Possible to send polio the smallpox way

Yet it is very, very easy to prevent. The first vaccines became available in the mid-1950s and by the early 1960s, a simple oral vaccine had replaced the rather unpleasant injection that had done so much to halt the epidemic that broke out in Southern Africa a decade before. In fact, polio is the next disease slated for total eradication from the planet. This is possible since it has only one vector, humans, and because there is such an effective and simple vaccine. What was done with smallpox in the 1970s can, and must, be repeated with polio now. The one small problem, and what makes the polio eradication campaign a little more difficult than the smallpox eradication, is the presence of “wild polio”; that is, the virus can lie dormant in the wild for some time. This is what has hit Namibia. Excellent rains picked up dormant viruses and spread them. So eradication needs a continual vaccination campaign for several years, targeting all babies in the year after birth and with the necessary boosters in later years. But this is not an insurmountable problem. Polio is one of the five diseases that the United Nations Children’s Fund and the World Health Organisation have listed as essential for vaccination. And these UN bodies are prepared to put their money where their mouths are. Even the poorest country can obtain free doses of the five vaccines and technical help in setting up a distribution chain. Namibia now plans to embark on a mass vaccination campaign, and is showing that it has already an adequate health infrastructure to reach every one of its 1,9 million residents. Although there is some worry about stocks, these can easily be replenished quite quickly. Where the country’s health administrators appear to have come short is not keeping up the unrelenting pressure to ensure all children are vaccinated at the required times. Regrettably, there was some complacency, probably arising from the very success of earlier efforts which saw Namibia totally free of this disease for several years. This is a common problem around the world. The United States has one of the worst records of child vaccination in the world, while some dirt-poor countries in Africa have recorded the best coverage of their populations. The reason is simple. Countries where most people live in abject poverty without access to decent drinking water and adequate sanitation know they are just one slip from a total medical disaster. So they take steps, using free or very cheap vaccines to prevent death and the need for expensive medical care, which probably is not available for all. Countries which have advanced out of such desperation are likely to be a bit less worried. What is slightly worrying is that some Namibian children are also likely to have missed vaccination for other easy to prevent diseases, including measles and mumbs which are still present in the region. We hope that once the authorities have coped with the present emergency they will go back and fill in these gaps. The Namibia polio outbreak must be a wake-up call for the entire region. If polio can erupt in one of the better developed states in the region, it can hit any of us, without notice. All countries need to redouble their efforts in making their vaccination programmes as effective as possible. The Democratic Republic of Congo especially, and possibly Angola, might need to make special efforts to overcome the likelihood that many were missed in the years of rebellion and civil war. And if we do this, then the day will come when no one will ever need polio vaccine again. There just will be no more polio. The scourge can be eliminated. All it takes is an unrelenting effort for a couple of decades.

June 2006
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