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

vaccination rates in Papua New Guinea

Across the globe, access to adequate healthcare appears to be of paramount concern for both governmental and non-governmental organizations. Not only does providing health services to underserved and under-represented populations increase general wellbeing and happiness, it has also proven to be beneficial for the economy, per the U.S. Chamber of Commerce.

Pushing for Vaccinations

In February, the southeast Asian nation of Papua New Guinea declared 2019 as “The Year of Immunization,” in an effort to stave off preventable diseases and promote healthier lifestyles. This push to increase vaccination rates in Papua New Guinea was further intensified following several polio outbreaks across the country in Summer and late 2018 as well as in early 2019, and outbreaks of measles in 2014 and 2015 with 2,000 total confirmed cases and over 350 deaths. This recent resurgence in the near-eradicated virus can be attributed to sub-optimal living conditions and lack of wide-spread, generalized immunization.

Furthermore, the efforts to increase vaccination rates in Papua New Guinea would hopefully spur the economy, lifting more citizens out of poverty (as of 2002, 37 percent of New Guinea’s population lived below the global poverty line – approximately 2.5 million people), though this economic boost would act primarily as an added bonus to preventing polio, rubella and measles.

Widescale immunization quickly became a top priority for the government and National Department of Health of Papua New Guinea. While initially a daunting task, the southeast Asian nation partnered with the World Health Organization (WHO), UNICEF and other non-profit organizations, such as the Bill & Melinda Gates Foundation, in order to better coordinate these immunization campaigns.

According to UNICEF, one of the polio campaigns sought to immunize over three million children up to the age of 15-years-old. As of late July 2019, these campaigns have been deemed as successful by the government, significantly increasing vaccination rates in Papua New Guinea. Since February, Papua New Guinea’s National Department of Health, along with the WHO, and UNICEF have led eight successful immunization campaigns, vaccinating approximately 1.28 million children under the age of five for polio, in addition to just over one million children of the same age for rubella and measles.

Cooperation Among Organizations

The success of these campaigns can be traced to swift action and cooperation between the primarily players. The WHO estimates that over 12,000 workers (from vaccination specialists, mobilizers and surveillance officers) helped to orchestrate these movements across the country – movements, which according to The Papua New Guinea National Department of Health, have had a 95 percent success rate.

While these increased vaccination rates in Papua New Guinea are positive signs for the future of the country’s health promotion and disease prevention, it is important to note that Papua New Guinea was declared as polio free in 2000 and went 18 years without a confirmed case of polio. It is essential that Papua New Guinea continue these immunization campaigns in order to guarantee healthier lifestyles for the rest of 2019 and into the future.

– Colin Petersdorf
Photo: Flickr

Vaccine Hesitancy in Developing CountriesVaccine hesitancy, the reluctance or refusal to vaccinate despite the availability of vaccines, has been around since the invention of the vaccine. Recently, there has been an increase in vaccine hesitancy in developing countries due to safety concerns and long-term effects. With this skepticism, outbreaks of vaccine-preventable diseases that were once thought mostly eradicated such as measles, pertussis and diphtheria, have increased in frequency around the world.

This year, the World Health Organization named vaccine hesitancy one of the top 10 threats to global health. Vaccines remain the safest and most cost-effective ways of preventing diseases. Currently, vaccines save between two and three million lives a year.

Furthermore, if coverage improves, vaccines can save an additional 1.5 million lives per year. The reasons for vaccine hesitancy are complex, but a vaccine advisory group identified complacency, inconvenience in accessing vaccines and a lack of confidence as some of the root causes. With these factors identified, if now becomes a question of how to fight these causes of vaccine hesitancy in developing countries.

Complacency

Some health experts have theorized that vaccine skepticism stems from the fact that vaccines are so effective that parents no longer remember or fear vaccine-preventable diseases like measles and polio. Instead, they may focus their anxieties on the safety of vaccines, effects or the number and timing of injections.

Without a proper understanding of the devastating effects of these diseases, parents have less of a motivation to vaccinate. EU Health Commissioner Vytenis Andriukatis said at an international health conference, “We have become victims of our own success.”

Convenience

Vaccine hesitancy in developing countries is often bolstered by the need for medical infrastructure. Inadequacy and the inequities in health systems like poverty, the disparity in infant mortality and life expectancy and a need for trained providers damages community trust.

To combat this, many countries have implemented mandatory vaccinations in schools, with mixed results. In India, for example, during their measles and rubella vaccination campaign, parents objected to their children being vaccinated without their consent, stalling the campaign in court.

Rwanda, on the other hand, was successful in its HPV vaccination campaign by coupling it with an information campaign. The campaign targeted parents and explained the need for this vaccine.

Confidence

Much of the anti-vaxxer movement is built in misinformation. Vaccine hesitancy in developing countries often stems from rumors about vaccines. For instance, that the polio and HPV vaccines caused infertility and impotency. The movement stems from general concerns about the safety of vaccines.

Health workers, especially those operating in the communities, are the parents’ most trusted health advisors and act as the biggest influencer of vaccination decisions. Because of their position, they must be supported so that they may provide parents with credible information. The most effective campaigns to fight vaccine hesitancy in developing countries are the ones that tailor to the community. Healthcare workers in the community are vital for implementing these campaigns.

In Rwanda, for example, healthcare workers went door to door to explain the benefits of the HPV vaccine. They focused on the fact that the vaccination is meant to prevent cancer. The workers brought diagrams of the female reproductive system. They also dispelled rumors by explaining that cervical cancer is far more likely to cause infertility than vaccines. Because the campaigned was tailored to the community, it was met with a lot of success.

Overcoming Vaccine Hesitancy

While there is an increase in vaccine hesitancy in developing countries and around the world, immunization campaigns are experiencing successes. Transmission of wild poliovirus, for example, may stop in Afghanistan and Pakistan this year. Additionally, cervical cancer may be eliminated in 181 countries by the end of the century.

To keep this up, health officials have to be proactive in fighting vaccine hesitancy in developing countries by fighting complacency, making access to healthcare more convenient and building confidence by creating programs tailored to the community.

– Katharine Hanifen
Photo: Flickr

Polio in Somalia
After eradicating polio in 1997, Somalia has reported new cases since 2005 with a surge in outbreaks in 2018. The gradually increasing number of cases shows that the disease is far from gone and caused the World Health Organization (WHO) to call for immediate action in eliminating polio in Somalia in 2018.

Background

Somalia reported 228 cases of polio between 2005 and 2007. The country responded with an immunization campaign of four rounds of national immunization days conducted in 2008. Somalia maintained a polio-free status for six years following the campaign. And the country continues to require two national days of immunization per year following the end of the 2007 outbreak. Its National Child Health Day initiative has added a polio vaccination attempting to broaden the number reached. However, due to a number of challenges, National Child Health Day reaches less than one-half of eligible children.

Resurfacing of Disease

In 2013, polio in Somalia resurfaced with 194 cases. Polio outbreaks around the region were frequent in 2013, due to the influx of refugees fleeing Syria, a country which has had severe outbreaks since the start of the Syrian Civil War. Fourteen months after the first confirmed case, the outbreak was officially over. WHO commended the country for quickly containing the epidemic highlighting the importance of cooperation and commitment between government health officials and parents.

Polio rates in Somalia are highest in southern Somalia, which the WHO considers an inaccessible area. Only 3 percent of children in south Somalia have all three of their polio vaccinations, compared to the 17 percent of children that have all three doses in the northern region. The differing rates correlate with the national borders of Somalia and Somaliland. Northern Somalia declared independence in 1991 as the state of Somaliland, although no other nation recognizes it as independent. Somaliland has since flourished in comparison with democratic elections, working government institutions, a police force and its own currency. Many consider Somalia, by contrast, a failed state. It remains under the control of an Islamist armed group and fights instability and insecurity, causing it to remain in a constant humanitarian crisis. Due to the forces that govern, vaccination campaigns rarely occur, and many NGOs lack access to the region’s vaccination eligible children.

Fighting Back Against Outbreak

Following the 2013 outbreak, UNICEF funded the creation of Dhibcaha Nolosha or Drops for Life. Dhibcaha Nolosha is a weekly 15-minute radio segment attempting to combat the misinformation about polio and polio vaccinations. Of children vaccinated in 2019, less than half of their caretakers understood that children had to have multiple doses of vaccinations. The radio show has medical experts explain how polio transmits and how the vaccination works, including personal stories and space for listeners to ask questions about polio.

Somalia launched a nationwide three-day campaign in March 2019 to vaccinate 3.1 million children under the age of 5. The campaign, launched by the government and supported by the WHO and UNICEF, went door to door with 15,000 frontline polio health workers. The campaign sought to vaccinate all children under the age of 5 with at least the first round of the oral polio vaccine. The WHO plans to continue supporting the efforts with annual campaigns in Somalia along with monitoring any future outbreaks.

Polio in Somalia continues to be a problem with the most recent report in June 2019. Somalia currently has 15 confirmed and open cases but continues to promote vaccination campaigns, trying to regain polio-free status. However, with little cooperation with governing figures in the southern region, the WHO continues to monitor the situation closely.

– Carly Campbell
Photo: Wikimedia Commons

Polio Eradication in Afghanistan, Pakistan and Nigeria - The Final Three
Poliomyelitis, often called polio or infantile paralysis is an infectious disease caused by the poliovirus. It is a devastating disease that primarily impacts children and it can survive in the wild, but not for long without a human host. There is no cure, therefore, immunization is the foundation for eradication efforts. Today, polio is almost entirely eradicated from the planet.

Global immunization campaigns have made terrific progress in decreasing wild poliovirus (WPV) cases by over 99 percent in the past 30 years, down from an estimated 350,000 cases in 1988 to 29 reported cases in 2018. While more work needs to be done, the world is closing in on the virus and all eyes are on polio eradication in Afghanistan, Pakistan and Nigeria– the three final endemic countries. In the text below, the status of polio in these three countries is presented.

Polio Eradication in Afghanistan

Between the three countries listed above, in 2018 the most global polio cases were reported in Afghanistan. However, Afghanistan is the only endemic country not currently battling vaccine-derived polio, a form that can paralyze, in addition to WPV, which is a victory. The Global Polio Eradication Initiative (GPEI), in conjunction with Afghanistan’s Emergency Operation Centres, has dedicated continuing high-priority surveillance and instituted an aggressive immunization campaign to eradicate WPV in order to protect those most affected.

In November 2018, the country concluded an immunization campaign that targeted over five million children in the highest-risk provinces. These accomplishments are impressive, but at the same time fragile, because every single child must be vaccinated in this rapidly growing country. The Emergency Operation Centres are continuing to work under a National Emergency Action Plan and with local communities to ensure that all children are consistently reached now and in the future.

Polio Eradication in Pakistan

Polio could be eliminated from Pakistan this year, with continued strategic implementation. A vaccination campaign in December reached nearly 40 million children and the number of reported cases in the country is the lowest it has ever been. The race to the finish line requires continued focus on immunity gaps in high-risk and mobile communities, especially those that are close to the places where the virus is still indigenous, as well as continued accountability and high childhood vaccination rates.

Additionally, several of the endemic polio regions remain on the border with Afghanistan, which will require the two countries to continue addressing these WPV strongholds together. This region highlights the continued global threat of a virus that transcends geopolitical boundaries.

Polio Eradication in Nigeria

While WPV has never stopped circulating in Nigeria, there have not been any WPV cases since 2016. This is a terrific start towards wild polio eradication, but Nigeria has seen years without a WPV outbreak in the past only to see it return. The country is also managing continued vaccine-derived outbreaks. While immunization is paramount to eradication, some forms of the vaccine can infect patients and cause an outbreak. Though this adds a complex level to eradication strategies, immunization remains the most viable solution.

Currently, a variety of innovative solutions are underway to reach children in high-risk areas, including international immunization campaigns in the Lake Chad Basin whenever security permits, market vaccinations and seeking out nomadic communities. Similar to Afghanistan and Pakistan, continued efforts remain focused on closing immunity gaps, vaccinating all children and working with the country’s neighbors, but additional support for political and financial commitment is needed in Nigeria.

Going Forward

Wild polio eradication in Afghanistan, Pakistan and Nigeria is almost complete, but there are several challenges facing major vaccination efforts. In order to achieve elimination, every single child needs to be immunized. Even one unvaccinated child leaves the entire world at risk of infection.

There are, however, real challenges to this seemingly straightforward goal. Barriers like reaching children in mobile populations or in active conflict zones require international political coordination and more resources for mobile and stationary vaccination teams. Another major barrier is vaccine-derived polio cases, which threaten populations that don’t currently see polio in the wild. Research into the implications of adjusting the vaccine are underway and seek to address eliminating the spread of vaccine-derived infection.

It will not be possible to eradicate every disease with vaccination. Polio is one of the ones that can be. As global health efforts target polio eradication in Afghanistan, Pakistan and Nigeria, the world will likely be able to list polio next to smallpox and rinderpest on the coveted list of globally eradicated diseases.

– Sarah Fodero

Photo: Flickr

Australia Pledges $10 Million to Fight Polio in Papua New Guinea
Recently, the Australian government pledged $10 million to fight polio in Papua New Guinea. Australia’s contribution will go towards preventing the spread of infectious diseases and expanding the reach of vaccination campaigns. Earlier this year, the first case of polio since 2000 arose in Papua New Guinea. The government has declared the polio outbreak a national public health emergency. Since Australia is Papua New Guinea’s closest neighbor, the polio outbreak is a health threat to both countries. This shared interest spurred Australia’s decision to help contain Papua New Guinea’s polio outbreak.

Polio Around the World

Poliomyelitis, or more commonly known as polio, primarily targets children under the age of five. Polio is caused by a virus, which spreads primarily through contact between people. Though the first symptoms are relatively mild, as the infection spreads through the nervous system, it can lead to paralysis, which is the case in one out of every 200 infections. While there is no cure for polio, the disease is entirely preventable. If children receive the polio vaccine for the recommended amount of times, they can become immune to the virus.

Though the global incidences of polio have fallen by more than 99 percent since 1988, polio is still a public health threat to children around the world. According to The World Health Organization, if even one child still has polio, children in every country are at risk for contracting it. Unless polio is completely eradicated, there could be nearly 200,000 new cases of polio worldwide each year over the next 10 years. Because of polio’s highly infectious nature and the great health risks it brings, the international community must focus on vaccinating children worldwide.

An Outbreak of Polio in Papua New Guinea

For the past 18 years, Papua New Guinea was polio-free. Unfortunately, in April 2018, a young boy in Papua New Guinea’s northern region surfaced with symptoms consistent with polio, including lower limb paralysis. The following month, doctors diagnosed the boy with a vaccine-derived poliovirus type one. The single case worsened shortly afterward when stool samples from two children in the same neighborhood displayed the same strain of polio. The National Department of Health of Papua New Guinea and The World Health Organization both confirmed the diagnosis and Papua New Guinea’s polio outbreak.

In the Morobe province, where the first case emerged, only 60 percent of the children had received the approved three-dose polio vaccination cycle. Lack of proper sanitation and clean water also increased the risk of polio contagion in the area since the virus can spread through contaminated food or water. Immediately following the outbreak’s announcement, The National Department of Health, along with the World Health Organization and the Global Polio Eradication, introduced a large-scale immunization campaign.

Papua New Guinea’s Health Secretary, Pascoe Kase, underlined the importance of this vaccination campaign, saying the “immediate priority is to respond and prevent more children from being infected.” Moving forward, Papua New Guinea will work in conjunction with The World Health Organization to continue investigating the outbreak and enhancing the response efforts.

Fighting Polio in Papua New Guinea

Alongside other donors, such as The U.S., Canada and Papua New Guinea’s government, the Australian government hopes its $10 million donation will curb the current polio outbreak as well as prevent future infectious diseases. All these donations will benefit the country’s emergency vaccination campaign, totaling $21 million. The campaign hopes to vaccinate more than 3.3 million children in the country, with a special focus on children in densely populated areas.

With the donations from Australia, as well as other countries and organizations, the government of Papua New Guinea has enough funding to cover nearly all of the vaccination expenses. Dr. Mills in Euga province, who is also the president of The Society of Rural and Remote Health, remains hopeful that vaccination efforts will eradicate polio in Papua New Guinea once again.

In recent years, funding for immunizations had dropped, leaving many children vulnerable to polio. As he put it, “let’s hope [the outbreak] provides the impetus to refocus our attention on these basic things,” such as consistent vaccinations programs. He emphasizes that to prevent future polio outbreaks, methods of prevention and intervention must be a priority for Papua New Guinea.

– Morgan Harden
Photo: Flickr

Polio in Papua New Guinea
A polio outbreak was reported in Papua New Guinea. This is the first time polio has been seen in the country in nearly two decades, and an especially poignant occurrence as polio is extremely close to eradication around the world.

What is Polio?

Polio is a dangerous virus spread through food, water and contact with infected people. Those who do not have access to adequate sanitation are especially vulnerable to the virus.

Polio multiplies in the intestines but can move to other parts of the body through the bloodstream and affect the nervous system. This can lead to paralysis. The poliovirus has no cure once contracted, so the only route to the end of polio is through vaccination and other methods of prevention.

How Do You Treat Polio?

There are two forms of vaccination against the polio virus, but oral poliovirus vaccines (OPVs) are the vaccine predominantly used across the world today. OPVs are inexpensive, at a maximum of $0.18 for countries supplied by UNICEF in 2016.

They also are easy-to-use as they are administered orally. Such facility means that the vaccine does not need trained healthcare personnel or sanitized syringes for application.

Polio in Papua New Guinea

The strain of polio in Papua New Guinea is known as vaccine-derived poliovirus type 1. This form of poliovirus is caused by a mutation of the weakened version of the polio virus used in the oral vaccine. The weakened version of the virus stays inside the person who has received the vaccine for several weeks. During this period of time, the body excretes the virus.

In areas with poor sanitation, the vaccine virus can be transferred from person-to-person and can also pass on a passive immunization to others in the community. However, if there is low immunization in a region, the virus can continue transferring for an extended period of time. This spread can lead to mutations in the virus and, in extremely rare cases, the virus can become neurovirulent again in what is called a vaccine-derived poliovirus.

Morobe Province and Prevention Methods

Within the Morobe Province — the region of Papua New Guinea where the virus outbreak was found — only 61 percent of the children had received the three doses of the oral polio vaccine recommended by the World Health Organization (WHO). This lack of immunization in conjunction with the lack of adequate sanitation increases the spread of the virus and the danger of the outbreak.

WHO, the National Department of Health, the Global Polio Eradication Initiative and other groups are working alongside the government of Papua New Guinea to contain the virus. Since the confirmation of an outbreak of polio in Papua New Guinea, several large-scale measures have been put into place to prevent any further spread of the disease.

These measures include extensive immunization of those in the region where the virus has been detected, especially for children under the age of 15, and increasing surveillance measures in order to detect any new cases of polio. Plans have also been established to employ more immunization campaigns in the coming weeks.

International Aid

Global efforts to eradicate the polio virus were launched in 1988. Since that time, polio incidence has dropped by 99 percent across the world. The wild poliovirus only remains endemic in three countries: Afghanistan, Pakistan and Nigeria. In 2017, there were 22 cases of wild poliovirus and 96 cases of vaccine-derived poliovirus.

This dangerous disease is close to global eradication; however, the outbreak of polio in Papua New Guinea shows that the virus remains a danger in areas with insufficient sanitation and lack of adequate vaccinations. Organizations across the world continue to fight to keep everyone safe and to end the poliovirus once and for all.

– Lindabeth Doby
Photo: Google

Polio in Nigeria
This year, the Bill and Melinda Gates Foundation will start paying off Nigeria’s $76 million debt over the course of the next 20 years. The money was originally borrowed from Japan by Nigeria to fight the polio epidemic in the country.

In 2017, Nigeria had no new cases of polio, which is a significant improvement compared to 2012, when Nigeria accounted for half of all cases worldwide. The Gates Foundation decided to repay the debt on the premise that Nigeria would ramp up its polio vaccination efforts.

The Importance of Polio Eradication

Polio cripples and can potentially kill those who suffer from it. The disease damages spinal nerve cells, causing temporary and sometimes permanent paralysis. Paralysis can sometimes occur within a matter of hours. It is often spread through contaminated food and water. Up to 10 percent of those who become paralyzed die.

Thankfully, there is a vaccine that has contributed to the almost total eradication of polio worldwide. The main problem is getting the vaccine to the children who need it. In order for Nigeria to receive the money from the Gates Foundation, it has to provide vaccine access to at least 80 percent of the country.

The key to eradicating polio in Nigeria is to send health workers across the country to provide the vaccine. Children and families are unable to travel to receive the vaccine, so Nigeria has begun a campaign to bring the vaccine straight to people’s homes, with the support of the Gates Foundation.

Fighting Polio in Nigeria a Priority of the Gates Foundation

Polio in Nigeria was by far the biggest issue in the overall epidemic, which is why Bill and Melinda Gates honed in on the country after announcing that the eradication of polio was their highest priority. In addition to beginning to repay Nigeria’s loan, the Gates Foundation donated $3 billion in 2017 to polio eradication.

The change these donations have made in the epidemic of polio in Nigeria is tangible, since there are currently no known cases in the country. Worldwide, there are only 22 known cases, down from 350,000 cases 30 years ago.

Children today are walking that would have been paralyzed were it not for the generosity of the Gates Foundation and organizations like it. Volunteers on the ground are also the unsung heroes.

On his blog Gates Notes, Bill Gates wrote, “The heroes who have made this progress possible are the millions of vaccinators who have gone door to door to immunize more than 2.5 billion children. Thanks to their work, 16 million people who would have been paralyzed are walking today.” The efforts of these workers should not go unnoticed, as the progress made would not have been possible without people like them.

The progress towards mitigating polio in Nigeria has been phenomenal, with the disease now entirely eradicated from the country. It only takes one child or one traveler for polio to begin to spread again, so it is essential for the countries with a history of the disease to continue their efforts to fight it. Continual vaccinations and immunizations are necessary to maintain the current polio-free Nigeria.

– Amelia Merchant
Photo: Flickr

Vaccinations in Egypt
Vaccinations have been proven to be the most powerful and most cost-effective health intervention that can be provided to a population. Vaccinations have been proven to reduce disease, disabilities and deaths, especially in children under the age of five. The majority of unvaccinated children reside in low to middle-income countries where health systems are compromised, such as Egypt. Vaccinations in Egypt have proven incredibly successful, but the country still has a ways to go.

There are three main organizations that supply vaccinations to low-income countries. These are UNICEF, the Pan American Health Organization and the Gavi, the Vaccine Alliance. These organizations understand the impact vaccinations have on the eradication of disease.

Vaccinations in Egypt Have a Track Record of Success

Vaccinations have had a large impact on the health of children in Egypt. The vaccinations in Egypt that have been the most successful are poliomyelitis and neonatal tetanus. These vaccinations are responsible for nearly eradicating these diseases. The last case of polio was recorded in 2004, and by 2005, only 25 cases of neonatal tetanus were recorded.

Egypt established the National Immunization Program in the 1950s, and the first vaccinations introduced to the population were tuberculosis and diphtheria. Pertussis and tetanus vaccinations in Egypt became available in the 1960s. In 1977, the measles vaccination was introduced, followed by the measles, mumps, and rubella (MMR) combination in 1999.

However, better access to vaccinations in Egypt is critical. Measles and rubella were the most common diseases prior to vaccination programs in 1977, and even though it has been estimated that as of 1999, 95 percent of children were vaccinated with MMR, there were still major outbreaks of measles and rubella in Egypt between 2005 and 2007. Measles was considered endemic until 2008, when measles cases were estimated at less than one per every 100,000 people.

International Efforts to Increase Access to Vaccines in Egypt

Egypt has developed a strategy to increase access to vaccinations for the general population. The main organizations that coordinated and funded this plan are the Ministry of Health and Population, UNICEF and the World Health Organization. The plan is to increase access to vaccinations in Egypt in these ways:

  • Target 36 million children between the ages of two and 19
  • Maintain coverage of the vaccinations already supplied
  • Strengthen and increase school immunization programs
  • Obtain stronger disease surveillance
  • Improve social mobilization
  • Establish the Interagency Coordinating Committee

Egypt has put forth great effort to provide vaccinations to all of its children. However, there is still a substantial need for more vaccinations in Egypt.

There are nonprofit organizations that are working to improve this situation for Egypt and other countries in need. The Access to Medicine Foundation is motivating the pharmaceutical industry to aid low to middle-income countries such as Egypt. In 2008, the Access to Medicine Foundation published the first Access to Vaccines Index. This index acknowledges the pharmaceutical companies that are responding to the need for vaccination in low-income countries and highlights each company’s progress. There are many positive actions that are improving access to vaccinations in Egypt and other low-income countries. However, the need is still present and crucial.

– Kristen Hibbett
Photo: Flickr

India’s fight against Polio
Polio, or poliomyelitis, is an infectious disease spread through poliovirus. Since the early twentieth century, polio has been widespread in many countries, causing paralysis in thousands of children every year. With the help of various nonprofit organizations and the Global Polio Eradication initiative, the disease is now narrowed down to a handful of nations.

In 2014, India was certified as a polio-free country, leaving Pakistan, Nigeria and Afghanistan on the list for polio eradication programs. India’s fight against polio is a remarkable achievement because of the various challenges the country faced. Nicole Deutsch, the head of polio operations for UNICEF in India, called it a “monumental milestone.”

Polio: Cause and Prevention

Poliovirus is highly contagious, infecting only humans and residing in the throat and intestine of the infected person. It spreads through feces and can contaminate food and water in unsanitary conditions.

The virus affects the brain and spinal cord of the infected person, causing paralysis which cannot be cured. Immunization through inactivated poliovirus vaccine and oral poliovirus vaccine are the only possible methods to fight against the virus. In the case of India, it was the second option which was administered.

India’s Fight Against Polio: the Challenges Faced

India’s fight against polio faced unique challenges, such as its huge population density and an increased birth rate. The number of people living in impoverished conditions with poor sanitation is huge, making them vulnerable to the polio disease.

Lack of education and prejudice among certain sects of the population also hindered the immunization process. Other challenges faced were the unstable healthcare system, which does not support people from all levels of society, and the geographically-dispersed inaccessible terrain, which made the immunization process difficult.

Overcoming these Challenges

Overcoming the challenges of polio eradication was possible due to the combined help provided by UNICEF, WHO, Rotary Club, the Indian government and millions of frontline workers. They took micro-planning strategies to address the challenges faced by the socially, economically, culturally and linguistically diverse country that is India.

India began its oral polio vaccine program in 1978 but it did not gain momentum until 1994, when the local government of New Delhi successfully conducted a mass immunization program for children in the region. From the year 1995, the government of India began organizing National Immunization Day, and in 1997, the first National Polio Surveillance Project was established.

Other initiatives taken include:

  • Involving almost 7,000 trained community mobilizers who went door-to-door, educating people in highly resistant regions.
  • Engaging 2.3 million vaccine administrators who immunized almost 172 million children.
  • The government running advertisements on print media, television and radio.
  • Enlisting famous Bollywood and sports celebrities to create awareness among common people.
  • Involving religious and community leaders in encouraging parents to vaccinate their children.

Inspiration for Other Countries

In 2009, almost 741 polio cases were reported in India, which dropped down to 42 in 2010, until the last case was reported in 2011 in the eastern state of West Bengal. This unprecedented success is an inspiration for countries like Pakistan, Afghanistan and Nigeria, where the disease is still looming at large.

India’s fight against polio has set an example in the world that the country can be proud of, but the fight is not over yet. Although India has been declared polio-free by the WHO, it is of the utmost importance that the nation continue to assist other nations still facing the polio epidemic.

– Mahua Mitra

Photo: Flickr