samples of poliovirus type 2 in the wastewater.

Dr. Matshidiso Moeti, the World Health Organization’s (WHO) Regional Director for Africa, praises Burundi health authorities’ fast virus detection in a WHO press release. “The detection of the circulating poliovirus type 2 shows the effectiveness of the country’s disease surveillance. Polio is highly infectious and timely action is critical in protecting children through effective vaccination,” said Dr. Moeti.

How It Started

Poliovirus is transmitted through contaminated water and food. The virus lives in a person’s throat and intestines and spreads through fecal contamination. Early detection of cases is imperative to prevent the viral disease from spreading, as it is extremely contagious.

There are three types of wild poliovirus (WPV): types 1, 2 and 3. The symptoms of poliovirus often look similar to the flu and usually, last two to five days, though symptoms can be worse. Paralysis is associated with the most severe cases.

According to the Global Polio Eradication Initiative (GPEI), and echoed in the WHO’s press release, the cases detected from the polio outbreak in Burundi are “circulating vaccine-derived poliovirus type 2 (cVDPV2).”

The GPEI explains cVDPVs as variants of the poliovirus that can occur as a result of low vaccination rates among children. GPEI informs that areas with poor sanitation and low immunization rates can develop cVDPVs.

According to GPEI, the prevention of cVDPVs outbreaks is possible through immunization campaigns and the immunization of all eligible children. Previous efficient vaccination campaigns have alleviated the outbreak. The GPEI states “the vaccine continues to be a safe, effective tool for outbreak response across the continent.”

Addressing the Outbreak

Since the Burundian government declared a state of public health emergency on March 17, they’re aiming to provide and administer vaccines to as many children under age seven as possible. The vaccine campaign is a necessary step in stopping the outbreak.

According to the CDC, the oral polio vaccine (OPV) and inactivated poliovirus vaccine (IPV) prevent poliovirus infections. OPV contains a weakened version of one of the three types of poliovirus: IPV protects against all three poliovirus types, and contains no live virus.

Both the WHO and GPEI are assisting the Burundi health authorities in contact tracing and risk assessment to prevent a further outbreak in Burundi and nearby nations. Early detection of the virus is essential in containing the illness before it can spread. Burundi health authorities’ quick detection of the outbreak allowed the WHO and GPEI to begin contact tracing and rolling out vaccines efficiently. This efficiency since its first detection means that Burundi, the WHO and GPEI are in a great position to address the outbreak before it worsens.

Curbing the outbreak of polio before it spreads could save the lives of countless people in the country. And with the help of vaccines and other organizations intent on mitigating polio’s effects, those experiencing poverty in Burundi can look to the future with hope.

– Maya Steele
Photo: Flickr

Ending Polio
During the World Health Summit in October 2022, the Bill & Melinda Gates Foundation committed $1.2 billion USD towards ending polio worldwide. This commitment falls in support of the Global Polio Eradication Initiative’s (GPEI) Polio Eradication Strategy 2022 – 2026. The Gates Foundation has donated almost $5 billion to the GPEI.

“Polio eradication is within reach. But as far as we have come, the disease remains a threat. Working together, the world can end this disease,” said Bill Gates, co-chair of the Bill & Melinda Gates Foundation.

The GPEI’s Strategy will need $4.8 billion for full implementation. With the help of The Gates Foundation, UNICEF, The Rotary Club, the United States and many more, a total of $2.6 billion in funding is going towards the Strategy. 

What this Means for Polio Eradication

The Gates Foundation’s financial commitment is only second in amount out of all parties who donated to the GPEI’s Strategy. “The fight against polio has done far more than protect children against polio. It has played a key role in strengthening health systems,” said Melinda French Gates, co-chair of the Bill & Melinda Gates Foundation.

The commitment from the Gates Foundation and all the other parties involved will focus on ending polio in the “last two endemic countries – Pakistan and Afghanistan – and stop outbreaks of new variants of the virus.”

Polio cases have often affected those in the most underserved and impoverished areas across the globe. This is in part because the virus is transmissible through poor hygiene practices which are hard to practice for those without proper water and health care. The following countries and organizations are the others who contributed to the GPEI’s Strategy.

  • Australia
  • France
  • Malta
  • Monaco
  • Spain
  • Turkey
  • United States
  • Bloomberg Philanthropies
  • Islamic Food and Nutrition Council of America
  • Latter-day Saint Charities
  • Rotary International
  • Luxembourg
  • Republic of Korea
  • Japan
  • Germany

GPEI Strategy 2022 – 2026

The Strategy adds to two vital goals that are in line with the current progress of the eradication effort. The two goals are: (1) To permanently interrupt all Poliovirus transmission in endemic countries (Afghanistan and Pakistan). (2) To stop cVDPV (circulating vaccine-derived poliovirus) transmission and prevent outbreaks in non-endemic countries.

The GPEI Strategy will achieve these goals by “[transforming] its approach in each region and country through five mutually reinforcing objectives.” GPEI’s structure and holistic approach to the strategy support these objectives and goals. With everything in place for what the GPEI’s Strategy stands for, the eradication of polio is within reach.

Looking Forward

The Gates Foundation’s ongoing donation to the important goal of eradicating polio is vital to helping those in poverty. Polio disproportionately affects those in poverty as they are often unvaccinated and without proper means for hygiene regimens that would otherwise prevent the virus from spreading. The work of the GPEI, the Gates Foundation, UNICEF and many others can result in the eradication of polio with support from around the globe.

Sean McMullen
Photo: Flickr

Polio Vaccination Campaign
In October 2021, the Global Polio Eradication Initiative reported two polio cases in Bissau and one in Biombo, a region neighboring the capital of Guinea-Bissau. The Ministry of Public Health, with assistance from UNICEF, WHO and partners of the Global Polio Eradication Initiative commenced two polio vaccination campaigns in 2022. “Polio Never Again” vaccinated hundreds of thousands of children in April and June 2022, successfully preventing the spread of the disease, and ensuring that no child in Guinea-Bissau will suffer from polio in the future.

The Vaccination Process in the Polio Vaccination Campaign

Guinea-Bissau’s vaccination campaign involved 3,385 volunteers, split into 677 teams, who traveled door to door in rural communities during the first round of the campaign. UNICEF reports that the campaign began in front of Guinea-Bissau’s Ministry of Public Health on April 27 and decentralized from there. In addition to administering the polio vaccine, teams also administered Vitamin A and Mebendazole.

Upon receiving their vaccinations, vaccination teams marked the children with blue for identification and counted and registered the number of children per household. Purchasing 907,000 doses of polio vaccines and five refrigerators for storage beforehand, the Ministry of Health ensured that the vaccination teams possessed sufficient vaccines when traveling across neighborhoods and villages. Furthermore, Guinea-Bissau’s Community Health Workers (CHWs) strategically planned the targeted households before the start of the campaign, guaranteeing that every child would receive a dose of the polio vaccine.

Succeeding in Spite of Obstacles

Despite the campaign’s eventual success, Guinea-Bissau’s polio vaccination campaign faced several issues throughout the two vaccination rounds. For instance, since Guinea-Bissau contains multiple islands, such as in the Bijagos archipelago which consists of 88 islands, many families frequently traveled between the islands and to the mainland and were hard to track. Coupled with limited transportation methods, vaccination teams often experienced time-consuming routes to vaccinate all children. Fortunately, by frequently interacting with each other, the vaccination teams were able to track down the vast majority of households in Guinea-Bissau.

Another problem that arose during the campaign occurred due to the cashew harvest season, which forced many children to travel to cashew nut fields with their parents. Considering the fact that cashews are among Guinea-Bissau’s top exports, many households rely on cashew harvesting for money, forcing both parents and children alike to take advantage of the short season. Luckily, by consistently interacting and providing updates to one another, the vaccination teams and CHWs were able to track down the majority of households for polio vaccination.

A Brighter Future

By the end of the second vaccination round in June 2022, Guinea-Bissau successfully vaccinated 340,462 children in the nation. With 99.2% of children under 5 vaccinated, the Global Polio Eradication Initiative considered Guinea-Bissau’s polio vaccination campaign a success, with the coordinator of the organization labeling Guinea-Bissau a “pioneer” for reaping such positive results. Furthermore, the vaccination campaign’s strategy also helped create the framework for successive national measles campaigns. Overall, because of such results of its polio vaccination campaign, one can say that Guinea-Bissau has successfully eradicated polio in children for the foreseeable future.

– Emma He
Photo: Flickr

Polio in Pakistan
Polio, for many in the United States today, is not much more than a history lesson. Whether it is former President Franklin Delano Roosevelt’s battle with the disease or the innovations of Dr. Jonas Salk in his creation of a vaccine, the illness tends to only touch most people through books and movies, or when a newborn is vaccinated. Over the last few decades, much of the rest of the world has shared in these triumphs. It is still present in the human population and though outbreaks are diminishing, they do occur. After experiencing significant progress throughout 2021 and for some time into 2022, there are new cases of polio in Pakistan.

What the Outbreak Looks Like

While most people will clear the polio virus without experiencing serious issues, its debilitating symptoms can leave victims with brain and spinal cord injuries. Polio will cause meningitis in around one out of 25 people infected and paralysis in one out of 200. Furthermore, adults who have previously recovered can develop post-polio syndrome which presents itself as new muscle pain or paralysis later in life.

For centuries, people lived with the fear of disability from this disease. Since the advent of vaccinations, the vast majority of nations have eradicated polio. Pakistan, along with its neighbor Afghanistan, has been slower to share in this progress. These two countries are the last where polio is still considered an endemic disease, meaning that it is constantly spreading.

Cases have been diminishing for a long time, however. For example, the incidence of paralysis from polio in Pakistan fell from around 20,000 in the early 1990s to just 84 in 2020. The country recently experienced a hiatus in polio detection that lasted from January 2021 until April 2022 when the diagnosis of polio in a baby boy in the North Waziristan district interrupted the progress, The Guardian reports. Eleven children in Pakistan have been diagnosed with the illness since.

Why is Polio Resurging in Pakistan?

Polio continues to cause outbreaks in Pakistan for much of the same reason that other diseases as many in the population do not have immunity against it. Polio vaccines have proven to be highly effective on the individual level and can create herd immunity when around 80-85% of the population receives a vaccine.

Reaching the level of vaccine coverage that herd immunity from polio requires is difficult because of the misinformation surrounding vaccines in Pakistan. Due to vaccine hesitancy, some parents in Pakistan have obtained fake vaccine markings or simply refused inoculation. Even when they do follow through on receiving a vaccine, mistrust is still high. In 2019, more than 25,000 students asked for hospitalization after unsubstantiated claims of adverse vaccine reactions spread in northwest Pakistan.

Mistrust is not just an endogenous problem. The actions of foreign entities have also caused harm to Pakistan’s health system. In 2011, the CIA ran a fake vaccination program, which collected blood samples of children in an attempt to track down Osama bin Laden by finding his relatives. Oxford University Press article demonstrates that news of the CIA’s campaign not only led to a drop in vaccine uptake between 23% and 39% but also empowered extremist groups.

These groups have engaged in violence against vaccination workers that carry on to this day. Most recently, on June 28, 2022, a gunman killed a polio worker and two policemen involved in vaccination.

What Are the Solutions?

While imperfect, things are far from grim in the fight against polio in Pakistan. As noted earlier, the incidence has plummeted in the last few decades. Much of this is due to vaccine drives from a number of sources including the government and international organizations.

Since the 1990s, the Pakistani government has partnered with the Pakistan Polio Eradication Initiative (PPEI), a group that a consortium of international organizations funded, to create the annual National Emergency Action Plan (NEAP). These plans have demonstrated success through various initiatives to immunize populations via vaccination programs, disease surveillance and outreach.

Under part of its plan, hundreds of thousands of vaccinators go door-to-door offering immunizations to children below the age of 5. Another method these groups have employed to keep spread in check is regular wastewater inspections. This gives public health officials a better idea of disease prevalence and where it is spreading. Finally, to counter much of the misinformation and hesitancy, the plan calls for partnerships with civil society and religious leaders to mainstream the use of vaccines.

Though most countries technically eradicated polio, Pakistan is not alone in the recurrence of it. In 2022, cases have occurred in 30 countries across Africa, Europe and the Middle East. In June 2022, the United Kingdom detected the disease in London’s wastewater. With a polio vaccination rate of 86% in London, a significant part of the population is susceptible to infection demonstrating the danger that festering diseases, such as polio, pose to people all around the world.

– Joey Harris
Photo: Wikipedia Commons

Polio Vaccines in Liberia
After enduring a surge in COVID-19 cases during the month of June 2021, Liberia may be experiencing some relief in its battle to beat the pandemic. According to Dr. Francis Karteh, a chief medical officer in Liberia, the country’s COVID-19 cases declined in the week leading up to July 12, 2021. However, Karteh also emphasized that the Liberian people must remain diligent in their COVID-19 prevention measures. The highly contagious Delta variant may regain strength if individuals become too relaxed. Nevertheless, this news offers hope for the country’s desire to move toward reopening businesses. But, even as COVID-19 infections decline in Liberia, vaccine hesitancy persists. This distrust of vaccines does not solely apply to the coronavirus vaccine though. UNICEF is currently undertaking efforts to reassure Liberians about the safety of polio vaccines in Liberia.

History and New Vaccine Hesitancy

In 2008, Liberia declared itself a polio-free country as a result of its mass vaccination success. However, Liberia recently discovered a circulating vaccine-derived poliovirus (VDPV) strain that stems from what was originally contained in the oral polio vaccine but has evolved to behave “more like the wild or naturally occurring virus.” Consequently, VDPV is more transmittable to the unvaccinated, especially in areas with inadequate sanitary conditions.

For this reason, the eradication of the poliovirus relies on the continued vaccination of children. Unfortunately, the COVID-19 pandemic forced Liberia to halt immunization programs, and as poliovirus infections increased, in February 2021, Liberia’s Ministry of Health announced the poliovirus outbreak as a “public health emergency” for the country.

On top of this, as Liberia begins to resume its polio vaccination operations, individuals are more hesitant about the polio vaccines. Following a year of COVID-19 vaccine misinformation circulating the globe, many Liberians wonder if one can trust any vaccine. Comfort Morphe, a midwife at Hydro MERCI Clinic, says she can “feel the weight [of the misinformation].”

Additionally, Mohamed Shariff, a teacher in the Liberian city of Monrovia, said that the campaign for polio vaccines in Liberia has had to evolve since there have been “so many refusals.” Many find the polio vaccine hesitancy peculiar since Liberia has “been using [the poliovirus vaccine] for years.” With vaccine uncertainty festering throughout the country, it is more challenging to quell the current rise in poliovirus infections.

UNICEF Partnership

Fortunately, in an effort to reduce vaccine hesitancy, UNICEF is partnering with Liberia’s Ministry of Health to communicate factual polio vaccine information through “radio talk shows, community engagement meetings, SMS” as well as posters and banners. The use of SMS notifications is especially beneficial since some communities in Liberia do not have stable internet access.

Volunteers also use the door-to-door approach to speak with parents on the importance of vaccinating children. Ummu Paasewe, for example, who works for Liberia’s Ministry of Health as a community mobilization officer, described how her team assures mothers that the vaccine is “the same kind of oral polio vaccine but more advanced” to combat this specific variation of the poliovirus. As a mother herself, Paasewe’s children are vaccinated and she contends that “immunization is a preventative method.”

Looking Forward

Other countries also see the benefits of supporting Liberia’s vaccination efforts. The Japanese government has supplied UNICEF with $2.7 million since 2020 to support women’s and children’s health in Liberia. Moreover, one of the Japanese government’s chief objectives is to get Liberians vaccinated against the poliovirus and COVID-19.

UNICEF representative to Liberia, Laila Omar Gad, stated that “just one child affected by polio is a risk to all children.” However, UNICEF volunteers remain optimistic and report that they have convinced many Liberian families about the polio vaccine’s safety and reliability. Through the dedication of Liberia’s Ministry of Health and support from UNICEF and Japan, vaccinating communities against the poliovirus looks to be an achievable goal.

Madeline Murphy
Photo: Flickr

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, age 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, 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 Elaka understood that the poliomyelitis virus had infected him, a case that could have been prevented if he had received the polio vaccine. Unable to walk without the use of crutches from the age of 7, Elaka does not take his survival for granted. He spends his free time engaging in community outreach, roaming the streets in an attempt 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 exacerbates 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 lack 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 purchase the vaccines.
  4. Conflict and insecurity in the area.

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

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, can have lifelong consequences. In June 2020, the DRC  doubled the immunization funding budget it had in 2019. In fact, about $16.4 million went toward the purchase of vaccines.

Along with the financing from UNICEF, 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 after 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 established 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 impacts of COVID-19 on the DRC’s mission to vaccinate is challenging. In 2020, the DRC contended not only with COVID-19 but also 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