With the polio vaccine, new-born children have a better chance of a healthy life © WHO/Chad

Therese and Léonie reminded me of this hard truth in a recent visit to a hospital in N’Djaména, Chad. One is a newborn girl and the other is a veteran of the campaign to eradicate a human disease for only the second time in history –polio-.

As a Gender Champion for Polio Eradication, I have committed to supporting the global initiative to eradicate polio and the women who work tirelessly to protect children from lifelong paralysis. During my visit to Chad, I had the honour of giving two drops of life-saving oral polio vaccine to two newborns.

Protected from a disease which once struck millions of children, Therese now has a better chance of a healthy life. Thanks to the Global Polio Eradication Initiative (GPEI) – spearheaded by Rotary International, national governments, the World Health Organization, UNICEF, CDC, the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance –  she is one of more than 2.5 billion children who have received the oral polio vaccine, as the global polio caseload has been reduced by 99% since 1988.

But as I looked at Therese, I also wished that she would have a better chance not just for health, but also for opportunities to prosper. I thought of a recent WHO report I had read – Delivered by Women, Led by Men – which observed that women make up 70% of the global health workforce but hold only 25% of senior roles – a situation that is no different for the polio program. Would Therese’s future reflect that disparity?

Administering the polio vaccine to Therese © WHO/Chad

I found both frustration and hope in answer to my question when I listened to Ms. Léonie Ngaordoum, the woman responsible for the campaign which brought the vaccine to Therese.

Léonie is head of vaccine operations for Chad’s immunization programme. It is women like her who have brought us this far in the long fight against polio. It is women like her who have gone the extra mile to keep their countries safe when, in 2020, the polio programme faced unprecedented challenges in the face of a new pandemic- COVID-19.

Her journey to a senior public health position in Chad has been difficult. Driven to remote areas on dangerous roads to oversee vaccination campaigns, she has twice suffered accidents, one of which left her with severe spinal injuries. She has faced gender discrimination, countered vaccine misinformation, convinced vaccine sceptics, and stayed the course despite the severe strain of COVID-19, and struggling for respect and recognition in a male-dominated environment.

Today she has a clear vision to share: “I speak about vaccination as if it were a vocation…the program change needed to achieve polio eradication is to empower enough women.” Léonie’s experience highlights the necessity of increasing senior roles among women in the health workforce and involving them in policy decisions.

Women like her frequently operate in dangerous and conflict-affected areas, putting their own personal safety at risk – all in efforts to protect communities from deadly diseases.  Women have a greater level of trust with other women and thus are able to enter households and have interactions with mothers and children necessary to deliver the polio vaccine. And this way they can also provide other services, such as health education, antenatal care, routine immunization, and maternal health.

Ms. Léonie Ngaordoum (second from the right) is the head of vaccine operations for Chad’s immunization programme © WHO/Chad

The knowledge and skills gained by this workforce are already being deployed against COVID-19, in surveillance, contact tracing, and raising public awareness. Indeed, more than 50 percent of the time spent by GPEI health workers is already dedicated to diseases and threats beyond polio. It’s clear that the future of public health is inextricably linked to the status of women. Their heroic actions provide nothing less than a blueprint for the future of disease prevention. The Resolution on “Women, girls and the response to COVID-19”, adopted last year by the UN General Assembly, should play a key role when addressing these challenges and the specific needs of women and girls in conflict situations.

The centrality of women to the success of public health projects has for too long gone unrecognised, and must be formalized. That is why today, on International Women’s Day, we must pay tribute to the tremendous contribution of women like Léonie around the world in protecting their communities from deadly diseases such as polio.  But at the same time, thinking of the world in which Therese will come of age, we need to commit to empower every woman and girl. It will not only make for a more just world – but a healthier one too.

Polio outbreak response in Chad, 2018 ©WHO/D Levison

N’Djamena – One of the largest polio immunization campaigns in the African Region this year has just concluded in Chad, where over 3.3 million children in 91 districts were vaccinated. This pushes the total number of children vaccinated against polio to over forty million across 16 countries in the Region, since campaigns resumed following a necessary pause in immunizations due to the COVID-19 pandemic.

While Africa was declared free of the wild poliovirus in August 2020, another form of polio continues to affect children: circulating vaccine-derived poliovirus, or cVDPV. This type of polio is rare and can only occur in areas where not enough children are immunized. The only way to stop spread of cVDPV is through immunization.

The current type 2 cVDPV outbreak in Chad was detected in February 2020—yet immunizations were halted due to COVID-19 and the virus spread to 36 districts across the country, paralyzing more than 80 children and even leading to cases in neighbouring Sudan and the Central African Republic.

“Viruses do not respect national borders,” said Dr Ndoutabé Modjirom, head of the polio Rapid Response Team at the World Health Organization (WHO) African Region. “Given Chad’s central geographic location and its mobile populations, it was important to carry out a large-scale campaign that targeted key populations and high-risk areas throughout the country.”

The vaccination campaign was carried out in two phases, the first taking place between 13-15 November and the second from 27-29 November.

While mass polio vaccination campaigns were stopped across Africa due to COVID-19 restrictions, they resumed in July 2020. The response in the region overall, and in Chad in particular, demonstrates the commitment by Global Polio Eradication Initiative partners and countries across Africa to stop polio, even amidst the difficult operating context of COVID-19.

“The number of children reached since polio campaigns have resumed is extremely encouraging,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “This large-scale campaign in Chad during COVID-19 is a reflection of the Region’s commitment and ability to face multiple difficult health challenges and protect the health of all children.”

Although campaigns were on hold for several months, work did not stop. Chad’s team of national and international polio experts together with the AFRO Rapid Response Team tracked the virus, conducted a comprehensive risk assessment, and planned an outbreak response to take place as soon as it was safe to do so, taking into account timelines in outbreak response standards of practice. Consultations were also held with the national COVID-19 task force to ensure that best practices in infection prevention and control would be followed. The commitment and efforts of the Ministry of Health and other key national and regional health leaders and partners, including UNICEF, were instrumental in conducting the campaign.

“With increased immunizations and the continued commitment of health leaders and partners, we are confident that we will soon see the end of this outbreak and the end of all forms of polio in Africa,” said Dr Jean Bosco Ndihokubwayo, WHO representative for Chad.

About polio eradication

The Global Polio Eradication Initiative is spearheaded by WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC), UNICEF, the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance.

On 6 November, WHO and UNICEF jointly issued an urgent call to action to avert major measles and polio epidemics as COVID-19 continues to disrupt immunization services worldwide, leaving millions of vulnerable children at heightened risk of preventable childhood diseases. Learn more about the call to action.

A child in west Africa receives polio vaccine. Photo: WHO.

More than 190 000 polio vaccinators in 13 countries across west and central Africa will immunize over 116 million children over the next week, to tackle the last remaining stronghold of polio on the continent.

The synchronized vaccination campaign, one of the largest of its kind ever implemented in Africa, is part of urgent measures to permanently stop polio on the continent.  All children under five years of age in the 13 countries – Benin, Cameroon, Central African Republic, Chad, Côte d’Ivoire, Democratic Republic of Congo, Guinea, Liberia, Mali, Mauritania, Niger, Nigeria and Sierra Leone – will be simultaneously immunized in a coordinated effort to raise childhood immunity to polio across the continent. In August 2016, four children were paralysed by the disease in security-compromised areas in Borno state, north-eastern Nigeria, widely considered to be the only place on the continent where the virus maintains its grip.

“Twenty years ago, Nelson Mandela launched the pan-African ‘Kick Polio Out of Africa’ campaign,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.  “At that time, every single country on the continent was endemic to polio, and every year, more than 75 000 children were paralysed for life by this terrible disease.  Thanks to the dedication of governments, communities, parents and health workers, this disease is now beaten back to this final reservoir.”

Dr Moeti cautioned, however, that progress was fragile, given the epidemic-prone nature of the virus.  Although confined to a comparatively small region of the continent, experts warned that the virus could easily spread to under-protected areas of neighbouring countries. That is why regional public health ministers from five Lake Chad Basin countries – Cameroon, Central African Republic, Chad, Niger and Nigeria – declared the outbreak a regional public health emergency and have committed to multiple synchronized immunization campaigns.

UNICEF Regional Director for West and Central Africa, Ms Marie-Pierre Poirier, stated that with the strong commitment of Africa’s leaders, there was confidence that this last remaining polio reservoir could be wiped out, hereby protecting all future generations of African children from the crippling effects of this disease once and for all. “Polio eradication will be an unparalleled victory, which will not only save all future generations of children from the grip of a disease that is entirely preventable – but will show the world what Africa can do when it unites behind a common goal.”

To stop the potentially dangerous spread of the disease as soon as possible, volunteers will deliver bivalent oral polio vaccine (bOPV) to every house across all cities, towns and villages of the 13 countries.  To succeed, this army of volunteers and health workers will work up to 12 hours per day, travelling on foot or bicycle, in often stifling humidity and temperatures in excess of 40°C.  Each vaccination team will carry the vaccine in special carrier bags, filled with ice packs to ensure the vaccine remains below the required 8°C.

“This extraordinary coordinated response is precisely what is needed to stop this polio outbreak,” said Michael K McGovern, Chair of Rotary’s International PolioPlus Committee .  “Every aspect of civil society in these African countries is coming together, every community, every parent and every community leader, to achieve one common goal: to protect their children from life-long paralysis caused by this deadly disease.”

The full engagement of political and community leaders at every level – right down to the district – is considered critical to the success of the campaign.  It is only through the full participation of this leadership that all sectors of civil society are mobilized to ensure every child is reached.

More information

A child in northern Nigeria receives a dose of the oral polio vaccine. Vaccination teams are going to great lengths to protect every last child against polio. UNICEF/T.Moran

Experts from across the Global Polio Eradication Initiative (GPEI) partnership convened an emergency meeting in Abuja, Nigeria, from 3 – 5 November.  Led by senior epidemiologists from the governments of Nigeria and neighbouring countries, the group examined a detailed review of the current impact of the outbreak response, and identified area-specific challenges and prioritized operational plans accordingly.

The detection of new wild poliovirus type 1 (WPV1) cases in Borno, Nigeria, in August – the first detected on the African continent in more than two years – has prompted an unprecedented response.  The outbreak was immediately declared by both the Government of Nigeria and governments of surrounding countries to be national and regional public health emergency.  This opened the way for a regional outbreak response, mobilizing emergency resources from across the public and civil society sectors.

Thousands of health workers across the region have been mobilized and trained, and in Borno alone more than 1.7 million children have been vaccinated.  But many more continue to be un- or under-immunized, either due to operational deficits in outbreak response implementation, hampered access due to insecurity or large-scale population movements within countries.

Unless these missed children are rapidly reached, the risk remains that the current outbreak could spread further, including internationally, and cause more preventable, incurable paralysis.


Access and reaching populations everywhere

Insecurity, geographical challenges and difficulties with communication in some of the hardest to reach areas are providing barriers to reaching all children. Internally displaced persons (IDPs), refugees and nomads are particularly vulnerable groups, with insecurity blocking transit routes and the ability to accurately predict population size ahead of vaccination campaigns reduced. Due to population displacement, detailed micro-plans are frequently disrupted.

Children across northern Nigeria and other countries in the Lake Chad region must be protected rapidly against polio to end the outbreak. UNICEF/T.Moran

Cross-border coordination, embedding the response within the broader humanitarian emergency context, and innovating rapidly to adapt strategies to local challenges is what has stopped similar outbreaks with similar challenges elsewhere in the world.

Yet despite these challenges, the GPEI can draw on a vast array of experience from running outbreak responses in similar settings, most recently in the Middle East, Central Africa and the Horn of Africa from 2013-2015. These existing, proven strategies are rapidly adapted to the evolving environment. Permanent vaccination teams are now in place, as and when an area becomes accessible, to rapidly implement ‘mini’ vaccination campaigns in between larger-planned activities. Such teams are also critical to reach populations as they leave inaccessible areas. Children in both formal and informal IDP camps are a particular focus for the delivery of the polio vaccine alongside other humanitarian and basic health needs.
Assuming that many children living in conflict-affected areas will not have been vaccinated for several years, the target age group has been raised to protect children over 5 years of age.

The Volunteer Communication Network of vaccination advocates within communities has been expanded to cover Internally Displaced Populations living in camps and host populations, while Koranic School teachers have been engaged to address non-compliance and the mobilization of women and youth to ensure local protection for vaccination teams.

Volunteer community mobilizers wearing distinctive blue hijabs are working in IDP camps and host communities to identify unvaccinated children, pregnant women and those with severe acute malnutrition. UNICEF/T.Moran

Coordinating across borders

While cases of polio have only been found in Borno, extensive population movement, insecurity and previous cross border population movements require the outbreak response to cover the entire Lake Chad region. Cameroon, the Central African Republic (CAR), Chad, Nigeria and Niger are working together to track population movements and addressing the challenges inherent in accessing some hard-to-reach areas in each country, including sourcing communication equipment to operate where there is a lack of telecommunication network, closed borders in some places and language barriers. Efforts are being intensified to map out the seasonal movement of nomads, identifying resting places and water points with the support of nomadic community leaders in order to improve micro-planning to inform the response. In Chad, vaccination campaigns are providing livestock vaccines alongside polio vaccines to children in order to increase uptake in nomadic communities.

It is not insecurity alone that leads to hampered access. Sometimes it is simply a more natural phenomenon: the rains! The rainy season in the region typically runs from June to mid-October. Some areas are completely cut off from roads and other transport networks as a result of the associated flooding. With the rainy season now over, many areas and populations will be able to be reached with polio vaccine and other urgent health services.

Stopping outbreaks in such challenges settings is possible

There is no doubt that running an outbreak response with such challenges is far more complex, dangerous, costly and slower than under normal circumstances. However, what is equally clear is that the plans being intensified and implemented across the region are having an impact, and will continue to have an impact. Cross-border coordination, embedding the response within the broader humanitarian emergency context, and innovating rapidly to adapt strategies to local challenges is what has stopped similar outbreaks with similar challenges elsewhere in the world.

The groundwork set by this first phase of the outbreak response has set for reaching previously missed children in late 2016 and throughout 2017.

With continued leadership of political, health and community leaders at the local, national and regional levels alongside the international development community, this outbreak will be stopped and children across Africa protected against polio.

© WHO/J-M Giboux

Following the recent detection of wild poliovirus in Nigeria, Ministers of Health from Cameroon, Central African Republic, Chad, Niger and Nigeria have declared the polio outbreak in Nigeria as a public health emergency for countries of the Lake Chad basin. The declaration, coming out of the 66th session of the World Health Organization Regional Committee for the African Region, demonstrates commitment from governments across the region to bolster momentum in the fight against the virus.

A regional response to a regional risk

The declaration requests that Nigeria and all countries of the Lake Chad Basin, as a matter of the utmost urgency, fully implement coordinated outbreak responses in order to quickly interrupt this outbreak before the end of 2016 and prevent international spread. It calls on all Member States of countries of the Lake Chad Basin to extend all possible support, including political advocacy and engagement at all levels, for successful coordination and implementation of synchronized polio vaccination activities across the countries of the Lake Chad sub-region. The declaration builds on the sustained commitment of member states across the region in the path towards polio eradication, highlighted at the African Union summit in June 2015 where African heads of state gathered to declare polio eradication a “historical legacy for future generations”.

Immediate action, challenging terrain

An immediate response was mounted by the Nigerian government following the outbreak by quickly declaring it as a public health emergency and mobilizing the needed resources, with a large-scale vaccination campaign implemented and further rounds planned across the Lake Chad sub-region.

While challenging terrain lies ahead in beating the poliovirus for good, in Nigeria, and in Africa – not least because of the grave humanitarian situation in many of the countries around Lake Chad – the declaration of a regional emergency provides an important foundation for action, including the mobilization of necessary financial, political and technical support from partners of the Global Polio Eradication Initiative and governments across the region.

Lake Chad public health emergency declaration
Nigeria declares polio outbreak as a national public health emergency


Children in Equatorial Guinea proudly show the dot of ink on their finger that demonstrates they have received a dose of oral polio vaccine.
Children in Equatorial Guinea proudly show the dot of ink on their finger that demonstrates they have received a dose of oral polio vaccine. ©UNICEF/Equatorial Guinea

This week, 18 countries across western and central Africa have been holding synchronised polio immunization campaigns to reach nearly 94 million children with oral polio vaccine (OPV). This is a monumental coordination effort, incorporating strong governmental commitment, global support from international organisations such as the World Health Organization and UNICEF and the motivation of members of communities themselves to mobilize their friends and neighbours to ensure every child is protected.

National Immunization Days in Angola, Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Cote d’Ivoire, the Democratic Republic of the Congo, Equatorial Guinea, Gabon, Gambia, Ghana, Guinea Bissau, Mauritania, Niger, Nigeria, the Republic of the Congo and Senegal are working to build immunity across western and central Africa. Each child needs at least 3 doses of OPV to build immunity and end the transmission of the virus, making it crucial that campaigns such as this reach every child.

Africa is closer than ever before to achieving eradication, with only 22 cases across the continent to date in 2014 compared to 232 by the same point in 2013. This decrease of over 90% in one year is due to increased commitment from the governments of the last remaining endemic country in Africa, Nigeria, and the sites of current outbreaks in Cameroon, Equatorial Guinea, Somalia and Ethiopia.

Nigeria saw only 6 cases in 2014 compared to 53 in 2013 by this date. This dramatic improvement can be attributed to measures put in place to avoid missing children from campaigns, and to a surge in staff to the country to support Emergency Operations Centres. The international spread of polio, affecting Cameroon, Equatorial Guinea, Somalia and Ethiopia as well as countries in the Middle East, lead to the declaration of polio as a Public Health Emergency of International Concern (PHEIC) in May 2014 by the Director General of the World Health Organization. With temporary recommendations to stop the international spread of polio, the PHEIC is another step towards ensuring a polio-free Africa.

Through these measures – improved surveillance, innovative community engagement strategies and a surge in staff to affected areas – the past year has seen gains in the eradication effort that must be protected. Synchronized campaigns such as this bring us ever closer to the important milestone of ending transmission in Africa.
These synchronised campaigns demonstrate the commitment of the governments of countries across central and western Africa to ending the transmission of polio once and for all, despite the increased focus on Ebola prevention and response in 2014. In some cases, polio resources are being utilized to strengthen the Ebola response, demonstrating the Global Polio Eradication Initiative’s commitment to securing the polio infrastructure for a polio-free world.


Chadian musicians encourage parents to vaccinate their children against polio. (UNICEF Chad/Cao)

9 January 2013 – Toma Mamout has found her calling: to encourage Chad’s mothers to vaccinate their children. Four of her seven children died young, including one from polio. Now she works in the West Mongo health centre, also venturing out to local communities to discuss the importance of vaccination, basic hygiene and the use of bed nets to prevent malaria.

“We advise mothers to bring their children to every vaccination drive and to stick to the calendar,” she says.

According to Ms. Mamout, on her rounds to the more distant villages, the semi-nomadic local communities “refused until recently to allow their children to be vaccinated, out of ignorance and fear.”

“Mobilizing communities themselves is the best chance for making improvements, because Chad’s health system is still too weak,” she explains. “For low-cost training and awareness efforts, UNICEF supports an effective and engaged outreach network – community outreach volunteers, vaccinators and supervisors – in which everyone is truly a champion of vaccinations.”

“The vaccine against polio may cause sterility and makes our children sick” – or at least Rachel, a mother of four from the Chadian capital, N’Djamena, thinks so.

Unfortunately, Rachel is not alone. According to the latest social data analysis, the number of missed children and vaccine refusals has recorded an increasing trend over the last few months in N’Djamena. A recent report by the Independent Monitoring Board of the Global Polio Eradication Initiative expressed concerns that “the percentage of children missed for ‘social reasons’ is still high in Chad. Caregivers’ poor awareness of vaccination campaigns is now rated as high-risk by UNICEF.”

While the main reason children miss out on the polio vaccine in Chad is the weakness of the health system in getting vaccine to the most vulnerable, creating understanding and awareness among the community helps build demand, which can ultimately only strengthen health services.

In response to the escalating number of missed children in N’Djamena, the Government, with the support of the Global Polio Eradication Initiative partners, carried out an intensified social mobilization and communication campaign involving prominent Chadian Artists, the Scouts Movement and the National Council of Youth during the last immunization campaign.

Popular Chadian musicians rallied in the fight against polio with an open air, free-admission concert to raise awareness in N’Djamena. They captured the attention of thousands of people, not only through their music, but also by expressing strong messages about the importance of vaccinating children against polio.

“Youth, I say this: when you see the vaccinators, it is to give two drops against polio. So ask your parents to allow them to vaccinate your siblings. Parents leave behind the preconceptions. If you want your children to play as soccer players, have them vaccinated so they are not paralyzed,” expressed Ngass David, a famous Chadian singer during the campaign.

Hajj-related travel may accelerate spread.

A child being vaccinated at the Bredjing refugee camp, Ouaddai State. Giboux Jean-Marc/WHO

9 June 2011 – Chad is experiencing outbreaks of both wild poliovirus type 1 (WPV1 – 65 cases in 2011) and wild poliovirus type 3 (WPV3 – three cases). The WPV3 outbreak has been ongoing since November 2007, while the WPV1 outbreak began in September 2010 as a result of a new importation virus from northern Nigeria. Originally restricted to the greater N’Djamena area, the WPV1 outbreak has been intensifying in 2011, spreading to other areas of the country.

The Independent Monitoring Board (IMB), set up at the request of the World Health Assembly in 2010 to independently monitor progress towards a polio-free world, in April 2011 called the situation in Chad a public health emergency, highlighting that – more than any other country – Chad represents a scenario of the greatest urgency. Given the uncontrolled and widespread geographic transmission of both WPV serotypes, historical spread to neighbouring countries, recent geographic expansion of WPV1 across Chad (including close to the borders with CAR and Sudan), the World Health Organization (WHO) rates the risk of further international spread as high.

With the Hajj (pilgrimage to Mecca, Kingdom of Saudi Arabia) expected to begin in early November and Ramadan in early August, it is anticipated that pilgrims are now beginning to move across west and central Africa, further increasing the risk of polio spread. The Kingdom of Saudi Arabia last month issued polio vaccination requirements for travellers to the Hajj. WHO recommends that all travellers from polio-infected areas be fully vaccinated prior to travel.

In 2010 and 2011, Chad’s outbreak response vaccination activities had been inadequate to stop transmission. More than 20% of children have been regularly missed during supplementary immunization activities (SIAs) in some high-risk areas (including the greater N’Djamena area); in other areas, the quality of SIAs cannot be verified by WHO due to inadequate independent monitoring. Additionally, subnational gaps remain for surveillance of acute flaccid paralysis (AFP), and further undetected circulation cannot be ruled out. Urgent improvements are needed during SIAs, through strengthened engagement and ownership for SIA operations by provincial- and district-level political and administrative leadership.

To urgently address the situation, the Government of Chad with the technical support of partners has just finalized a 6 month national polio emergency plan. National Immunization Days (NIDs) using bivalent OPV have been conducted in May, with further SIAs planned for June. The Government of Chad and partners are working to ensure that technical support is allocated to priority areas; special strategies will be used to reach high-risk populations and technical capacity to fill subnational surveillance gaps will be scaled up. As part of efforts to increase accountability for programme implementation, key indicators will be regularly monitored. Under the National Polio Emergency Plan, heads of district administrations will be charged with overseeing implementation reviews following each SIA, and providing summaries with clear outcomes and recommendations to provincial governors, whose offices will oversee direct oversight of the operationalisation of the plan. At the national level, monthly implementation reports will be prepared by the Ministry of Health and shared with the office of the Prime Minister.

Throughout 2010 and 2011, countries neighbouring Chad – notably Cameroon, CAR and Sudan – have all conducted multiple SIAs, to minimise the risk of re-infection. It is important that countries across central Africa and the Horn of Africa strengthen AFP surveillance in order to rapidly detect any poliovirus importations and facilitate a timely response. Countries should also continue to boost routine immunization coverage against polio to further strengthen population immunity and minimize the risk of any importation.

As per recommendations outlined in WHO’s International travel and health, travelers to and from Chad should be fully protected by vaccination. Travelers to Chad who have in the past received three or more doses of OPV should be offered another dose of polio vaccine before departure. Any unimmunized individuals intending to travel to Chad require a complete course of vaccine. Travelers from Chad should have a full course of vaccination against polio before leaving Chad, with a minimum one dose of OPV before departure. Some polio-free countries may also require travelers from Chad to be immunized against polio in order to obtain an entry visa.

On 8 August 2010, the President of Chad, Idriss Deby Itno, received the prestigious Rotary ‘Polio Eradication Champion’ award.

The award was given in recognition of the President’s personal engagement in Chad’s polio eradication efforts. Officially presenting the award at a ceremony at the Presidential palace in N’Djamena, Chad, Bob Scott, Chairman of Rotary’s International PolioPlus Committee, said: “Your personal engagement in the fight against this disease has translated into concrete action which has led to the reduction in polio cases in your country.”

Receiving the award, the President re-affirmed his commitment to polio eradication: “We will not let down our guard, we are remaining steadfast and multiplying our vaccination campaigns,” he re-affirmed.

Chad has been affected by re-established transmission from an imported poliovirus since November 2007. Its outbreak response efforts had been marred by significant operational challenges during supplementary immunization activities (SIAs) – as recently as last year, upwards of 50% of children were regularly missed during SIAs in the greater N’Djamena area. In February of this year, however, the President personally intervened, officially launching National Immunization Days (NIDs), declaring ‘war’ on the polio outbreak and issuing a Presidential directive to all Provincial Governors for direct oversight of SIAs. Since then, under the President’s personal leadership, significant operational improvements have been noted, in particular with regard to more effective planning and vaccinator performance, and the number of newly-reported cases has begun to decline.
The ‘Polio Eradication Champion’ award was established in 1995, and is the highest honour Rotary presents to heads of state, health agency leaders and others who have made significant contributions toward polio eradication.

In receiving Rotary’s ‘Polio Eradication Champion’ award, President Deby Itno joins a group of other distinguished leaders whom Rotary has honored including India’s Prime Minister Manmohan Singh, Chancellor of Germany Angela Merkel, current UN Secretary-General Ban Ki-moon and former Secretary General Kofi Annan, President Asif Ali Zardari of Pakistan, and former Chairperson of the African Union Commission Alpha Oumar Konare.

Top-level leadership at launches of vaccination campaigns

President of Chad, Idriss Deby Itno, wears the yellow hat of a Rotary vaccinator as he gives vaccine to a child WHO/Chad

The President of Chad started the day by announcing, “I am personally declaring war on polio.” The President of Mali launched campaigns in his country, calling on his peers to help make Africa polio-free. The First Lady of Ghana encouraged her fellow citizens to vaccinate their children. In many west and central African countries, the highest levels of leadership were visible and voluble in supporting vaccination and in exhorting national and sub-national administrators to ensure all children were reached.

President Idriss Deby Itno of Chad was joined by American actress Mia Farrow, a UNICEF Goodwill Ambassador who was in the country for several days to highlight the challenges to eradicating polio there. Chad has re-established transmission of an imported wild poliovirus of Nigerian origin.