The Africa regional certification commission of the World Health Organization (WHO) has declared Africa free from wild polio. Two and half decades ago thousands of African’s children were paralyzed by the polio virus. Presently, more than 95% of Africa’s population has now been immunized against the virus. This was one of the conditions that the Africa Regional Certification Commission of the World Health Organization (WHO) set before declaring the continent on 25th August, 2020 free from wild polio. 177 new cases of vaccine-derived poliovirus was identified this year which make it the remaining poliovirus in African. Is a rare form of the virus that modifies from the oral polio vaccine and then extent to under-immunized communities. Nigeria, having accounted for more than half of all global cases of polio in that last decade was the last country in Africa to be declared free from wild polio. The vaccination campaign in Nigeria involved a huge effort to reach remote and dangerous places under threat from militant violence and some health workers were killed in the process.
What is polio virus?
Polio is a virus called poliovirus which spreads from person to person, usually through infected water. It attacks the nervous system causing paralysis in children. One third of wild poliovirus strains have been eliminated globally.
The virus mainly affects children aged under five. The following are the early symptoms: vomiting, fever, fatigue, headache, pains in the limbs and stiffness of the neck. It also causes total paralysis within an hour by invading the nervous system. One in 200 infections leads to irreparable paralysis and among those paralyzed 5% to 10% of people die when their breathing muscles become immobilized.
How Africa journey to wild polio freedom began
Some Africa countries have been identified with number of cases by WHO, they include; Nigeria, the Democratic Republic of the Congo, Central African Republic and Angola. When the disease was first discovered there was neither vaccine nor cure. Until 1952 when Dr Jonas Salk developed a vaccine that restored the hope that children could be protected from the disease.In 1961, Albert Sabin pioneered the oral polio vaccine which has been used in most national immunization programmes around the globe.
In 1996, Nelson Mandela in coalition with other groups such as Rotary International launched the “Kick Polio Out of Africa” programme, mobilizing millions of health workers who went village-to-village to hand-deliver vaccines. That was after the poliovirus had paralyzed over 75,000 children across the continent. It is noteworthy that the Rotary International had spearheaded the polio vaccination drive in the 1980s
Since 1996, billion of oral polio vaccines have been provided, averting approximately 1.8 million cases of wild poliovirus.
What have been the challenges of Immunization coverage in Nigeria?
Nigeria was the last country in Africa to be declared free of wild polio owing to the very low immunization coverage which was due to the inability to access many children in the remote communities and vaccine hesitancy, for instance, Nigeria had gone two years without any case been identified before the Boko Haram insurgency in the north eastern part of Nigeria as at 2016, it was a frustrating set-back particularly in Borno state, it made the children in the state difficult to reach, more than two million people were displaced by the fighting, frontline workers, 95% of whom were women, managed to navigate areas of conflict like Lake Chad by boat and deliver vaccines to remote communities. The conflict also led to a wide range of rumors and misinformation about the vaccine there by slowing down immunization efforts.
Polio survivors and other stakeholders a useful tool for campaign?
Nigerian Polio Survivor Association president, Misbahu, Lawan Didi, said the position of survivor has been crucial in probing people to accept the campaign. Many rejected the polio vaccine, but they see how much reaching them was a struggle. Sometimes, health workers have to pass through a large distance, to speak to them. With a question such as: ‘Don’t you think it is important for you to protect your child not to be like us?’ From polio survivors, to traditional and religious leaders, school teachers, parents, volunteers and health workers, a huge ally was developed to defeat polio. They work together and travelled to hard-reach communities to administer immunization to children.
Could wild polio return?
A country that is polio free can easily have the polio through importation from another which can later spread among under immunized populations. This happened in Angola, which despite decades of civil war, defeated polio in 2001. Until 2005 when new cases was brought from outside the country. World Health Organization suggested that it is important countries build walls against the polio and avoid complacency until there is global eradication. For all types of polio including vaccine-derived polio to be eliminated, vaccination efforts will need to continue alongside surveillance, to protect children from being paralyzed by the disease in the future.
Omame Joseph Benjamin is a public health enthusiast with focus on mental and reproductive health. He has passion for reproductive health of individuals and family, and obtained his bachelor’s degree in Rehabilitation Science from the prestigious University of Jos in Nigeria. He is currently undergoing his postgraduate study in public health focusing on population and Reproductive health at the University of Ibadan. Omame is also a good data analyst with verifiable track record.