Africa and polio eradication – an ‘unfinished’ success story

An eye on regional certification of wild poliovirus eradication

Africa has not detected any wild poliovirus from any source since September 2016, from north-eastern Nigeria.  And although surveillance gaps in some parts of that area remain, surveillance (and immunity levels) is significantly stronger today than it was in 2016, when the surveillance system did succeed in detecting the virus.

Africa stands on the cusp of a historic public health success:  the potential certification of the eradication of wild polioviruses, which could occur as early as 2020.  Certification – the independent ‘stamp of approval’ that wild poliovirus indeed is gone from the continent, and with it the assurance that no African child will ever again suffer the lifelong pain and disability caused by wild poliovirus.

This stands in stark contrast to 1996, a year when wild poliovirus paralysed more than 75,000 of our children across every country on the continent.  It was also the year that Nelson Mandela issued a stark call to action, to everyone.  His challenge rang out loud and strong:  Kick Polio Out of Africa!

And his challenge was heard.  Africa and Africans came together.  Political leaders, traditional and religious leaders, public health experts, partners, donors, Rotarians, frontline health workers and most importantly parents.  All came together, to unite for one common goal:  to find and vaccinate and protect every single child from lifelong wild poliovirus paralysis.  The successful eradication of wild poliovirus would be a fitting tribute to the dedication and commitment of all levels of public and civil society.  But it would be more than that.  It would in fact be a clear example of what can be achieved, when all these levels unite towards a common goal, and indeed, already the polio effort on the continent is helping to address other urgent public health challenges.

But this success would be only half the story.  In fact, polio eradication in Africa can today best be described as ‘an unfinished success story’.  To finish it, the increasing threat of circulating vaccine-derived poliovirus (cVDPV) outbreaks on the continent must also be addressed.  For even though they are not wild polioviruses, such rare strains – which can emerge in areas of low population immunity – also paralyse children.

The good news is that we know how to stop these viruses.  We have the tools, we have the networks, we have the infrastructure.  We need the political and public health leaders in those countries with ongoing cVDPVs to ensure emergency outbreak response is fully implemented.  We need all other countries to keep complacency at bay – by continuing to maintain high population immunity levels, strong disease surveillance and outbreak response readiness plans.  We need everyone who has been involved in this effort, and who has helped bring us to where we are today, to build on their fantastic engagement one more time.

We have it in our hand to finish this success story.  And thereby ensure that no child will ever be paralysed by any form of poliovirus – be it wild or vaccine-derived.

So let us listen to Nelson Mandela one final time.  Let us unite one final time.  If indeed Africa will be certified free of wild poliovirus, this will be cause for celebration.  But it will also be cause for a final re-doubling of all our efforts to finish the job once and for all.  For all future generations of children to come.

Let us finally ensure that we can proudly say we followed entirely Nelson Mandela’s lead… knowing that we have Kicked Polio out of Africa!

Thank you.