News Category: Outbreak countries

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© 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

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© WHO

Geneva 11 August 2016 – After more than two years without polio in  Nigeria, the  Government reported today, that two children have been paralyzed by the disease in the northern Borno state.

As an immediate priority, the Government of Nigeria is collaborating with the World Health Organization (WHO) and  other partners of the Global Polio Eradication Initiative to respond urgently and prevent more children from being paralyzed. These steps include conducting large-scale immunization campaigns and strengthening surveillance systems that help catch the virus early. These activities are also being strengthened in neighbouring countries.  In response to confirmation of these cases, the Government of Nigeria declared this outbreak as a national public health emergency.

Genetic sequencing of the viruses suggests that the new cases are most closely linked to a wild poliovirus strain last detected in Borno in 2011. Low-level transmission of the poliovirus is not unexpected, particularly in areas where it is difficult to reach children with the vaccine. Subnational surveillance gaps persist in some areas of Borno, as well as in areas of neighbouring countries.

“We are confident that with a swift response and strong collaboration with the Nigerian Government, we can soon rid the country of polio once and for all. This is an important reminder that the world cannot afford to be complacent as we are on the brink of polio eradication – we will only be done when the entire world has been certified polio-free,” said Mr Michel Zaffran, Director of polio eradication at WHO Headquarters.

As recently as 2012, Nigeria accounted for more than half of all polio cases worldwide, but the country has made significant strides, recently marking 2 years without a case on 24 July 2016. This progress has been the result of a concerted effort by all levels of government, civil society, religious leaders and tens of thousands of dedicated health workers. Recent steps including increased community involvement and the establishment of Emergency Operations Centers at the national and state level have been pivotal to Nigeria’s capacity to respond to outbreaks.

Full release
GPEI statement
Interview with Michel Zaffran, Director of the GPEI
Nigeria declares polio outbreak as a national public health emergency (18 August 2016)
External Experts Commend the Strong Surveillance Structure for detecting Outbreaks in Nigeria (25 August 2016)
States in the North East intensify preparation for Outbreak Response Campaign (26 August 2016)

 

WHO
WHO

Last week, global political commitment to eradicating polio was affirmed at the World Health Assembly (WHA) in Geneva. During the polio agenda item, member states discussed progress made in the last year and the remaining hurdles that stand in the way of polio eradication.

In her opening address to the WHA, Dr Margaret Chan, Director General of WHO, said polio eradication has never been so close to the finish line. “During the short span of 2 weeks in April, 155 countries successfully switched from trivalent to bivalent oral polio vaccine, marking the largest coordinated vaccine withdrawal in history. I thank you and your country teams for this marvellous feat,” she said.

Member states reviewed the latest global epidemiology, noting the strong progress made across Africa with no case of wild poliovirus in approaching two years. Delegates from Afghanistan and Pakistan, the final remaining polio endemic countries, outlined the steps they are taking to ensure that transmission is interrupted as a matter of urgency. With fewer missed children than ever before and just 74 cases across the two in 2015, achieving eradication has never appeared to be such an achievable target.

Many member states spoke to reaffirm their commitments to fulfilling the objectives of the resolution passed at the last WHA to commit to ending polio once and for all. Michel Zaffran, Director of Polio Eradication at WHO, stated that strong progress had been made against all four objectives of the Polio Eradication and Endgame Strategic Plan.

Delegates also commended the historic achievement of the switch, warning that shortages of the inactivated polio vaccine and potential outbreaks of type 2 vaccine-derived polioviruses would be some of the major challenges of the coming year. They also expressed appreciation for the global contingency plans put in place to adequately manage the risks associated with the supply shortage, notably the availability of the stockpile of monovalent oral polio vaccine type 2.

Gavi, the Vaccine Alliance, supported the interjections of several member states highlighting the importance of ramping up transition planning in countries to prepare for the end of the polio infrastructure after eradication. “To be sustainable, the decision on which polio assets to sustain must be fully led and driven by countries themselves, based on national ownership, national plans and investments,” said the Gavi spokesperson.

Rotary international spoke to affirm that their 1.2 million volunteers worldwide remain fully committed to polio eradication. “We have three key challenges remaining,” said the Rotarian speaker. “First, we have to interrupt polio in Pakistan and Afghanistan. Second, we must avoid complacency. An additional US $1.5 billion is needed through 2019 to sustain high levels of immunity, repeatedly reaching more than 400,000,000 children in up to 60 countries and carrying out high quality surveillance to protect progress. Finally we must fully leverage the physical and intellectual assets of polio eradication so that they can benefit broader public health priorities.”

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