On 24 October, the World Health Organization will join millions of people around the world to commemorate World Polio Day to galvanize support to end polio, an incurable but completely vaccine preventable disease that still threatens children in a few places around the world.
Since the launch of the Global Polio Eradication Initiative (GPEI) nearly 30 years ago, new cases of polio have dropped by more than 99.9 percent, from about 350 000 cases annually when the world saw about 1000 cases per day in the 1980s, to just 37 cases globally in 2016.
The African region had made tremendous progress towards polio eradication, from accounting for almost half of the global polio burden with 128 cases in 2012, to 4 cases in 2016. After not confirming any wild poliovirus for close to two years, the region suffered a set-back in 2016 when four cases of wild poliovirus were detected in geographically remote and insecure areas of northern Nigeria.
In response to the polio outbreak in Nigeria, the WHO African region quickly convened the Ministers of Health of Nigeria and its Lake Chad neighbours, Cameroon, the Central African Republic, Chad and Niger. These governments declared the polio outbreak in Nigeria a public health emergency of the sub-region and took quick, decisive action to vaccinate children.
In an example of best practice, political and community leaders were engaged to ensure the success of the largest ever polio campaign in Africa. Over 190 000 polio vaccinators simultaneously immunized more than 116 million children under five in 13 countries in a coordinated effort in West and Central Africa. Volunteers and health workers travelled on foot or bicycle, working up to 12 hours a day, often in soaring temperatures of over 400C.
This averted new cases of wild poliovirus, and the African Region has now reached an important milestone towards eradication - a year has passed since the last case of wild poliovirus in Nigeria.
I applaud this gallant effort of these governments, polio eradication partners, communities, parents and community health workers. However, there are some areas that have remained inaccessible to polio vaccination and surveillance teams due to insecurity; and there is a possibility that transmission may not have been interrupted.
Therefore, this is no time to be complacent. Until polio is eradicated, all countries remain at risk of outbreaks. As a Region, Africa can only be certified to have eradicated polio if three years have passed without any confirmed wild poliovirus, and if polio surveillance has been maintained at the level required for certification. If no new case is confirmed, and surveillance is quickly strengthened, the African Region can be certified to have eradicated polio by the end of 2019.
As a Region, our surveillance efforts are presently not meeting the mark. A number of countries have sub-optimal surveillance, in both secure and insecure areas. It would be a disaster if we failed to be certified because of poor surveillance performance. I urge all countries – whether they have had a case of polio or not – to recommit to strengthen surveillance urgently.
In 2017, the Addis Ababa Declaration on Immunization was endorsed by Heads of State at the African Union. It called for Governments to invest further in immunization services which are key for sustaining the gains towards polio eradication and post certification of polio eradication. Eradication of polio needs political commitment and adequate resources. WHO assures all countries of its dedicated support.
We are close to ending this debilitating disease. I call on all countries to work together to ensure that this becomes a reality, and the African Region is declared to have eradicated polio by end 2019. Let us all be part of that historical achievement.
Dr Matshidiso Moeti
WHO Regional Director for Africa