African region marks one year since being certified wild polio-free

by Ryan Hyland

Rotary joined its partners in the Global Polio Eradication Initiative (GPEI) to mark the first anniversary of a historic public health milestone: the World Health Organization’s African region being certified free of wild polio.

The anniversary was celebrated on 25 August during a WHO Regional Committee for Africa meeting, which also addressed current challenges to eradicating polio and new tactics to achieve a polio-free world.

Africa’s milestone has already benefited children’s health and public health across the continent. The infrastructure and innovations that helped the African region become free of wild polio are playing an important role in the COVID-19 pandemic response and are available to use in future public health emergencies. Polio workers also now conduct other routine immunizations, deliver medicines, and provide other health care services.

The achievement in Africa is the result of a decades-long effort by millions of Rotary members, health workers, government officials, religious leaders, and parents. Since 1996, when wild polio paralyzed an estimated 75,000 children across Africa, health workers have administered more than 9 billion doses of oral vaccine, preventing 1.8 million wild polio cases.

Rotary members have contributed nearly $920 million toward eradicating the virus in the region, advocated for support from their governments, mobilized communities around National Immunization Days, and conducted events to raise funds and public awareness.

Five of the WHO’s six regions, representing more than 90% of the world’s population, are now free of the wild poliovirus.

Africa’s success in eliminating wild polio proves that the virus can be eliminated under complex circumstances and provides a blueprint for eradicating wild polio in the last two countries where it’s endemic: Afghanistan and Pakistan.

Dr. Tunji Funsho, chair of Rotary’s Nigeria PolioPlus Committee, says the certification of the African region is a monumental public health achievement, but the ultimate goal of global eradication remains.

“Our job is not done,” says Funsho, a member of the Rotary Club of Lekki Phase 1, Nigeria. “Africa still has a vital role to play in ending polio globally and must continue to reach children everywhere with polio vaccines.”

“We also face a final hurdle in ridding Africa of all forms of polio,” he adds, citing outbreaks of the circulating vaccine-derived poliovirus type 2 (cVDPV2) variant. These outbreaks, he says, “continue to harm under-immunized communities across the region and paralyze children.”

Health officials confirmed 609 cases of cVDPV2 across 20 countries in Africa in 2020, a sharp increase from a year earlier. One factor in the increase in polio transmission was the unprecedented pause in polio vaccination campaigns from March through July 2020 in more than 30 countries in order to protect communities from COVID-19. According to the WHO and UNICEF, 23 million children missed out on basic vaccines in 2020, including polio vaccinations.

Although the African region’s anniversary is evidence of what can be achieved, the two countries where wild polio remains endemic are evidence that as long as polio exists anywhere, it is a threat everywhere.

The GPEI’s new 2022-26 polio eradication strategy aims to overcome the remaining hurdles and finish the job by introducing innovative tools and tactics to reach more children with vaccines. The strategy includes the broadening distribution of a new vaccine to address outbreaks of cVDPV2. This novel oral polio vaccine type 2 (nOPV2) protects children against polio while being more genetically stable and less likely to regain strength and cause the vaccine-derived polio. It has already been introduced in several African countries, including Benin, Chad, Liberia, Niger, Nigeria, the Republic of Congo, and Sierra Leone.

The new strategy will expand the regional rapid response teams that quickly start work in areas with outbreaks. Health workers will also have more access to electronic surveillance technologies, which expedite the detection of cVDPV2.

The program will broaden an initiative that has helped more than 250,000 health workers access digital payments for their work in as little as two days. And the program calls for digitization with real-time data and automated dashboards that will help health workers plan more effective campaigns.