By Ronald Joshua
GENEVA | BRAZZAVILLE (IDN) – While COVID-19 pandemic is playing havoc with the global economy and a frantic search continues for a vaccine, thanks to a concerted campaign of immunization, Africa is free of a highly infectious disease which mainly affects children under 5 years of age. It is a significant development marking the eradication of the second virus from the face of the continent since smallpox 40 years ago.
“Today is a historic day for Africa,” said Professor Rose Gana Fomban Leke, Chairperson of the African Regional Certification Commission for Polio eradication (ARCC), which has declared the region free of polio. JAPANESE | SPANISH
The virus invades the nervous system and can cause total paralysis in a matter of hours. The virus is transmitted by person-to-person spread mainly through the faecal-oral route or, less frequently, by a common vehicle (for example, contaminated water or food) and multiplies in the intestine.
Initial symptoms are fever, fatigue, headache, vomiting, stiffness of the neck and pain in the limbs. One in 200 infections leads to irreversible paralysis (usually in the legs). Among those paralysed, 5% to 10% die when their breathing muscles become immobilized.
The African region has “successfully met the certification criteria for wild polio eradication, with no cases of the wild poliovirus reported in the Region for four years”, the ARCC Chair said.
The ARCC’s decision comes after an exhaustive, decades-long process of documentation and analysis of polio surveillance, immunization and laboratory capacity of the region’s 47 member states, which included conducting field verification visits to each country, the World Health Organization (WHO) Africa said in a press release on August 25.
In 1996, African Heads of State committed to eradicating polio during the Thirty-Second Ordinary Session of the Organization of African Unity (OAU) in Yaoundé, Cameroon. At the time, polio was paralyzing an estimated 75,000 children, annually, on the African continent.
In the same year, Nobel Peace laureate Nelson Mandela with the support of Rotary International jumpstarted Africa’s commitment to polio eradication with the launch of the Kick Polio Out of Africa campaign. Mandela’s call mobilized African nations and leaders across the continent to step up their efforts to reach every child with the polio vaccine.
The last case of wild poliovirus in the region was detected in 2016 in Nigeria. Since 1996, polio eradication efforts have prevented up to 1.8 million children from crippling life-long paralysis and saved approximately 180,000 lives.
“This is a momentous milestone for Africa. Now future generations of African children can live free of wild polio,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “This historic achievement was only possible thanks to the leadership and commitment of governments, communities, global polio eradication partners and philanthropists. I pay special tribute to the frontline health workers and vaccinators, some of whom lost their lives, for this noble cause.”
“However, we must stay vigilant and keep up vaccination rates to avert a resurgence of the wild poliovirus and address the continued threat of vaccine-derived polio,” said Dr Moeti.
While the eradication of wild poliovirus from the WHO African Region is a major achievement, 16 countries in the region are currently experiencing cVDPV2 outbreaks, which can occur in under-immunized communities.
The 16 countries in Africa currently affected by circulating vaccine-derived polioviruses outbreaks include Angola, Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Côte d’Ivoire, the Democratic Republic of the Congo, Ethiopia, Guinea, Ghana, Mali, Niger, Nigeria, Togo and Zambia.
“Africa has demonstrated that despite weak health systems, significant logistical and operational challenges across the continent, African countries have collaborated very effectively in eradicating wild poliovirus,” said Dr Pascal Mkanda, Coordinator of WHO Polio Eradication Programme in the African Region.
“With the innovations and expertise that the polio programme has established, I am confident that we can sustain the gains, post-certification, and eliminate cVDPV2,” added Dr Mkanda.
“The expertise gained from polio eradication will continue to assist the African region in tackling COVID-19 and other health problems that have plagued the continent for so many years and ultimately move the continent toward universal health coverage. This will be the true legacy of polio eradication in Africa,” said Dr Moeti.
Thanks to the dedication of the Global Polio Eradication Initiative (GPEI), polio cases have reduced by 99.9% since 1988, bringing the world closer than ever before to ending polio, according to WHO Africa.
Over 90% of the world’s population are now free of the wild poliovirus, moving the world closer to achieving global polio eradication. Only two countries worldwide continue to see wild poliovirus transmission: Pakistan and Afghanistan.
The GPEI has congratulated the national governments of the 47 countries in the WHO African Region for the latest achievement.
“Ending wild poliovirus in Africa is one of the greatest public health achievements of our time and provides powerful inspiration for all of us to finish the job of eradicating polio globally,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “I thank and congratulate the governments, health workers, community volunteers, traditional and religious leaders and parents across the region who have worked together to kick wild polio out of Africa.”
Strong leadership and innovation were instrumental in stopping the wild poliovirus in the region. Countries successfully coordinated their efforts to overcome major challenges to immunizing children, such as high levels of population movement, conflict and insecurity restricting access to health services, and the virus’s ability to spread quickly and travel across borders.
In addition, the continued generosity and shared commitment of donors – including governments, the private sector, multilateral institutions and philanthropic organizations – to achieving a polio-free world helped build the infrastructure that enabled the African region to reach more children than ever before with polio vaccines and defeat wild polio.
“During a challenging year for global health, the certification of the African region as wild poliovirus-free is a sign of hope and progress that shows what can be accomplished through collaboration and perseverance,” said Rotary International President Holger Knaack.
The resources and expertise used to eliminate wild polio have significantly contributed to Africa’s public health and outbreak response systems. The polio programme provides far-reaching health benefits to local communities, from supporting the African region’s response to COVID-19 to bolstering routine immunization against other vaccine-preventable diseases.
While this is a remarkable milestone, we must not become complacent. Continued commitment to strengthening immunization and health systems in the African region is essential to protect progress against wild polio and to tackle the spread of type 2 circulating vaccine-derived poliovirus (cVDPV2), which is present in 16 countries in the region. Pockets of low immunity mean such strains continue to pose a threat and the risk is magnified by interruptions in vaccination due to COVID-19, which have left communities more vulnerable to cVDPV2 outbreaks.
The GPEI calls on countries and donors to remain vigilant against all forms of polio. Until every strain is eradicated worldwide, the incredible progress made against polio globally will be at risk. [IDN-InDepthNews – 25 August 2020]
Photo: A child being given polio oral vaccination. Credit: WHO Regional Office for Africa