World has ‘limited window of opportunity’ to eradicate polio, experts warn – The Telegraph

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A Pakistani health worker administers polio vaccine drops to a child during an immunisation campaign Credit: Insiya Syed There is a “limited window of opportunity” for the world to consign polio to the history books, experts launching a new five-year eradication plan have warned.  The Polio Endgame Strategy, published on Tuesday, says that efforts to eradicate the final cases of the disease are proving difficult due to war, mass migration and weak health systems – meaning many children miss out and do not receive vital vaccinations. The highly infectious childhood disease has been the target of a concerted elimination campaign since the 1980s, when roughly 350,000 children in 125 endemic countries were infected each year. By 2018 that figure had dropped to just 33 cases in Afghanistan and Pakistan – along with Nigeria, these are the only countries in the world where wild poliovirus remains endemic. The new strategy, published by the Global Polio Eradication Initiative, says that reaching these children is “the primary underlying challenge” in attempts to stop all new cases of the debilitating disease. Vaccination is the only way to prevent the disease, which is incurable. “We know that the last mile has proven to be the toughest phase of polio eradication,” said Dr Michel Zaffran, director of polio eradication at the World Health Organization. “We have yet to stop transmission in some of the most difficult to reach areas of the world, and detection of a single polio case anywhere points to the remaining gaps in vaccination.  “The new strategy comes at a very critical moment. [There is] a limited window of opportunity to overcome the final obstacles,” he added. The report says that further strengthening surveillance systems and community cooperation, which have been central to delivering anti-polio vaccination campaigns, will be key to eradicating the disease before 2023. But the strategy also outlines several new innovations, including the creation of an Afghanistan-Pakistan regional hub to increase cooperation between the two countries, which bear the brunt of the polio disease burden. “The regional hub will help us to focus and consolidate our response in the remaining epidemiological block simultaneously,” said Jalaa Abdelwahab, deputy director of the global polio team at Unicef. “[It] will be staffed by people who are very aware of the geopolitical and cultural realities.” Just this week, Pakistan decided to halt anti-polio vaccination campaigns after a health worker and two police officers were shot dead.  The attack followed the circulation of false claims that the vaccine causes vomiting and fainting on social media – causing near hysteria when 25,000 healthy children were taken to hospital by concerned parents. “Clearly the events in Pakistan are extremely concerning,” said Dr Zaffman. “But while these events have made a lot of impression on the news, the national vaccine campaign was very successful. It was conducted for about a week in Pakistan and covered more than 37 million children across the country.” The strategy presents a road-map to prevent any new new wild polio cases after 2020, which would pave the way for the certified eradication of the disease in 2023. If there continue to be no new cases of wild polio in Nigeria, the disease will be declared eradicated in Africa later this year. However vaccine-derived polio – a rare mutated strain of the disease which was reported in Nigeria, Niger, Somalia and Democratic Republic of Congo in 2018 – persists. Dr Zaffman said the mutated strain of the disease would be eliminated only when vaccines to prevent wild polio are no longer required, as there is no disease reservoir. He also added that while he was confident the strategy could be successful, it is not yet fully funded. Enacting the plan would cost roughly $4.2 billion, but GPEI still needs to raise $3.27 billion of this total. The organisation is in the process of writing an investment case and will hold a pledging event in November.  “It is a lot of money, however this is a very good investment,” said Dr Zaffman.  “If we fail to [eradicate polio] in the next couple of years and decide to stop our efforts, this could easily result in 200,000 cases a year within the next decade, because the virus circulates very silently and rapidly.” “We need to fill that $3.27 billion,” he added. “Now is the time to finish the job and we have all the tools and strategies available to do so.” Protect yourself and your family by learning more about Global Health Security 
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