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Liberia: Close to Ending Polio - No Time to Be Complacent | Daily Observer via allAfrica.

[25 OCTOBER 2018]

Dr Matshidiso Moeti, WHO Regional Director for Africa

Message of the WHO Regional Director for Africa, Dr Matshidiso Moeti, on World Polio Day 2018

On 24 October, the World Health Organization (WHO) will join millions of people around the world to observe World Polio Day and galvanize support to end polio, an incurable but completely vaccine preventable disease that still threatens children in a few places around the world.

Since the launch of the Global Polio Eradication Initiative (GPEI) nearly 30 years ago, new cases of polio have dropped by more than 99.9 percent - from 350,000 cases every year in more than 125 affected countries to 22 wild polio cases in 2017 in two affected countries.

The African Region has made tremendous progress towards polio eradication. As late as 2012, the Region accounted for more than half of the global polio burden, but polio cases have dropped steadily from 128 cases in 2012 to 4 cases in 2016 to 0 cases in 2017 and 2018. The African Region has now reached an important milestone towards eradication - it has been more than two years since the last case of wild poliovirus. I applaud the excellent efforts of governments, polio eradication partners, communities, parents and health workers in achieving this magnificent milestone.

However, this is no time to be complacent. Until polio is eradicated, all countries remain at risk of outbreaks. As a Region, Africa can only be certified to have eradicated polio if three years have passed without any confirmed wild poliovirus, and if polio surveillance (closely looking out for polio cases) has been maintained at the level required for certification. If no new case is confirmed and surveillance is quickly strengthened, the African Region can be certified to have eradicated polio by the end of 2019 or early 2020.

As a Region, our surveillance efforts need to be further strengthened. A number of countries have sub-optimal surveillance, in both secure and insecure areas. It would be a disaster if we fail to be certified because of poor surveillance performance. I urge all countries - whether they have had a case of polio or not - to recommit to strengthen surveillance urgently.

Additionally, as was agreed at the 71st World Health Assembly (WHA) in May 2018, I call upon all Member States to implement containment of polioviruses and potential polioviruses infectious materials according to the global action plan (GAP III), in a timely manner, to avoid any leakage of polioviruses into the environment and populations which could result in catastrophic outbreaks and reverse the gains towards eradication. The progress on polioviruses containment by Member States will be presented at the next WHA in May 2019.

The African Region has confirmed continued emergence of circulating vaccine-derived polioviruses (cVDPVs) in some Member States, attributed to weak routine immunization services delivery. In 2017, the Addis Ababa Declaration on Immunization was endorsed by Heads of State at the African Union. It called for governments to invest further in immunization services which are key for stopping emergence of cVDPVs, sustaining the gains towards polio eradication and post certification of polio eradication. Eradication of polio needs political commitment and adequate resources. WHO assures all Member States of its dedicated support.

We are close to ending polio. I call on all countries to work together to ensure that this becomes a reality, and the African Region is declared to have eradicated polio by end of 2019 or early 2020. Let us all be part of that historical achievement.

Read the original article on Observer.


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Joint Statement on World Polio Day: WHO, UNICEF and Rotary International reaffirm their commitments to stop off polio in the Horn of Africa | WHO Ethiopia.

World Polio Day partial participants
World Polio Day partial participants.

24 October 2018, Addis Ababa: As the world commemorates World Polio Day on October 24 2018, we, the World Health Organization (WHO), UNICEF and Rotary International, reaffirm our commitment to stopping polio in the Horn of Africa.

Polio is a virus which can cause lifelong paralysis. The number of polio cases has decreased globally from 350,000 every single year in 1988 to just 22 in 2017. We are 99% of the way to ending polio for good. However, polio anywhere in the world is a treat to under-immunized children everywhere. Luckily, it can be prevented with a few doses of a simple, safe vaccine. We cannot rest until we have found every case of polio and vaccinated every last child.

The Horn of Africa is currently experiencing two simultaneous outbreaks of circulating vaccine-derived poliovirus (cVDPV). Outbreaks of vaccine-derived poliovirus can be stopped in just the same way as wild polio: by vaccinating every last child. The Governments of Somalia, Kenya and Ethiopia, as well as countries across the Horn of Africa, are committed to working together to stop the outbreaks as soon as possible. Increased efforts from all health partners are necessary to stem the outbreaks. While no poliovirus has been found in Ethiopia during this current outbreak, children across the country are at risk due to the high levels of population movement across the border and gaps in the polio surveillance system.

To stop the outbreak, we call on all partners to work together to increase community awareness, enhance surveillance to find the virus wherever it is hiding, and ensure that all children are vaccinated with at least three doses of the oral polio vaccine. We all have a role to play. Parents and communities are working to ensure that their children are protected; donors are committing the necessary funds; partners and governments are working together to keep up momentum. Polio staff on the frontlines are going above and beyond in challenging environments to reach children with vaccines, track the virus and raise awareness.

Smallpox is the only human disease ever to have been eradicated before. The Horn of Africa was the final resting place of smallpox before it was eradicated in 1980. Let’s work together to ensure we are not the final resting place of polio. It is critical for health facilities and parents across the Horn of Africa to work together to help eradicate polio and make history.

Two rounds mOPV2 vaccination campaigns have been held in at-risk areas of Ethiopia in 42 districts of five zones which are bordering with Kenya and Somalia namely Korahey, Afder, Shabele, Liben and Dawa in July and August 2018 to ensure that children are protected and that there is no place for the virus to hide. The next bOPV2campaign is scheduled to take place from the 29th October to 3rd targeting high risk areas which would cover 19% of the total under five children from Oromia, Gambella and Somali regions including the refugee camps found in these respective regions; and the preparation is almost done.

All parents living in these areas should ensure that their child is vaccinated on these dates. The oral polio vaccine is safe and effective, and has brought the world close to eradicating the second disease in human history.

The theme for this year’s World Polio Day in Ethiopia is “Bold steps to end polio.” While we celebrate Ethiopia’s polio-free status, we remain committed to continuing our joint polio eradication efforts shoulder-to-shoulder with our fellow countries in the Horn od Africa in order to end polio for good. We must take bold steps to address the remaining challenges and strengthen surveillance to ensure that if polio returns to Ethiopia, we can respond rapidly. By ending this outbreak, the Horn of Africa will contribute not only to protecting the health of our children, but also to the global eradication of polio – a historic feat.

Let us take bold steps together to end this outbreak and keep Ethiopia polio free.

Media Contacts:
Selamawit Yilma; WHO; +251 911 671134; yilmas@who.int
Victor Chinyama, UNICEF Ethiopia, Tel: +251 115 184 039, vchinyama@unicef.org
Mohammed Sani, Rotary International +251 911 19 77 55; mohammedsani@gmail.com,

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For Additional Information or to Request Interviews, Please contact:
Yilma Selamawit

Tel: +251 911 671134
Email: yilmas@who.int


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Every Last Child Story Project Launched | GPEI.

[25/10/2018]

New collection of 30+ multimedia stories from Afghanistan, Pakistan and India now available on GPEI website.

A child in Afghanistan shows off their pinky after receiving the polio vaccine. Photo credit: ©UNICEF Afghanistan/Hibbert

Front-line health workers and volunteers represent the backbone of the global polio eradication effort. As they work tirelessly to reach and vaccinate every last child against polio – often in remote, hard-to-reach or even dangerous areas – they are not only protecting children from the poliovirus, but also paving the way for other health programmes to reach the world’s most vulnerable children.

The Every Last Child project is a collection of over 30 stories and profiles from India, Pakistan and Afghanistan about the collective efforts of front-line health workers, governments and global health partners to protect children from the poliovirus in some of the world’s most challenging environments. These multimedia pieces illustrate the complexity and scale of polio eradication efforts in each of these key countries through in-depth narratives, compelling profiles and interactive visuals.

To end polio, the global polio programme must reach every last child and take bold steps to take the world across the finish line once and for all. Visit the Every Last Child project page to learn more about the history of these remarkable efforts, as well as stories of heroic front-line workers.


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Govt committed to eradicating polio from Pakistan | The News International.

[October 25, 2018]

Muhammad Nasir writes:

KARACHI: Prime Minister’s Focal Person on Polio Eradication Babar Bin Atta has said that he salutes over 260,000 valiant polio team members, the real heroes on the frontline who go against all odds, down countless streets, to cover the length and breadth of Pakistan, with One Goal: No child is left unprotected against lifelong paralysis.

“Our government is fully committed to ending polio in Pakistan. I am confident, together with our people, we will achieve a safer, healthier and polio-free Pakistan for our children. Over the past years, Pakistan has made tremendous progress towards polio eradication from highs of 306 in 2014 to only 6 polio cases so far in 2018. Thanks to our frontline workers for their exemplary commitment to end polio.”

He was talking in Geo News morning show Geo Pakistan with host Abdullah Sultan and Neelum Yousuf. Babar said that World Polio Day observes across the globe on 24th October is not only a day to express our gratitude to all those associated with this noble cause across our great country but it is also a call to action for all of us to do our part to reach this historic goal. “This World Polio Day offers compelling evidence for Pakistan to celebrate the milestones that the country has achieved in its crusade against polio. More importantly, however, it is an occasion for serious contemplation: despite being on the brink of eradication, why is Pakistan still one of last three remaining polio endemic countries in the world? Why do hundreds and thousands of children remain unvaccinated in every single campaign despite marked improvements in campaign quality and surveillance? What precautions has the country taken to pre-empt future outbreaks? And the list of questions goes on. Pakistan’s epic fight to reverse the odds in the face of a major polio epidemic is a story of courage, resilience and innovation,” he said.

He said, “Major challenges are being addressed with an unshakable resolve and a well thought-out and effectively executed strategy under the leadership of Prime Minister Imran Khan.”

The current polio virus picture of Pakistan provides reason for optimism. It is however critical that the gains so far achieved are sustained and intensified in the remaining areas of polio virus transmission. Over the years, through incredible focus and hard work, polio counts are edging close to zero, with substantial increase in immunity levels of children—meaning we are reaching a majority of the eligible child population with polio vaccine. Yet, despite all efforts, six cases of polio have been reported so far this year—meaning that we are not reaching every child, he added.

“We are now in the low transmission season where the virus is most vulnerable. We must use the upcoming campaigns to reach and vaccinate every child and give the virus no place to hide. Every parent and every citizen is our soldier in taking the fight to the virus. There are 260,000 Sehat Muhafiz operating on the ground across Pakistan, ensuring that children from each and every house, in every street, district and province have been given the two essential vaccine drops in every campaign. I call upon fathers, mothers, and caregivers to ensure that two drops of the safe and effective polio drops are administered to their children. World will be a witness when the current government will declare final victory against the disease so no child ever is paralysed by the polio virus,” he added.

It is noted that during the journey or travel should be careful of this disease because polio virus is transferred from one country to another. Especially this virus comes from Afghanistan when people came from here. In Afghanistan, 16 cases have been reported, there are some areas where polio teams were not accessible, until these teams will not arrive in those areas the dream of eliminate polio will be impossible. There is no individual responsible for polio virus existence, only conditions and virus itself responsible for it. This is the problem of children so it should be no politics.

"I do not feel shame to say that in the last 5 years, our government is in KP and polio virus is being transferred from KPs headquarter Peshawar and the reason is that there are a lot of people came and go there from Afghanistan. In Karachi Gadap Union council have polio case, reason same that there are people from Quetta and other parts of the country came here. It is good less polio cases in Pakistan, but it does not mark the end of polio. If we can run the full campaign with the help of parents, polio virus will totally finish in 2019,” he said.

On the other hand, famous singers, musicians and United Nations Goodwill Ambassador for the eradication of Polio Salman Ahmad said polio has been eliminated all over the world. Nigeria, Afghanistan and Pakistan only three countries where polio cases are found, little efforts can become Pakistan a polio-free country.

In his message Salman Ahmed said that the good news for us is that there were very few polio cases remaining, in 2014, 306 cases was reported. He said about 100 workers most of them women were martyred during polio campaign. “We are just 6 cases away in making polio-free Pakistan. Prime Minister Imran Khan, federal and provincial governments, WHO,UNICEF and all stakeholders and especially in underdeveloped areas, polio workers who risk their souls are participating polio-free Pakistan campaign.”


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Improved security in Pakistan helpful in fight against polio, says WHO | The News International.

[October 25, 2018]

Murtaza Ali Shah writes:

PARIS: The World Health Organisation’s (WHO) Director of Polio Eradication Michel Zaffran has said that tackling the issue of polio has been made easier because of the fact that Pakistan’s security forces led a gallant fight against militants and improved security situation in the country which has helped campaign against polio – bringing the cases of polio to a single digit in a country of more than 210 million people.

At a conference here to mark the World Polio Day organised by Sanofi Pasteur, Michel Zaffran told The News/Geo that security situation on the side of Afghanistan remains a concern and that has impact across the border in Pakistan as there is fear that increase in polio cases in Afghanistan could lead to resurgence – and increase – in cases of polio in Pakistan. He said that Pak-Afghan border is porous and situation in Afghanistan is “less under control”. He said that improved security means that Pakistan has progress, numbers of polio cases are low and “Pakistan is on the right track” but risk factors remain there.

The event, held at Rue La Boétie, was attended via web links by experts from Africa, Asia, and Europe on the question of whether now is the time to stop polio eradication effort. Shahnaz Wazir Ali and Aziz Memon from Pakistan attended the discussion and provided updates from Pakistan.

When asked about the arrest of Shakil Afridi in Pakistan and the resultant issues, Michel Zaffran said that a lot of positive discussion took place in Pakistan and awareness was raised after mobilisation at big scale. He said that progress in fight against polio is possible with help from the people and “we are on the tack”.

He said that the targets achieved have been extraordinary and bringing polio to under single digit was no small task but it also means that “we still have to achieve a lot, together”.

David Loew, head of Sanofi Pasteur, said that the WHO is getting close to polio eradication with help from volunteers and international partners. He said polio is a dangerous disease which cripples children, puts them at disadvantages and kills many. He said the WHO had done a lot of work in achieving the targets. He said that his organisation and partners were committed to using everything in their power to ensure that campaign against polio continues.

Dr Roland Sutter, coordinator for polio research, policy and containment at the WHO, said that there is need to repeat vaccination over and over again. He said that polio workers battled challenges in many parts of the world and faced issues of various kinds. He said in many communities help of religious leaders have been sought to explain the importance of vaccination to local communities.

Dr Roland Sutter said that previous Pakistani governments provided full support to the WHO and now Imran Khan’s government has expressed full commitment in fight against polio. He said that Prime Minister Imran Khan has appointed Babar Bin Atta as a focal person to deal with the issue of polio. He said that Mr Atta will work as bridge between the government and aid agencies to ensure that the effort against polio remains on track. “Babar Bin Atta knows the issue well and has experience in the relevant area. H will provide link between political and technical sides. He will make sure action is taken is need at political level to highlight these issues. PM Khan has made strong statements to continue making efforts to make Pakistan polio free,” he said.

Dr Sutter said that recently two workers were killed in Quetta but “thankfully the Pakistani government increased the security of frontline workers ensuring that frontline workers are protected. In Afghanistan, polio volunteers can be the victims of bombings and attacks and attacks could also target people near and around them. There are sometime collateral victims. In Pakistan, security forces protect polio workers.”

He mentioned that situation in Pakistan has turned around a great deal from a point where people used to hide their children and didn’t like the idea of vaccination to now people understanding that vaccinating their children is good for them and will save their children from diseases.

“Now people trust us and let us administer polio, religious leaders and media played a big role and people are cooperating with us. Now polio cases remain only in Nigeria, Pakistan and Afghanistan."


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Large-scale genomic analysis reveals recurrent patterns of intertypic recombination in human enteroviruses | Virology.

[Open Access] [Received 20 April 2018, Revised 4 October 2018, Accepted 4 October 2018, Available online 23 October 2018]

Highlights.

* We analyzed 2949 publicly available human enterovirus/rhinovirus complete genomes/coding sequences for recombinations.

* Two prominent recombination hotspots exist at the 5′UTR-capsid junction, and at the beginning of the P2 region.

* In general, P2 was enriched in recombination events.

* Key phylogenetic groups implicated in recombinations are E71 and CVA6 (in EV A), E30 and E6 (in EV B), PV 1 & 2 (in EV C).

* Many events involve recombination partners that have not been sequenced yet.

Abstract.

Recombination is a driving force for the emergence, evolution and virulence/epidemics of viruses, comprising the Enterovirus genus of the Picornaviridae family, important for human and animal health. By analyzing 2949 complete genomes/coding sequences, we provide a thorough and up-to-date overview of the genome-wide patterns and hotspots of intertypic recombination between the genogroups of this genus. Two prominent recombination hotspots are identified/verified, at the 5′UTR-capsid region junction, and at the beginning of the P2 region. In general, P2 was enriched in recombination events. Key phylogenetic groups implicated in recombination events are E71 and CVA6 in Enterovirus A species, E30 and E6 in Enterovirus B species, polioviruses 1 and 2 in Enterovirus C species. In addition, many events involve recombination partners that have not been sequenced yet, thus strongly suggesting a large environmental reservoir of genetic variation with a high potential for the emergence of new modified pathogens by recombination.


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UNICEF Iraq Monthly Humanitarian Situation Report, September 2018 | UNICEF via ReliefWeb.

[24 Oct 2018] [Published on 30 Sep 2018]

Highlights.

• In advance of the new school year, learning environments were improved for 2,751 children (1,403 girls) in Anbar and Salah al Din as temporary tented learning spaces were upgraded to semi-permanent facilities and new classrooms were delivered. In addition, 17,200 new and repaired desks were delivered to schools in multiple locations in Ninewa and in Ramadi, Anbar.

• UNICEF supported activation of Education and WASH coordination structures in southern Iraq, to respond to continuing water scarcity challenges. In September, five water pumps were installed and are now operational in Basrah’s ‘R-Zero’ water project, with pumps helping to improve fresh water provision to parts of Basrah City Centre and surrounding districts. Water trucking for affected schools is being finalized to ensure no delays in opening schools for the new academic year.

• In September, 2,000 cases of diarrhoea were reported in Qadissiya Governorate; the local Directorate of Health (DOH) confirmed that no cases of cholera had been found. As immediate support, UNICEF dispatched 50,000 oral rehydration sachets (ORS) to the DoH.

• After agreements with the local authorities in Mosul City, Ninewa, UNICEFsupported water trucking continued in September on a smaller scale, with 39,700 individuals served in 10 neighbourhoods of the Old City.

September 2018.

4 million children in need out of
8.7 million people affected (OCHA, HRP 2018)

1.89 million internally displaced people (IDP)
4.07 million people returned to newly accessible areas (IOM, Displacement Tracking Matrix, 30 September 2018)

Target population in 2018
Rapid Response: 1,030,000 IDPs
WASH: 1.3 million people
Education: 450,000 children
Health: 1.2 million children (polio)
Child Protection: 186,300 children and caregivers

UNICEF Appeal 2018
US$ 101.2 million

Funding Status+
US $ 97.6 million

Situation Overview & Humanitarian Needs.

Water scarcity in the southern governorates of Iraq continues to be a concern. It is estimated that 25 per cent of the total population (around 1.8 million people) in 17 districts in the four most-affected governorates are critically impacted by water shortages. Low water levels in the main Shat Al-Arab river, and seawater incursion into the river, mean salinity has increased and water is increasingly undrinkable. This is compounded by severe environmental problems, including discharge of sewage and petro-chemicals directly into the river without adequate treatment.

These factors are making it extremely hard to secure safe drinking water. Between 12 August and 23 September, around 88,550 cases of gastrointestinal (GI) illnesses were recorded. Efforts to understand the cause of this outbreak have pointed to factors related to water quality and quantity, which has been decreasing significantly since June 2018 because of lack of snowfall in the previous winter, upstream demand, closure of feeder water sources and damming by neighbouring countries. In September, preliminary results of tests indicate presence of ‘Escherichia Coli’ in 50 per cent of cases. No other specific biological causes were identified as all cases show non-pathogenic organisms or normal rate of endemic pathogens. Given the scale and complexity of the situation, immediate needs include securing access to safe water, with specific need to ensure that the start of the school year is not delayed by lack of access to safe water, as well as supporting government surveillance and multi-sectoral coordination, access to health care, and awareness-raising on water safety. There is a need for short and medium-term measures to ensure safe water and preparedness for outbreak of waterborne disease as Iraq’s cholera season approaches, as well as longer-term approaches to address water scarcity.

More than four million people, including over two million children, have returned to their homes, while more than 1.8 million people, including one million children, remain internally displaced across the country. Around 62 per cent of the internally displaced people (IDP) are living in private settings and non-camp locations. Due to rates of return, in September the government closed Daquq IDP camp in Kirkuk and Khaldiyah camp in Anbar, causing movement of more than 860 families to retaken areas, host communities and other camps. In 2018, a total of 32 camps have been closed across Iraq, an indication of decreasing need for camp shelter, but of those remaining IDPs, nearly 29 per cent remain in camps (an estimated 522,00 individuals, 245,340 children), and nine per cent are living in critical shelter arrangements (an estimated 162,000 individuals, 76,140 children). Ninewa (51 per cent) and Dahuk (27 per cent) governorates host 78 per cent of IDPs living in camps.

More than four million people, including over two million children, have returned to their homes, while more than 1.8 million people, including one million children, remain internally displaced across the country. Around 62 per cent of the internally displaced people (IDP) are living in private settings and non-camp locations. Due to rates of return, in September the government closed Daquq IDP camp in Kirkuk and Khaldiyah camp in Anbar, causing movement of more than 860 families3 to retaken areas, host communities and other camps. In 2018, a total of 32 camps have been closed across Iraq4 , an indication of decreasing need for camp shelter, but of those remaining IDPs, nearly 29 per cent remain in camps (an estimated 522,00 individuals, 245,340 children), and nine per cent are living in critical shelter arrangements (an estimated 162,000 individuals, 76,140 children). Ninewa (51 per cent) and Dahuk (27 per cent) governorates host 78 per cent of IDPs living in camps.
The Iraq Ministry of Health (MoH) declared an outbreak of measles in September, and has requested support from UNICEF and the World Health Organisation (WHO) to activate a two-phase nationwide measles vaccination campaign targeting five million children between 9-59 months. The first phase took place in 10 governorates between 2 and 13 September, and data is being finalised at time of this report’s preparation. The second phase of the campaign, which will require direct UNICEF and WHO support, is scheduled to take place in January 2019.

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