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.

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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.


For seven countries in west Africa and Horn of Africa

For seven countries in west Africa and Horn of Africa
Rotary International/Chris Offer

Washington, D.C. — The United Nations Foundation today announced that the Kingdom of Saudi Arabia had delivered $10 million of its $30 million commitment to the Global Polio Eradication Initiative (GPEI). Half the funds will be used in 2011 by UNICEF for vaccines and a further US$ 5 million will go towards the World Health Organization (WHO) to support campaign operations. The remaining funds will be released in 2012 to support both agencies. Countries benefiting from the funds include several members of the Organization of Islamic Cooperation countries, such as Yemen, Somalia and Sudan.

“This significant contribution will save thousands of children from the crippling and sometimes deadly effects of polio,” said Timothy E. Wirth, President of the UN Foundation. “This is more than a donation – it is a gift that symbolizes successful partnership among donors and an investment in health for millions of children.”

Polio is a disease that mainly affects children aged below five years and is known to cause lifelong paralysis and potentially fatal complications. Polio cannot be cured, but it can be prevented with a safe and effective oral vaccine that costs approximately fifty cents to deliver to a child. As a result of international efforts by the Global Polio Eradication Initiative to immunize every child, the vast majority of the world is now polio-free. The GPEI is supported by its spearheading partners, namely WHO, UNICEF, US Centers for Disease Control & Prevention and Rotary International as well as the Bill & Melinda Gates Foundation and the UN Foundation.

In 2011, polio remains endemic in only four countries — Nigeria, India, Pakistan and Afghanistan. However, more than 20 countries are affected by the spread of the wild polio virus, and the recent resurgence of the disease in Russia and the Central Asian Republics and very recently in China — after more than 10 polio-free years is proof that if the virus is not eradicated everywhere, it can re-emerge anywhere.

WHO Assistant Director-General for Polio, Emergencies and Country Collaboration, Dr. Bruce Aylward welcomed the contribution: “This new commitment from Saudi Arabia enables the last steps towards the eradication of this ancient disease, and we hope it will inspire others in the region to bring their considerable financial and political support to ending polio and protecting the most vulnerable.”

Polio was endemic in more than half the world’s countries and the highly infectious disease paralyzed hundreds of thousands of children every year less than half a century ago. Fortunately, an effective vaccine was introduced in the 1950s and 1960s, but in 1988 an estimated 350,000 polio cases still occurred annually. Since the launch of the GPEI that year, polio cases globally have decreased by over 99% by 2010, when fewer than 1,350 cases were reported globally during the course of the year.

“The fight against polio is a global challenge for all of us,” said Anthony Lake, UNICEF Executive Director. “Its defeat will be a ringing victory for all of humanity – marking only the second time in history a disease has been eradicated. With this generous donation from the Kingdom of Saudi Arabia we move closer to achieving this goal, and to saving millions of people from the threat of this crippling disease.”

The United Nations Foundation

With west Africa on the verge of success, experts caution that complacency could breathe new life into outbreak

Massive international effort to stop polio epidemic across west Africa M Bachir Chaibou/WHO Niger

25 March 2011 – Health experts today confirmed that a devastating polio epidemic in west African countries is on the verge of being stopped – but warned that complacency could breathe new life into the outbreak. Since mid-2009, polio has re-infected eleven countries across west Africa, claiming many lives and leaving hundreds of children paralyzed for life.

A series of synchronized, multi-country immunization campaigns in the second half of 2009 and 2010 have now succeeded in all but wiping out this outbreak. A further multi-country campaign on 25 March and again on 28 April across 15 countries will aim to immunize more than 38 million children, by a network of more than 180,000 volunteers armed with 48 million doses of polio vaccine, to extinguish any remaining chains of polio transmission. At the same time, polio eradication efforts are further intensifying in Nigeria, the only endemic country in Africa; over the past 12 months, the number of new cases in the country has been slashed by an impressive 95% in 2010 compared to 2009.

But while the region stands on the threshold of a public health success, experts warned against complacency, cautioning that any pockets of unimmunized or under-immunized children could result in the outbreak gaining a second wind. This risk was further underscored with confirmation of a new case reported in March in Niger, across the border from northern Nigeria.

“These latest campaigns are critical to re-achieving a polio-free west Africa,” said Dr Luis Gomes Sambo, the World Health Organization Regional Director for Africa. “Under the leadership of the governments of countries across the region, this epidemic is on the verge of being stopped, but we must all invest the necessary resources to stop polio for ever in our Region.”

And the Regional Director for UNICEF in West and Central Africa, Dr Gianfranco Rotigliano to add: “We are now seeing the results of the tremendous efforts of the past two years. Tens of thousands of children have been spared life-long paralysis. But at the same time, we must remember that in 2010 alone more than 500 children and adults were affected and are today suffering the effects of this devastating disease, and far too many have died. We must ensure that the outbreak response continues and that all children are immunized.”

“At Rotary International, we will continue to do all we can to support communities and countries in their polio eradication efforts,” said Mr. Ambroise Tshimbalanga-Kasongo, chair of Rotary International’s African PolioPlus Committee. “Rotary members have contributed over US$1 billion to the fight against polio and will continue to do so until no child has to suffer from this crippling disease. We are proud to be able to be apart of this tremendous effort.”

Even after the outbreak is stopped, periodic vaccination campaigns, along with routine immunization, will continue to ensure immunity amongst the population and to minimize the risk of another outbreak. Key to success will be the continuing engagement of political, religious and community leaders whose support has underpinned the drive to stop polio in the region.