Hope to end polio in 2019 rises

Tuesday, October 24, marked Rotary International’s fifth annual World Polio Day (WPD), co-hosted by the Bill and Melinda Gates Foundation.

As Nigeria joined the rest of the world to mark the Day, there is renewed hope that the transmission of the Wild Polio Virus (WPV) could be halted by the end of this year.

The renewed hope is predicated on the fact that the world has made tremendous progress in the last 14 months to end the virus. The number of cases dropped from 37 in 2016, in five countries, to 12 in 2017 in only two countries- Afghanistan and Pakistan.

According to the Global Polio Eradication Initiative (GPEI), the year 2017 has seen the lowest case count of polio in recorded history, but the job is not done yet.

The GPEI, in February 2017, said polio has been restricted to five countries: Afghanistan, Pakistan, Nigeria, Guinea and Lao People’s Democratic Republic.

Pakistan had 20 reported cases in 2016; Afghanistan reported 13 while Lao People’s Democratic Republic reported three cases.

Meanwhile, Nigeria is also celebrating 14 months without any case of polio. After more than two years without wild poliovirus in Nigeria, the Government reported, August 11, 2016 that two children have been paralyzed by the disease in the northern Borno state. According to the WHO, Nigeria recorded only four cases of polio in 2016.

Also, leader of the Gates Foundation’s polio eradication efforts, Dr. Jay Wenger, told CNBC News, yesterday, that it is very possible that 2017 may see the end of the wild poliovirus — nearly two years earlier than Bill Gates predicted.

Wenger said: “What we are looking at now is sort of the endgame of polio eradication. We are closer than ever, and we are optimistic that we can see the end of wild poliovirus disease by as early as this year.”

According to Wenger, there are only 12 known cases of the wild poliovirus in existence today, in just two countries: Afghanistan and Pakistan. “In the last couple of years, we have seen unprecedented progress. In 2015 we could only find 74 cases; in 2016 we found 37, and then this year so far we have found only 12 in only two countries.”

According to the WHO Fact Sheet on Polio, polio (poliomyelitis) mainly affects children under five years of age. Polio is a highly infectious disease caused by a virus. It invades the nervous system, and can cause total paralysis in a matter of hours. The virus is transmitted by person-to-person spread mainly through the faecal-oral route or, less frequently, by a common vehicle (for example, contaminated water or food) and multiplies in the intestine.

Initial symptoms are fever, fatigue, headache, vomiting, stiffness of the neck and pain in the limbs. One in 200 infections leads to irreversible paralysis (usually in the legs). Among those paralysed, five per cent to 10 per cent die when their breathing muscles become immobilized.

Polio cases have decreased by over 99 per cent since 1988, from an estimated 350,000 in more than 125 endemic countries then, to 37 reported cases in five countries in 2016. As a result of the global effort to eradicate the disease, more than 16 million people have been saved from paralysis.

Of the three strains of wild poliovirus (type 1, type 2, and type 3), wild poliovirus type 2 was eradicated in 1999 and no case of wild poliovirus type 3 has been found since the last reported case in Nigeria in November 2012.

As long as a single child remains infected, children in all countries are at risk of contracting polio. Failure to eradicate polio from these last remaining strongholds could result in as many as 200,000 new cases every year, within 10 years, all over the world.

In most countries, the global effort has expanded capacities to tackle other infectious diseases by building effective surveillance and immunization systems.

In 1988, the Forty-first World Health Assembly adopted a resolution for the worldwide eradication of polio. It marked the launch of the GPEI, spearheaded by national governments, WHO, Rotary International, the United States Centers for Disease Control and Prevention (CDC), United Nation Children Fund (UNICEF), and supported by key partners including the Bill & Melinda Gates Foundation. This followed the certification of the eradication of smallpox in 1980, progress during the 1980s towards elimination of the poliovirus in the Americas, and Rotary International’s commitment to raise funds to protect all children from the disease.

Overall, since the GPEI was launched, the number of cases has fallen by over 99 per cent.

In 1994, the WHO Region of the Americas was certified polio-free, followed by the WHO Western Pacific Region in 2000 and the WHO European Region in June 2002. On 27 March 2014, the WHO South-East Asia Region was certified polio-free, meaning that transmission of wild poliovirus has been interrupted in this bloc of 11 countries stretching from Indonesia to India. This achievement marks a significant leap forward in global eradication, with 80 per cent of the world’s population now living in certified polio-free regions.

More than 16 million people are able to walk today, who would otherwise, have been paralysed. An estimated 1.5 million childhood deaths have been prevented, through the systematic administration of vitamin A during polio immunization activities.

According to the WHO, the strategies for polio eradication work when they are fully implemented. This is clearly demonstrated by India’s success in stopping polio in January 2011; in arguably the most technically challenging place, and polio-free certification of the entire South-East Asia Region of WHO occurred in March 2014.

Failure to implement strategic approaches, however, leads to ongoing transmission of the virus. Endemic transmission is continuing in Afghanistan, Nigeria and Pakistan. Failure to stop polio in these last remaining areas could result in as many as 200,000 new cases every year, within 10 years, all over the world.

Recognizing both the epidemiological opportunity and the significant risks of potential failure, the “Polio Eradication and Endgame Strategic Plan 2013-2019” was developed, in consultation with polio-affected countries, stakeholders, donors, partners and national and international advisory bodies. The new Plan was presented at a Global Vaccine Summit in Abu Dhabi, United Arab Emirates, at the end of April 2013. It is the first plan to eradicate all types of polio disease simultaneously – both due to wild poliovirus and due to vaccine-derived polioviruses.

Once polio is eradicated, the world can celebrate the delivery of a major global public good that will benefit all people equally, no matter where they live. Economic modelling has found that the eradication of polio would save at least $ 40–50 billion between 1988 and 2035, mostly in low-income countries. Most importantly, success will mean that no child will ever again suffer the terrible effects of lifelong polio-paralysis.

According to the WHO, Rotary International had the vision of a polio-free world nearly three decades ago, and millions of Rotarians have committed over $ 1.6 billion to the effort to date.

The WHO said polio eradication presents the global community with a unique opportunity: to eradicate a human disease for just the second time in history, after smallpox and paves the way to meet a plethora of other health needs. “Since last year, polio workers have contributed to fighting cholera in Nigeria, responded to Meningitis outbreaks, strengthened routine immunization, and brought other broader benefits to communities.”

However, all that efforts is being threatened by the killer injection rumour that is causing nationwide rejection of polio vaccination. The WHO, yesterday, said 13,502 children have rejected being administered polio vaccine in Potiskum Local Government Area of Yobe State after a rumour of ‘killer injection’ circulated in Yobe State.