Polio: Much done, much still to do

Namibia this past week hosted the third African Regional Conference on Immunization (ARCI) titled “Towards a Polio-free Africa”.
The aim of the conference was to review progress made to interrupting wild poliovirus transmission in priority countries and the remaining challenges faced in eradicating polio in the African region.
Concerted efforts were made to strengthen both the technical and logistical aspects of immunization systems, such as the vaccine cold chain supply, immunization financing, disease surveillance, integrated communications, and social mobilization towards reaching every child.
While polio was at the centre of the deliberations, progress made in combating other vaccine-preventable diseases such as measles, meningitis were also be discussed.
The high-level meeting also reviewed the latest clinical research trials for the introduction of the conjugate meningococcal A vaccine.
Ultimately, the conference aimed to ensure that no African child dies unnecessarily from vaccine-preventable diseases and thereby make progress towards Millennium Development Goal (MDG) 4 of reducing child mortality.
African countries account for 57 percent of all polio cases in the world.
While the majority of African countries have made progress in interrupting polio transmission, only Nigeria is polio-endemic in that it has never stopped transmission of endemic wild poliovirus (WPV); while another 10 countries have reported polio cases.
These are Angola, Chad and DRC, Central African Republic, Côte d’Ivoire, Guinea, Kenya, Mali and Niger.
Four countries in the African region are identified as priority countries for polio eradication, namely: Angola, Chad, DRC and Nigeria.  Only Nigeria is polio-endemic in that it has never stopped transmission of endemic wild poliovirus.
The country has seen a 90 percent decline in cases over the past 24 months. Angola, Chad and DRC have re-established polio transmission in that they have suffered importations of polio which they have not yet stopped.
In the past six months, five formerly polio-free countries in Africa have had cases of polio, namely: Central African Republic, Côte d’Ivoire, Guinea, Kenya and Mali.  West Africa experienced an outbreak – due to poliovirus of Nigerian origin which is now declining. Angola has not had cases in Benguela or Luanda – its main centres of transmission – for over nine months.
African governments and development partners have been busy in a move towards a polio-free Africa. One of the things they have done is forming the African Regional Committee resolution whereby member States of the WHO African Region made a decision in September this year “to declare the persistence of polio a national public health emergency”, to keep high routine immunization rates, to maintain sensitive surveillance, to engage political, religious and traditional leaders at all levels to ensure that children are vaccinated and to commit financial resources to eradicating polio.
Another measure taken to eradicate polio was the “enhanced surge capacity” under which governments are being supported by intensified technical assistance from the World Health Organization, UNICEF, the US Centres for Disease Control and Prevention (CDC) and the Bill and Melinda Gates Foundation (BMGF).
Despite some progress to eradicate polio, there have been a number of challenges for the African region such as high-level political commitment that does not always translate into programme ownership and community outreach strategies actions at lower levels.
Also, there is resistance and non-compliance to vaccination and this is requiring more social and behavioural research and supporting behavior change communication strategies for uptake of polio vaccination. Inadequate cross-border collaboration with ineffective implementation of recommendations from various ministerial cross-border consultations has also been a common.

December 2011
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