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Progress in Polio Eradication

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

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New Vaccine to Protect Children in Côte d’Ivoire

New Vaccine to Protect Children in Côte d’Ivoire-TBP
Under the recommendation from the Polio Eradication and Endgame Strategic Plan 2013-2018, the Ivorian government has introduced the Inactivated Polio Vaccine (IPV), a new vaccine to protect children, into routine immunization programs.

The plan was drawn up due to the spread of polio to over 20 virus-free countries in the past 10 years from regions still considered endemic areas.

Côte d’Ivoire has been implementing strategies from the Global Polio Eradication Initiative (GPEI), which has members who support the plan, since 1997, the last time a polio type 2 case was reported. There has been no detection of wild polio cases in the country since July 2011.

By introducing IPV into routine immunization programs, Côte d’Ivoire will ensure the protection of 650,000 children every year from the virus. The first vaccines were administered at a ceremony on June 26.

The Polio Eradication and Endgame Strategic Plan 2013-2018 focuses on four objectives. The plan aims to identify and disrupt the transmission of the virus, create a stronger immunization system and withdraw the oral polio vaccine (OPV), contain the virus and use the knowledge, and help address other global health goals.

By removing OPV from immunization programs, Côte d’Ivoire is eliminating the chance of vaccine-derived polio, a small risk associated with the vaccine.

IPV, however, will increase the protection of children in the West African nation.

The plan was originally endorsed by the World Assembly in 2013 and organizations such as the World Health Organization, Centers for Disease Control and Prevention, and United Nations Children’s Fund are helping to spearhead the plan.

– Matt Wotus

Sources: Gavi 1, Gavi 2, Global Polio Eradication Initiative
Photo: All Africa

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Eradication of Polio at Risk Due to Taliban

eradication_of_polio
Two years into a ban on polio vaccinations implemented by Tehrik-i-Taliban Pakistan (TTP), the Pakistani Taliban branch, the number of cases of children with polio in Pakistan has risen dramatically. Compared to 58 cases in 2012 and 72 in 2013, there are 257 cases in 2014 so far.

The ban was put into place in northern Pakistan, or the tribal belt where the Taliban has control, in retaliation for U.S. drone strikes in the area. The group says it will lift the ban when the strikes stop.

Polio only remains endemic in three countries: Afghanistan, Pakistan and Nigeria. At the height of infection, polio affected over 350,000 people. In 2013, there were 416 polio cases reported worldwide. Projections say this number will rise in 2014, largely because of an extreme uptick in cases in Pakistan.

Pakistan has been very aggressive in the eradication of polio efforts, with health workers going as far as setting up roadblocks for vaccine stops and boarding public buses and trains to vaccinate any child that looks to be under five years of age. The country also runs regular vaccination campaigns in both its rural and urban regions, reaching hundreds of thousands of people in a matter of days.

Nonetheless, Pakistani health officials estimate that there are roughly 300,000 children living in the tribal belt along the Afghan-Pakistani border that are missing their vaccinations. This region is largely rural and in extreme poverty.

The TTP has stemmed the number of children receiving polio vaccinations by using propaganda and bans against vaccinations, as well as committing violence against health workers. Since 2012, 61 health workers and accompanying security personnel have been killed in Pakistan and countless attacks and instances of intimidation have occurred. TTP claims responsibility for most of these actions.

Much of the pushback against vaccinations stems from a mistrust of the West and the U.S. after a CIA operation was revealed that involved a Pakistani doctor named Shakil Afridi. Afridi pretended to conduct a vaccination campaign while looking for information on the whereabouts of Osama Bin Laden. This, coupled with dangerous and consistent drone strikes, gives the Taliban enough firepower to shoot down any vaccination campaigns.

Because of violence, poverty and insecurity along the Afghan-Pakistani border in the north, many people have moved farther into Pakistan, raising the risk of more cases of polio in unvaccinated children.

– Caitlin Huber 

Sources: The News Tribe, Bloomberg, New York Times, NPR, CTC, Radio Free Europe/Radio Liberty, WHO
Photo: Flickr