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Eradicating Polio in Developing Countries

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

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International Affairs Budget: Prevent Funding Cuts

International affairsThe International Affairs Budget is a crucial investment in foreign aid and development. Fighting diseases and epidemics, providing humanitarian aid and educating children who are most vulnerable to dropping out and not receiving an education are just some of the areas where funding is applied. Those suffering from poverty are less likely to receive aid and proper health services necessary to prevent and cure illnesses.

Thinking about more recent epidemics, such as the Ebola and Zika virus, it can be seen that funding for health-related programs within The International Affairs Budget was crucial to lowering the statistics of those who are affected. Up to now, 16 percent of The International Affairs Budget is dedicated to global health funding. This includes maternal and child healthcare, nutrition and tackling diseases such as polio and HIV/AIDS.

The Polio Virus Around the World

The Polio vaccine is a great example of a threat that could be eradicated with the correct application of foreign aid. Polio, also known as Poliomyelitis, is an infectious disease that causes paralysis and possibly death. According to The Polio Global Eradication Initiative, as of 1988, polio has infected and paralyzed over 1,000 children daily worldwide.

In 1931, Sir Macfarlane Burnet and Dame Jean MacNamara were able to identify multiple strains of polio, which became known as types 1, 2, and 3. In 1955, a polio vaccine was introduced from wild-type poliovirus strains that were killed, therefore inactive. Also known as IPV, this form of the vaccine has been able to eliminate polio from countries such as Scandinavia and the Netherlands.

In 1961, the oral polio vaccine, a mixture of the 3 strains of polio, was introduced. The strains selected are less likely to originate within the body and be spread to others. Due to the high rates of success of the OPV, alongside its low cost to purchase, this version of the vaccine has been key in globally eliminating polio.

Despite these 2 forms of vaccines being available, The Polio Global Eradication Initiative reports that 430 million children are still at risk of contracting polio, mainly in Africa and Asia. As of February 2015, The United States government approved a $228 million in funds to tackle the elimination of polio.

Once a pandemic, now the rates of polio have been reduced by 99.99 percent because of funding that has gone towards research and creating initiatives such as The Global Polio Eradication Initiative to continually fight polio.

The Smallpox Virus Around the World

Variola virus, also known as smallpox, was an infectious disease that caused fever and a specific type of progressive skin rash. While many recovered from the disease, three out of 10 died and, of those who survived, many had large scars left on their body.

Looking back at the history, there had been several global outbreaks of smallpox from China to Africa to Australia. In 1959, The World Health Organization (WHO) started a plan to eradicate smallpox, but it was difficult to obtain funding and countries willing to participate. When The Intensified Eradication Program started in 1967, progress was made in areas such as South America, Asia and Africa. One thing that became clear was that, with the eradication of smallpox, comes lower medical expenses.

For instance, when smallpox was finally eradicated in 1980, quarantine conditions no longer had to be initiated. When combined with the costs of the disabilities of those who had survived the disease after fighting smallpox, the savings were around $1 billion. Therefore, it can be concluded that with funding, comes research and initiatives, which heightens the likelihood of vaccines and lowers medical expenses both domestically and globally.

HIV/AIDS Around the World

Around $330 million of the global health percentage of The International Affairs Budget has been dedicated to HIV/AIDS. Out of these funds, $275 million will be shared with Gavi, The Vaccine Alliance. According to The Lancet, AIDS-related deaths, when comparing 2005 to 2016, have decreased .9 million. In addition, the rates of new infections have decreased by 16 percent.

One reason for this decrease is because of increased treatments that are available due to an increase in funding. Therefore, if funding is reduced, inversely, there would be a rise in infection rates of HIV/AIDS due to lack of research, services and education about preventing the virus.

As readers can see, The International Affairs Budget is crucial to the progression of global health. Instances such as polio, smallpox and HIV/AIDS are prime examples of how funding can be the key to reduction and even eradication. With increased funding, comes increased research, cures, education and prevention techniques. E-mail your senators and representatives today to urge their support and protection for the funding of The International Affairs Budget.

– Jessica Ramtahal

Photo: Flickr

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Global Polio Vaccine Switch Successful

polio vaccineIn a coordinated effort of unprecedented size in vaccine withdrawal, 155 countries switched polio vaccines. The switch to the newer form of the polio vaccine occurred between April 17 and May 1 and could help stop the trend of polio-based paralysis in hundreds of thousands of children.

Monitors from the World Health Organization are following up in various countries to confirm that stocks of the old vaccine have been properly disposed of. The switch was the second phase of the WHO’s Polio Eradication and Endgame Strategic Plan 2013–2018.

Eventually, the WHO’s plan anticipates a complete withdrawal from oral polio vaccines in 2019 or 2020.  In addition, it foresees a complete reliance on inactivated vaccines, which contain dead forms of the virus.

Health care providers use oral vaccines because they are cheap and easy to administer. These vaccines work by containing a weakened, but still live, form of poliovirus and exit in the stool shortly after vaccination. In areas with very inadequate sanitation, the viruses have an extremely small chance of spreading between children and redeveloping the ability to cause paralysis.

The switch is from a trivalent form of the polio vaccine that protected against three strains of the virus. The newer, bivalent form no longer contains the type 2 strain, which has been declared eradicated in its “wild” form with no new cases since 1999. Because the Type 2 vaccine viruses can reduce immunity to the other strains and increase the chance of redeveloping paralysis, removal of the type 2 component was the next step in the long-term polio eradication plan.

The global polio eradication has found success in all but two countries, Pakistan and Afghanistan, since it began in 1988. The U.S., which discontinued use of the oral vaccine since 1999, relies on the injectable polio vaccine and was not involved in the recent switch.

The slight possibility of a Type 2 poliovirus outbreak exists because of the switch. Therefore, a stockpile of monovalent oral polio vaccine containing only the type 2 virus will be kept. Synchronizing the switch across the globe was thus crucial in minimizing the risk of the Type 2 poliovirus reemergence.

Polio is at its lowest rates in history. Leaders of the eradication program foresee that if no additional cases occur in the next three years, polio could be declared fully eradicated by 2019. However, countries should continue vaccination for at least five years afterward. If success continues, polio will be only the second disease after smallpox to be eradicated by vaccines.

– Esmie Tseng

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Fighting Polio in Pakistan

Polio Cases on the Rise in Pakistan
The focus on the fight against polio has shifted from Africa to Pakistan and Afghanistan, according to the World Health Organization (WHO). There have been no cases in Africa this year, with Nigeria to be removed from the list soon. Africa will have to go with two years of no polio cases before it can be considered “polio-free.”

There have been 34 polio cases this year, 28 of them have occurred in Pakistan and the rest have occurred in Afghanistan. There have been 28 cases of polio in Pakistan, 13 of which occurred in Khyber Pakhtunkhwa and 8 in Peshawar. Just last year, Pakistan saw the highest number of polio cases since 1998, a total of 296 polio cases.

The campaign to end polio faces a number of challenges. These vaccination campaigns have to deal with political instability and internal conflict in the region. They are often attacked by militants who believe immunization teams and polio workers might be a cover for espionage.

The political instability and internal conflict have caused a large population of refugees and slum areas where people are unaccounted for and have little to no access to health care.

There is also a lack of education regarding the effectiveness of polio vaccinations. In the region, there are rumors claiming they cause infertility. Before the vaccine was developed in the 1950s, polio affected everyone, rich and poor, and caused irreversible paralysis within hours.

The good news is, this past year, Pakistan ran its first eradication program. The World Health Organization (WHO) even reported more vaccinations in tribal areas where the government has less control.

WHO estimates that $50 billion could be saved in the next 20 years if polio is eradicated. In contrast, not eradicating polio could lead to 200,000 new cases every year within 10 years. Polio is on track to being the second infectious disease to be eradicated after smallpox.

– Paula Acevedo

Sources: Dawn, Thomson Reuters Foundation
Photo: Google Images

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Vaccine-Resistant Polio: the 2010 Congo Outbreak

Vaccine-Resistant Polio
On August  18, a study published in the Proceedings of the National Academy of Sciences discovered the cause of the particularly deadly 2010 polio outbreak in Congo: a mutated strain that is resistant to vaccination.

Of the 445 infected, almost half of them succumbed to the virus. The outbreak’s high death rate of 47 percent was originally attributed to low immunization coverage but is now thought to be caused by a mutated strain originating from Southeast Asia. The vaccine-resistant polio strain featured a combination of two mutations that both affected the proteins of the strain’s coat, effectively making it more difficult for the antibodies to recognize and stick on the virus.

The research team tested blood samples from Gabon and from German medical students that had been vaccinated. They found that their antibodies were less effective against the Congo variant and that approximately 15 to 29 percent of the students would have been unprotected from the Congo version.

The vaccine used in Congo and in most developing countries is a weaker, dead serum and was not sufficient in providing protection. In contrast, individuals that receive the live, oral polio vaccine are provided with the strongest immunity and are protected from this polio variant.

The spread in the Congo was stopped by the administration of oral vaccine to the entire population of the surrounding areas.

While the disease is only widespread in three countries, Nigeria, Afghanistan and Pakistan, the larger concern is that similar outbreaks will appear as the world is on the cusp of completely eradicating polio. Areas where dominant strains have been eradicated but vaccine coverage is low are at risk of mutated strains in particular.

However, there are a number of promising methods for prevention and the eventual eradication of polio.

By simply increasing vaccine coverage and surveillance, outbreaks can be detected earlier or completely prevented with high vaccine implementation.

In addition, double vaccination has also proved effective in boosting immunity. By combining the oral vaccine with an additional injection of the inactivated virus, the provided immunity is much more effective than the typical application of two drops of the oral vaccine.

On the other hand, there are still many barriers impeding efforts to eliminate polio.

Delays with updating the public database with the most recent poliovirus sequences have been impeding research among the wider scientific community.

Moreover, security issues in high-conflict regions where vaccination is used as a political tool prevent successful vaccination coverage. The effectiveness of the double vaccination approach is especially promising due to its efficiency under limited access. With a brief period of time, the double vaccination method achieves much more than with the oral vaccination method.

While much has been done to almost eradicate polio, there must still be efforts to achieve the complete annihilation of the virus.

– William Ying

Sources: Proceedings of the National Academy of Sciences of the United States of America, Nature, Yahoo News, Live Science, BBC
Photo: flickr

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Eradicating Polio in India

Polio_India_eradicating_health
The World Health Organization is currently testing the last samples of the polio virus to certify India’s clear status next month. Since 2012, India has been removed from the list of polio-endemic countries and through a sustained immunization program, has set an impressive public health goal for other developing countries to follow.

Eradicating polio has not been an easy feat for India. This infectious disease that causes crippling disabilities, left 35,000 people paralyzed every year during the 1980s. During this time, over 100 countries fought to eradicate polio by setting up campaigns that stopped this endemic in several nations. Countries such as Pakistan, Nigeria and Afghanistan are still suffering however.

According to the CDC, every child needs to be vaccinated against polio or consequently, a resurgence could lead to over 200,000 children worldwide being paralyzed every year. The success of India’s large scale immunization program has built up the nation’s confidence. India’s Minister of Health, Ghulam Nabi Azad, explained that the success of India would not have been possible without political involvement, financial resources and technological innovation to inoculate against the virus. Azad further detailed that 2.3 million volunteers worked tirelessly during the campaign to vaccinate approximately 170 million children for each round of immunization.

Despite these paramount changes, health experts fear that polio may rise in other areas, although statistics remain low for most developing nations. Recent polio cases from 2012 are from the following polio endemic countries:

Afghanistan – 26

Nigeria – 97

Pakistan – 47

India was removed from this list of polio-endemic countries because it met the following three milestones:

1. No new cases of polio reported within a three year period

2. Disease surveillance efforts coincide with international standards for polio

3. Workers are able to detect and respond to every polio case reported

Thanks to the Global Polio Eradication Initiative that began in 1988, over 2.5 billion children have been immunized against the polio virus. The CDC, Unicef and WHO and several national governments worldwide were able to decline the number of cases by over 99% since 1988. Fundraising efforts by many organizations, including the Bill & Melinda Gates Foundation, have also been key to polio prevention for several nations. The hope is that in 2014, cases of this debilitating disease will continue to decrease so that families worldwide can lead productive lives.

– Maybelline Martez

Photo: The Hindu
Sources: World Health Organization, FTDC, BBC

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A Picture of Polio

polio_immunizations_developing_countries
Since 1979 the United States has been free of the disease that at one point crippled 35,000 people per year. Although Polio has now been stopped in the United States, several countries continue to suffer from the Polio virus. This infectious disease spreads rapidly to the spinal cord and can ultimately lead to paralysis. Unfortunately there is no cure for the disease but thanks to the Polio vaccination, its spread is better controlled. Many are unaware of what causes Polio so an overview including symptoms will be presented. 

“Polio” is short for Poliomyelitis which is caused by a virus that infects the nervous system. Though the virus is usually transmitted through person to person contact, 95% of those infected don’t have any symptoms. The virus tends to remain inside the human body, reaching the environment through either a fecal or oral route. Infection is rampant in areas that are extremely unsanitary and where children are exposed to the fecal material of other infected people. Since the Poliovirus enters humans, for the most part, through the mouth or nose, it is inclined to spread easily. Once in the throat, the virus multiplies until reaching the bloodstream, possibly even infecting the nervous system. Complications that arise from the virus include the following:

  • Pneumonia
  • Shock
  • Urinary tract infections
  • Paralysis
  • Loss of intestinal function
  • Lack of movement
  • Muscle weakness

Several treatments in developing nations have been adopted to help counteract these symptoms including antibiotics for infections, painkillers for muscle pain, physical therapy and surgery for muscle complications. Additionally, the Polio immunization prevents the spread of the virus in over 90% of the population though cases in which the spinal cord and brain are not involved have a positive outlook from the start. This vaccination has proven to be extremely effective as illustrated through the fact that global immunization campaigns have diminished thousands of cases worldwide. Polio outbreaks are, however, still seen in Asia and Africa, but several organizations are continuing to campaign for vaccine accessibility.

Polio

– Maybelline Martez

Sources: Centers for Disease Control, Mayo Clinic, NIH,
Photo: Foreign Policy