Posts

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

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

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_EradicationToday, the Global Polio Eradication Initiative in collaboration with the World Health Organization (WHO), in the largest public-private partnership in healthcare, has reduced polio by 99 percent.

The two organizations first came together in 1988, a time when wild poliovirus was endemic in 125 countries and about 350,000 people, primarily young children, were paralyzed by polio annually. Since then, it is estimated that 10 million children globally have been saved from paralysis.

According to global polio surveillance data from November 4, 2015, 51 cases of wild poliovirus have been reported this year. Thirty-eight of those cases occurred in Pakistan and the remaining 13 cases appeared in Afghanistan.

The Initiative’s goal is to ensure a polio-free world for future generations by distributing a polio vaccine to every child.

According to NPR, the oral polio vaccine may go down in history as one of the most powerful public health tools of modern times. The vaccine is cheap, easy to administer and has pushed polio to the brink of extinction.

But, there is a downside to this version of the vaccine. Unlike its predecessor, a vaccine which is administered by injection, the oral version contains live polio virus. Under some circumstances, the virus from the vaccine can spread, mutate and cause the same paralysis it intended to prevent.

This occurs when a child who’s been vaccinated sheds live virus in their stool. Like wild poliovirus, these vaccine-derived strains thrive in places where there’s poor hygiene, particularly when drinking water is contaminated with human sewage.

The number of vaccine-derived polio cases relative to the hundreds of millions of doses of oral polio vaccine administered each year is incredibly low. According to the Initiative, to date this year, only 16 cases of vaccine-derived polio have been reported globally.

But, that’s almost 11 percent of all cases of polio globally.

Last month, the WHO announced the beginning of a program to phase out oral polio and switch to a safer oral vaccine by April 2016 that contains no live virus.

“The idea of the polio eradication is…to eradicate viruses whether they’re in vaccines or in the environment,” says Elias Durry, emergency advisor on polio for the WHO’s Eastern Mediterranean region. “To get rid of the virus we have to also remove the vaccine that contains the virus.”

Eventually, the rest of the oral polio vaccine used around the globe will be withdrawn from circulation and the final vials destroyed.

It is imperative that we make this final push towards eradication a top priority.

Dr. Thomas R. Frieden, director at the Center for Disease Control, explains, “If we fail to get over the finish line, we will need to continue expensive control measures for the indefinite future . . . More importantly, without eradication, a resurgence of polio could paralyze more than 200,000 thousand children worldwide every year within a decade.”

Kara Buckley

Sources: CDC, Gates Foundation, NPR, Global Polio Eradication Initiative, WHO
Photo: Flickr

polio_eradication_in_nigeria

1. Is Nigeria “polio-free?”

Not yet. Global health organizations have not documented a case of polio in Nigeria–one of three nations that have never fully eradicated polio–since July 24, 2014. However, the World Health Organization (WHO) will not declare Nigeria “polio-free” until the West African nation reaches a full year with no new cases.

2. Is it probable that polio will permanently be eradicated in Nigeria?

That depends on whom you ask. On one hand, polio eradication in Nigeria has almost been successful, and recent media coverage seems hopeful that no new cases will appear in the twenty-some days before the WHO’s approval. Eradication of polio on the entire contiguous continent of Africa also seems plausible, as officials declared in June 2015 that the outbreaks in Equatorial Guinea, Ethiopia and Kenya are no longer health threats. This could mean that worldwide efforts to eradicate polio from Africa have improved since the outbreaks began in 2013.

However, some health officials warn that the world should not be too quick to celebrate. Hamid Jafari, the polio chief at the WHO, warned that the virus is very difficult to detect.

“We are not yet certain that the wild poliovirus is gone from the African continent,” said Jafari, “there are areas in the African region in the northeast of Nigeria, Lake Chad, the north of Cameroon where the situation is uncertain security-wise. We may have undetected transmission of poliovirus there.”

3. Why is polio so difficult to detect in Nigeria?

There are a variety of health and political concerns that have made the nation difficult to vaccinate since the early 2000s. From the medical perspective, people often spread the virus without showing any symptoms. Only one in 200 polio cases cause paralysis.

In short, the fact that health officials have not reported any cases does not mean that people in Nigeria are not infected.

Additionally, some areas in Nigeria–like the locations that Jafari referenced above–are near impossible for vaccination teams to reach because of the control of Islamic militant groups. Boko Haram, one of the most “lethal and resilient” jihadist groups in the history of Nigeria, has repeatedly denounced efforts to eradicate polio, claiming that vaccinations are a ploy by the West to sterilize Muslim children.

4. Is religious opposition to vaccinations in Nigeria the source of the problem?

Not really. Boko Haram’s skepticism and violence toward polio vaccination campaigns are based more on its opposition to Western culture than the specific religious beliefs of Islam. Boko Haram is a loose translation of “Western education is forbidden.” Present in Nigeria since 2002 and active in military operations since 2009, Boko Haram is a group of roughly 9,000 men (according to CIA estimates) that seeks to establish the Islamic State in Nigeria by purging the nation of Western influence.

Analysts say that governmental effort to reduce Nigeria’s chronic poverty and construct an education system that is inclusive of local Muslims is the only way to eliminate the threat of Boko Haram. However, the violent actions of jihadist groups against vaccination campaigns are not representative of the entire Islamic community in Nigeria.

Although resistant to vaccination efforts initially, Muslim leaders were actively involved and very influential in vaccination campaigns in the years before 2012, often citing moral principles as justification.

“We don’t care if it’s something that will affect you and your family alone. But [if] you don’t comply with us, you allow your child to go—he’s going to spread it to 200 other innocent children around the vicinity,” said Nigeria’s top-ranking Muslim and the “polio point man” for the region of Kano, Wada Mohamed Aliyu.

5. What outside assistance do foreign organizations provide to Nigeria?

National and local municipalities and organizations in Nigeria play a role in polio detection and prevention as well as immunization, but many global actors have greatly contributed to efforts in order to eradicate the virus. The Global Polio Eradication Initiative (GPEI), spearheaded by the World Health Organization, Rotary International, UNICEF, the United States Center for Disease Control and Prevention, and the Bill & Melinda Gates Foundation, have worked with Nigerian groups to lower the global incidence of polio by 99% since 1988. The GPEI and its associated organizations have not only financially funded eradication efforts but have also actively been strategic partners that have provided technical and political support to Nigeria. Gavi, the vaccine alliance, has also been a major player in facilitating the implementation of inactive polio vaccines, which work in tandem with oral polio vaccines to secure a polio-free world.

Paulina Menichiello

Sources: NPR 1, NPR 2 , BBC, NPR 3, NPR 4, Polio Eradication
Photo: Monitor Healthcare

polio_free
In 1988, the Global Polio Eradication Initiative was created. It became the largest public-private public health partnership. Those working on the project include the World Health Initiative (WHO), Rotary International, national governments, the Bill & Melinda Gates Foundation, UNICEF and many others. So far, the program has seen a 99% reduction in the cases of polio. Over 3 billion children have been vaccinated by millions of volunteers.

Now, only three countries remain polio-endemic: Nigeria, Pakistan and Afghanistan. In 2013, only 416 cases were reported.

Most of Africa has been free of polio for years; however, Nigeria has been a trouble spot for the past 20 years. Actually, the leaders and people were very much against vaccinating children. The health organizations had little support, which meant that they lacked the necessary supervision and field staff. At times, the vaccinators were even killed. Currently, the political instability of Northern Nigeria makes monitoring and vaccinating children rather difficult. There could also be cases unreported.

Thankfully, the issues that held people back from vaccinating their children in the past have been solved for the most part. However, in the meantime, many other countries in Africa that were declared polio-free saw outbreaks of polio that were linked directly from Nigeria.

Nigeria saw what will hopefully become the last case of polio back in July of 2014. There have been no cases reported since then. If Nigeria can go a full year without another child contracting polio, then the WHO will remove Nigeria from the list of polio-endemic countries.

While Africa is steps away from being declared polio-free, vaccinating will not end there. As long as Pakistan and Afghanistan continue to report cases, mass global vaccinations will continue to take place to ensure that every child is safe.

Katherine Hewitt

Sources: NPR, WHO
Photo: Flickr

Poliovirus Spreads to Equatorial Guinea
The Polio Global Eradication Initiative announced that “a new wild poliovirus type 1 (WPV1) case was reported in Equatorial Guinea” on April 16 2014.  The country has reported three known cases and due to the genetic sequencing of the virus, health officials believe the virus spread from neighboring country, Cameroon.

This poliovirus outbreak contradicts Equatorial Guinea’s statistics in previous years. The UNICEF Annual Report 2012 for Guinea Bissau declared, “Guinea Bissau has been “polio-free” since 2009…due to vaccination campaigns through child health days and strengthened routine immunization.” According to NPR’s article “Polio Hits Equatorial Guinea, Threatens Central Africa” report, however, the country currently has a vaccination rate of only 39 percent, suggesting that routine immunization programs have decreased since 2009.

Similarly, in Cameroon, the origin of this outbreak, the World Health Organization calculated that 40 percent of children are inadequately vaccinated against the poliovirus. Immunization prevents the spread of the poliovirus, which is an infectious disease with no cure that can cause permanent paralysis. It is communicable via person-to-person contact. Children under the age of 5 are especially susceptible to contracting the virus, making proper immunization campaigns are essential to elimination of an outbreak.

According to the World Health Organization (WHO), from January 2014 to April 2014 ten countries reported a total of 61 polio cases.  When an outbreak of the poliovirus began in Cameroon in October 2013, the country conducted immunization campaigns in response. On March 17 2014, however, Cameroon confirmed new cases of the poliovirus.  In the WHO’s “Poliovirus in Cameroon update”, the WHO elevated “the risk assessment of international spread of polio from Cameroon to very high.” Despite the organization’s attempt to contain the outbreak, the poliovirus spread to Equatorial Guinea.

In an April 24, 2014 UNICEF news note, UNICEF Representative in Equatorial Guinea, Dr. Brandão Có, stated, “Stopping the transmission of polio in Equatorial Guinea is a key priority in order to ensure children, families and communities are protected against this terrible and crippling disease that also has enormous social costs.” UNICEF also reported that a campaign to vaccinate 300,000 children against the virus commenced on April 24, 2014.

— Jaclyn Ambrecht

Sources: NPR, Polio Global Eradication Initiative,, UNICEF(1), UNICEF(2), World Health Organization

Global Vaccine Summit in Abu Dhabi
Last week in Abu Dhabi, the Gates Foundation drew together a diverse group of partners and world leaders to highlight the investment case for immunization and recommit to the fight for polio eradication at the Global Vaccine Summit. At the Summit, Rotary International’s President Sakuji Tanaka stated that the eradication of polio requires “the commitment of national and local leaders where polio still exists, the continued support of donor countries, and the steadfast commitment of heroic vaccinators.”

At the Summit, global leaders made statements in support of efforts to immunize children around the world and the Global Polio Eradication Initiative formally launched its bold new 6-year endgame strategy. In response, public and private donors announced $4 billion in financial commitments towards the $5.5 billion global need for polio, including $1.8 billion forms the Gates Foundation, $457 million from the U.K., $250 million from Canada, $240 million from Norway, $120 million from Abu Dhabi Crown Prince Sheikh Mohammed bin Zayed al-Nahayan, $227 million from the Islamic Development Bank, and $130 million from Germany.

Even though there was much focus on the eradication of polio at this Summit, there were many other important issues that were addressed.

As the funding for immunization efforts was being pledged in Abu Dhabi, new child vaccines were being distributed on two other continents. Thanks to the previously-committed donor support to the GAVI Alliance, GAVI and its partners on the ground were about to distribute three vaccines in three new countries: pentavalent in Somalia, rotavirus in Haiti, and pneumococcal in Uganda.

– Matthew Jackoski

Source: ONE, SABIN
Photo: Breitbart