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From the front line: fight against polio stalls as cases in Afghanistan double | The Telegraph.

[24 OCTOBER 2018 4:15PM]

Ben Farmer writes:

rogress in eradicating polio worldwide has stalled because of difficulties vaccinating children amid insurgent violence, according to a frank review of the global effort to end the crippling virus.

While the virus has been rolled back over the past 30 years to only three countries, hopes of finally stamping it out in Afghanistan, Pakistan and Nigeria are so far thwarted by insecurity.

An 80-page external review commissioned for the Global Polio Eradication Initiative said cases in Afghanistan had more than doubled from last year as violence has worsened. The number of children beyond the reach of vaccinators because of Taliban or Islamic State group obstruction has jumped.

“Access limitations due to insecurity continue to represent the biggest threat to polio eradication and progress towards interrupting transmission has stalled,” the report concluded.

“Afghanistan’s security situation is deteriorating, and the number of cases has more than doubled compared to this time last year.”

While sewage testing shows Pakistan has widespread circulation of the wild polio virus, the report said the government “isn’t acting decisively on these findings”. In Nigeria a large section of the country is Boko Haram-controlled and out of bounds, leaving health workers little idea if the disease is still there.

“Unless access constraints related to insecurity are effectively addressed, the global effort cannot succeed and there can be no confidence that polio has been eradicated,” the reports said.

Afghanistan has had 15 cases so far this year, up from six in the same period in 2017.

The reviewers, who were commissioned to tell campaign chiefs what was working and what need more focus, paid tribute to the dedication and bravery of lowly paid vaccination teams. But they found the August vaccination round in Afghanistan failed to reach 1.3 million children because of bans from insurgent leaders in Helmand, Kandahar and Uruzgan.

The virus has been brought to the brink of extinction since the global eradication push began in 1988, at a time when there were 350,000 annual cases in 125 countries. Last year there were 22 cases.

Yet after 30 years, the campaign was suffering fatigue and the bureaucracy that had grown up may be hampering efforts by deluging officials in the three countries with guidelines and requests for data.

The report said “Due to its character as a chronic, long-standing emergency, it is hardly surprising that the programme appears to have lost its ‘edge’ in some of these aspects.

“However, in the last minutes of such a long game, now is not the time to ease-off. The programme cannot become bogged down in process and bureaucracy.”

Imran Khan, Pakistan's new prime minister, said his government remained committed to wiping the disease out.

He said: “I am confident, together with our people, we will achieve a safer, healthier and polio-free Pakistan for our children.”

Dr Arif Alvi, Pakistan's president, urged the nation “to rise and end polio, once and for all”. 


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Why is it so important to eradicate polio? | World Health Organization Eastern Mediterranean Regional Office (WHO EMRO).

Why is it so important to eradicate polio?

Dr Ahmad Al-Mandhari, WHO Regional Director for the Eastern Mediterranean

Why is it so important to eradicate polio?

Since 1988, when the global goal was first agreed by the member countries of the World Health Organization, vast amounts of effort and money have been spent on the global mission to eradicate polio, to wipe the disease clean off this earth. So why is it so important for us to keep investing time and effort after so long?

I am part of a team of people dedicated to eradicating polio in WHO’s Eastern Mediterranean Region. Working with national governments and our partners in the Global Polio Eradication Initiative, we have gradually cleared polio from our communities until only a few pockets remain in Afghanistan and Pakistan. So far this year, wild poliovirus has paralyzed 22 children. While this number represents incredible progress compared to even a few years ago, it is 22 too many. Our goal is zero and anything else is unacceptable.

Getting to zero transmissions is exhausting, expensive, and often frustrating. It’s frustrating not just for those on the frontline, but also for national governments and for the global partners that have played a crucial role in this long struggle.

But if we abandon the fight now, one thing is certain: polio will come back. It will regain ground in our villages and towns and communities, everywhere that we have collectively made free of polio through hard struggle. It will spread across borders and through children’s bodies, twisting muscles and shriveling limbs. The number of paralyzed children will rise again, to hundreds and thousands crippled each year by a disease we could have stopped.

The eradication of smallpox is widely seen as humankind’s greatest public health achievement. The eradication of polio can and should share this honour. But the most difficult stretch is upon us, and the last mile is harder than anyone could have imagined in 1988.

We can only stop the transmission of polio once there is no unprotected child left to pass it to. That means immunizing every last child. Every. Last. Child.

It means reaching children in the most far-flung places and from the most vulnerable communities, and engaging and convincing parents to allow their children to be vaccinated, again and again. Health workers are doing an incredible job building trust with communities, but that takes time, effort and money. And while science has taken us a long way, eradication is an all-or-nothing goal and getting over the line depends on painstaking, hard-won access in some of the most challenging environments in the world.

Globally, we have a vast team of remarkable people working on these challenges. Our team includes health professionals, community health workers, government leaders, generous donors, religious leaders, strategists, communicators and negotiators.

They are all engaged in this difficult, costly work. But it is work we must do to finally eradicate polio, and it is work we cannot afford to leave undone. Future generations depend on us to finish the job.


Dr Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean

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Note to editors:

The Global Polio Eradication Initiative receives financial support from governments of countries affected by polio, private sector foundations, donor governments, multilateral organizations, private individuals, humanitarian and nongovernmental organizations and corporate partners. Full list of all contributors.


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PODCAST: The Inside Story of How India Eliminated Polio | UN Dispatch.

[October 24, 2018]

Mark Leon Goldberg writes:

The challenge was immense.

About twenty years ago, India accounted for over 60% of all polio cases worldwide — in fact it was considered a “hyper” endemic country. Then, the Indian government teamed up with the United Nations and other partners, including through the Global Polio Eradication Initiative, to tackle polio head on.

India’s vast population, its geographic diversity, and pockets of extreme poverty seriously complicated this effort. But the Indian government and its partners adapted, innovated and above all persisted until they could reach the very last child with the polio vaccine.

In 2014, India was officially declared polio-free. There has not been a single case of wild polio in India in over eight years. Today, only three countries remain polio endemic. And as of October, there were fewer than 20 wild polio cases worldwide in 2018.

The world is now tantalizingly close to the total global eradication of polio, and India’s success in defeating polio within its borders is a big reason why total eradication is within reach

Through interviews and archival material, this special episode of Global Dispatches tells you the story of how, against all odds, India eliminated polio.

This episode is produced in partnership with the the United Nations Foundation as part of a series that examines successes in multilateral cooperation to tackle great global problems.  Previous episodes in this series include how the world closed the hole in the ozone layer, and how the UN Peacekeeping Mission in Liberia successfully completed its work  in 2015. 

Listen to or download this episode via player embedded in source article. You can also subscribe on iTunesStitcher, and Spotify


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Somalia: Acknowledging Bold Steps taken – and needed – to Save Somali Children from Polio [EN/SO] | WHO and UNICEF via ReliefWeb.

[Published on 24 Oct 2018]

MOGADISHU, Somalia, 24 October 2018 – This World Polio Day, UNICEF and WHO are taking a moment to acknowledge the tremendous efforts made by the polio eradication workforce and partners over the last two decades in Somalia. By way of one recent example, UNICEF, WHO, health authorities and partners are working tirelessly to stop two concurrent outbreaks of vaccine-derived polioviruses that were confirmed late in 2017 in Somalia.

“Today, we face a persistent lack of access to children due to insecurity, population displacement driven by conflict and natural disasters, and a struggling health system, all of which have contributed to low immunization rates in children,” said Dr. Ghulam Popal, WHO Somalia Representative. “This has seen the emergence of polioviruses that are highly contagious and spread through poor hygiene. But a simple series of doses of the polio vaccine will protect a child for life.”

The theme for this year’s World Polio Day is ‘Bold Steps to End Polio’ which is exactly what Government and health workers are doing today: taking bold steps to control these outbreaks, ensuring all children have access to vaccines.

Somalia’s stakeholders are hopeful: they have seen the country stop polio outbreaks before and believe it can be done again.

“Every day, frontline workers are identifying children who need to be vaccinated, often in highly volatile areas,” said Steven Lauwerier, UNICEF Representative in Somalia. “They are knocking on doors in communities and visiting camps for the internally displaced to educate families on the benefits of polio immunization and to deliver vaccinations. These are the unsung heroes in the fight against polio.”

During the last immunization campaign, held nationwide earlier this month, the Government, alongside WHO, UNICEF and partners reached more than 2.6 million children with the oral vaccine. Polio teams are working hard to ensure children most vulnerable to missing vaccination are included in plans for the next nationwide campaign ꟷthat will run from 29 October to 1 November in Somalia. Boosting overall immunity of Somali children through multiple doses of the polio vaccine is the only way to stop the polioviruses currently in circulation.

As part of the response to the outbreaks, polio teams are reaching out to Somali communities and health partners for their support to look out for polio symptoms - including the sudden onset of floppiness and inability to move arms and legs - in children under 15 years of age. Children with these symptoms should be taken to the nearest health facility as soon as possible to receive timely attention.

WHO and UNICEF note that the biggest challenges to full coverage of the polio vaccine include ensuring all children from mobile and displaced communities are included in microplanning, improving overall hygiene in children, and reaching children in inaccessible areas. The likelihood that the current outbreaks of circulating vaccine-derived polioviruses can survive in areas where there is low immunization uptake and lack of sanitation is high. As such the Government, WHO, UNICEF and health partners are calling for unimpeded and safe access to be able to vaccinate all eligible children in Somalia. Everyone has their own role to play in ending polio in Somalia.

Note to editors: See http://polioeradication.org/news-post/vaccine-derived-polioviruses/ for additional information on circulating vaccine-derived polioviruses.

About UNICEF.

UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. Across more than 190 countries and territories, we work for every child, everywhere, to build a better world for everyone.

Follow UNICEF on Twitter https://twitter.com/unicefsomalia and Facebook https://www.facebook.com/UnicefSomalia/

About WHO.

The World Health Organization is a specialized agency of the United Nations whose vision is the attainment by all peoples of the highest possible level of health.

About GPEI.

The Global Polio Eradication Initiative, is a public-private partnership led by national governments and spearheaded by the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC), and the United Nations Children’s Fund (UNICEF) working towards a future where no child will ever again be paralysed by polio.

For more information, please contact:
Dheepa Pandian, Chief of Communication, UNICEF Somalia
Email: dpandian@unicef.org
Mogadishu Cell: +252 613375885 WA: +1-917-318-1624

Leilia Dore, Communications Officer, WHO Horn of Africa
Email: leiliadore@gmail.com
Cell: +44 7521499274

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Pakistan: Battleground Polio – dealing the final blow! | The News International.

[October 24, 2018]

Babar Bin Atta writes:

World Polio Day observed 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.

Few ideas have greater gravity than the eradication of a human disease – just as people now live free from the fear of smallpox, so a polio-free world is within our grasp. 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. 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 indomitable courage of our polio workers who brave the odds in the face of often unfriendly and at times intimidating conditions in some areas finds no precedent elsewhere in the world. Nothing could dampen the spirit of these angels of hope who continue to spread light at every doorstep-unfazed, undeterred. These men and women represent the true spirit of Pakistan-a nation of the resilient, courageous and determined.

It is heartening to see that today as we observe the World Polio Day, 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.

I must say that of all the factors that continue to take the polio programme towards achieving its goal, the most important is resolute commitment from the highest level to those on the frontlines and a firm belief that it can be done and that no one other than us will do it. We must take key decisions including those that are critical and bold on the road to realising our goals.

Polio Eradication Initiative is a partnership in which contribution of each stakeholder has played an important role in taking the programme forward. Today on the occasion of World Polio Day I would like to pay tributes to all partner agencies who have provided sustained support and continue to stand by us as we forge ahead in this noble cause. We have come a long way when the Pakistan Polio Eradication Programme began about 25 years ago when polio was a raging epidemic. The virus paralysed up to 20,000 vulnerable children each year. 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. The number may seem insignificant in comparable terms, but in the current stage of disease eradication, even a single case is enough to reverse the gains of the past. And this, Pakistan can ill-afford.

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. When we succeed, no child will ever be needlessly paralysed by polio ever again, making it only the second human disease after smallpox to be eradicated in history, every parent and every citizen is our soldier in taking the fight to the virus.

Well planned, timely, high quality vaccination campaigns are being carried out by the programme in order to reach Pakistan’s most vulnerable children with essential vaccines. These campaigns are carried out by teams of highly committed frontline polio workers, including vaccinators, which we call Sehat Muhafiz or guardians of health. There are upto a total of 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; this needed to protect them against the crippling polio virus.

At the heart of this success, however, is the support, commitment, and collective conscience of parents, caregivers and communities. These allies always open their doors to ‘Sehat Muhafiz’ teams and ensure that their children receive the necessary polio vaccine drops. By fulfilling their dutiful responsibilities as parents and citizens, they have been key players in creating an environment in which the polio can no longer thrive or debilitate our nation’s youth. There is no limit to how many times these drops can be administered as the vaccine is safe, universally accepted, and the only means for prevention of polio.

The cause also enjoys the support of Pakistan’s doctors, religious scholars, and tribal leaders who have been instrumental in educating our citizens on the need to vaccinate against polio and other diseases such as measles and tetanus.

I call upon fathers, mothers, and caregivers to ensure that two drops of the safe and effective polio drops are administered to their children. There is no limit to how many times this drop can be administered as it is safe, universally accepted, and the only means by which to prevent the poliovirus from affecting your child. Despite major gains, it is too early for us to celebrate as the final battle is yet to be won. As long as the virus circulates, all of our nation’s children are still very much at risk of contracting polio. Having been assigned the task of the leading fight against polio to victory by none other than Prime Minister Imran Khan.

Let me say that the 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.

The author is Prime Minister’s Focal Person on Polio Eradication.


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Polio experts 'owe it to the children of the world' to wipe out the disease | The Telegraph.

[23 OCTOBER 2018 10:10PM]

Anne Gulland writes:

Any let up in the fight against polio risks a resurgence of the disease, leading to hundreds of thousands of cases of the deadly virus every year across the globe, one of the world's leading polio experts has warned.

Michel Zaffran, director of global polio eradication at the World Health Organization, told a press conference in advance of World Polio Day on October 24, that the world had never been so close to eradicating the disease, which used to kill and disable hundreds of thousands of children every year.

So far this year there have been just 22 cases of wild poliovirus in Afghanistan and Pakistan, down from a high of more than several hundred thousand cases a year in the 1980s.

“We are extremely close to eradicating wild poliovirus,” said Dr Zaffran. “When we started in 1985 there were over 125 countries where wild poliovirus was endemic and it was causing close to 300,000 cases of paralytic disease every year. We have reached a stage where we are closer than ever before to eradicating the disease.

He added that it was important to chase down the last few cases in order to wipe out the disease for good.

“If we were to stop the effort now and no longer strive to eradicate the wild virus we could see hundreds of thousands of cases every year. We owe it to the children of the world to finish the job,” he said.

Next year, Africa is due to be declared free of wild polio if no new cases are found in Nigeria, the last country in the region to report cases. The last case of the disease was reported in Borno State in the north of the country in 2016.

Ibrahima Koné, technical officer for polio eradication and routine immunisation at Unicef, said that poor security and access had forced Nigeria to be creative in its eradication efforts.

“One example is a strategy called hit and run – as soon as there’s a window of opportunity vaccinators take advantage and rush to the area to vaccinate as many children as possible,” he said.

However, four countries in Africa have reported vaccine-derived polio cases this year: Nigeria, Niger, Somalia and Democratic Republic of the Congo.

When a child is vaccinated the vaccine-virus replicates in the gut, generating an immune response. The vaccine is then excreted and, very rarely, can mutate and spread to other children, especially where vaccination coverage is low. This can then result in outbreaks of polio.

Last week scientists told the Telegraph that polio could not be declared eradicated if cases of the vaccine-derived virus were still circulating.

Dr Zaffran said that it would be "pretty odd" to declare Africa polio free if children are still being paralysed by the vaccine-derived form of the virus.

“But it could still be the case that at the end of next year or early the following year Africa is free of wild poliovirus,” he said. “I hope that the efforts we have already put in place in Democratic Republic of Congo and the Horn of Africa will have succeeded in stopping these outbreaks we currently have because normally they do not last for too long,” he said. 

Syria experienced an outbreak of vaccine-derived virus last year, with more than 50 cases  of the disease.

“In Syria we had a pretty aggressive set of campaigns which interrupted circulation of the disease in four to five months despite the war. In Somalia we have children who are not accessible in some areas but I believe that we should be able to address these current outbreaks,” he said.

Roland Sutter, coordinator of WHO's polio research, policy and containment team, said that cases of vaccine-derived polio were “a big concern”.

But he added: “The key is achieving very high immunisation coverage in the affected populations just like we would with wild poliovirus.”

Attacks on vaccinators, a lack of security and mistrust have hampered the final eradication efforts in the last two countries reporting cases, with Helmand and Kandahar provinces in Afghanistan proving particularly difficult, said Dr Zaffran.

“Afghanistan is facing tremendous difficulties, however the country and all communities are fully committed to eradicating the disease,” he said. “We need to gain access – consistent access  to children in all parts of the country. The surveillance system is extremely good and as soon as we know the virus is circulating, if we are able to access the area we go and vaccinate.”


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From polio victims to polio eradicators, on the frontlines of Pakistan’s battle against polio | GPEI.

[23/10/2018]

Polio frontline workers ensure that no child is left behind during door-to-door immunization campaigns.

For some of these workers, the cause of polio is very personal. They have been paralyzed by polio themselves, and today, they are the greatest champions and advocates of polio vaccines within their communities.

On World Polio Day, meet Rozi, Ashfaque and Bushra who are ensuring that no child succumbs to polio as they did.

Rozi Ahmed– Permanent Transit Point Supervisor, 31 Chaman, Kila Abdullah, Balochistan.


Rozi Ahmed, 31, is using his exemplary tale as a polio victim to convince refusal parents to vaccinate their children. @whopakistan/Saima Gul

​“I was only a year old when I contracted polio virus. The infection was almost immediate and within two days,I was paraplegic and also lost  function of one of my arms. Afterwards, my parents took me to several doctors and “mullahs” (religious scholars), but the disease was irreversible.

Being a person with disability, studying in a regular government school was too much of a hindrance in terms of physical accessibility. Consequently, I dropped out of primary school because I felt the environment was not inclusive for people like me.  Residing  near the Pakistan-Afghanistan border, the Friendship Gate, I would always notice the workers administering polio drops at border. As inspiring as it was to see their commitment to vaccinate hundreds of children every day, I noticed a lot of parents rejecting the vaccination as well. Seeing this, I resolved to work as a polio worker myself to raise awareness about the disease and the vaccination itself.

Today, I, along with 40 other workers at the Permanent Transit Point (PTP), vaccinate children every day. I hope that by doing so, my own example will serve as a cautionary tale for the parents and the larger community. I would not wish this disease on any child, which is why I am determined to end polio.”


Rozi Ahmed, 31, vaccinating a young girl at the Friendship Gate PTP. @whopakistan/Saima Gul

Ashfaque Naveed- Area Supervisor, 31 Pawakai, Peshawar, Khyber Paktunkhwa.


Ashfaque Naveed, 31, from Khyber Pakhtunkhwa is a committed worker in fight against polio. @whopakistan/Muhammad Shoaib

“Belonging to rural Khyber Pakhtunkhwa (KP), the polio vaccinations were not considered vital for a child’s health owing to misconceptions and myths. I was only a year old when polio virus left me paralyzed in my right leg. As a result, I could not walk or play like the other children.

Growing up, I was always on the outside looking in as I was never able to perform routine tasks with ease. Most of all, I was shunned by the community for being disabled. Determined to change my circumstances, thanks to my supportive family, I was able to get special corrective equipment and went on to not only stand on my own feet, but also completed by Bachelor’s degree.

I quickly jumped on the opportunity to work as a Social Mobilizer in the Polio Eradication Initiative. Since then I have sought to only vaccinate children, but also sensitize parents and the community about the irreparable dangers of polio and the importance of vaccinating all children under the age of five. I hope to see Pakistan rid of polio within my lifetime.”


Ashfaque Naveed, 31, from Khyber Pakhtunkhwa is a committed worker in fight against polio. @whopakistan/Muhammad Shoaib

Bushra– Union Council Polio Officer, 34 Lahore, Punjab.


Bushra, 34, determine to end polio to secure the future of children from permanent disability. @whopakistan/Anum Khan

“The biggest fear in a parent’s life is seeing their child falling sick. One of my legs were paralyzed due to polio at just three months old. Since then, it has been an ordeal for my family and I.

Growing up, I was left out from sports, and being an avid sports fan, the experience was very isolating for me. The community members, my teachers, and fellow students often pitied my condition. These unfortunate circumstances made me all the more determined in fighting polio within my community.

For the past three years, I have been working as a Union Council Polio Officer in the Polio Eradication Team. Although the polio programme has made tremendous progress, the biggest threat to this programme is the lack of awareness and convincing parents is a big challenge. By now, I have vaccinated hundreds of children, and I will continue to do so until we wipe off polio from within our country and communities.”


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Nigeria: World Polio Day - What Nigeria Needs to Do to Eradicate Scourge - WHO | Premium Times via allAfrica.

[24 OCTOBER 2018]

Nike Adebowale writes:

As Nigeria joins the rest of the world to observe the World Polio day, the World Health Organisation (WHO) has called for heightened surveillance

if the country is to be certified polio free by the year 2020.

In a statement issued to mark the day, the WHO Regional Director for Africa, Matshidiso Moeti, said it would be a disaster if the region fails to be certified because of poor surveillance performance.

The World Polio Day is observed on October 24 every year.

Poliomyelitis is an infectious disease that affects mainly children and causes paralysis of the limbs. Nigeria reportedly had more than half the world's cases in 2012 creating a lot of panic which prompted a swift response.

Polio is preventable by administering the polio vaccine over a period of time. The disease is spread from person to person through ingesting fecal matter or food and water containing the fecal matter.

In up to 70 per cent of polio infections, there are no symptoms but gradual development of muscle weakness leading to paralysis.

In June this year, the Minister of Health, Isaac Adewole, said the disease remains a threat in Nigeria as over 100,000 children are yet to be immunised in the North-eastern part of country,

Mr Adewole said this is largely due to the Boko Haram insurgency that makes some areas inaccessible to health officials.

He however noted that Africa has made remarkable progress towards eradicating poliomyelitis.

To back up his claims, Mr Adewole said in 2012, the African region reported 128 wild poliovirus (WPV) cases, which accounted for more than half of the global burden.

"But in 2013, only about 76 cases were reported; 2014, about 17cases and no case was reported in 2015.

"Nonetheless, in 2016, after almost two years, four cases were confirmed from areas that were under Boko Haram insurgency in Borno State in Nigeria and the outbreak was successfully contained," he said.

The last case of Wild Polio Virus (WPV) was reported 24 months ago in Monguno LGA, Borno State, until few days ago when a polio virus type 2 was discovered in Bauchi State.

Adamu Ningi, the WHO Bauchi State coordinator, said that the polio virus type 2 was found at Gwallaga mosque area linking three wards of Makama B, Hardo and Dankade.

This keeps Nigeria on the list of polio endemic countries as some areas in the North-east remain inaccessible to the polio programme.

Nigeria as at 2016 was on the verge of being certified polio-free by the World Health Organisation before new cases were reported.

This has stalled the certification of Nigeria as polio-free. Before a country is certified free, it has to have recorded no case of polio for three consecutive years.

Mr Moeti said new cases of polio have dropped by more than 99.9 per cent since the launch of the Global Polio Eradication Initiative (GPEI) nearly 30 years ago.

He said, the figures have dropped from 350,000 cases every year in more than 125 affected countries, to 22 wild polio cases in 2017 in two affected countries.

Mr Moeti noted that the African region has reached an important milestone towards eradication, as it has been two years since the last case of wild poliovirus.

He however said that until polio is completely eradicated, all countries remain at risk of outbreaks.

He said, "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," he said.

He urge all countries - whether they have had a case of polio or not, to recommit to strengthen surveillance urgently.


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Video: WHO World Polio Day 2018 | GPEI


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Micro-planning for immunization in Kaduna State, Nigeria: Lessons learnt, 2017 | Vaccine.

[Open Access] [Received 21 March 2018, Revised 24 August 2018, Accepted 5 October 2018, Available online 23 October 2018] [In Press, Corrected Proof]

Abstract.

Background.

The OPV 3 coverage for Kaduna State, 12–23 months old children was 34.4%. The low OPV 3 coverage, due mainly to weak demand for routine antigens and the need to rapidly boost population immunity against the disabling Wild Polio Virus (WPV), led the Global Polio Eradication Initiatives (GPEI) to increase supplemental OPV campaigns in Kaduna State, despite the huge cost and great burden on personnel. The OPV campaigns, especially in high risk (low vaccine uptake, <80% OPV 3 coverage and high vaccines refusal rate) states of northern Nigeria with poliovirus transmission has resulted in overestimated denominators or target population, as the highest ever vaccinated is used to set OPV campaign targets.

Methods.

We utilized a cross-sectional study that assessed the impacts and possible solutions to the challenges of overestimated denominators in immunization services planning, delivery and performance evaluation in Kaduna State, Nigeria. We used both descriptive and quantitative approaches. We enumerated households and obtained the target populations for routine immunization (<1 year), polio campaign (<5 years) and acute flaccid paralysis surveillance (<15 years).

Results.

We found a significant difference in mean scores between the micro-planning and supplemental vaccination data on a number of <5 years (M = 102967, SD = 62405, micro-planning compared to M = 157716, SD = 72212, supplemental vaccination, p < 0.05). We also found a significant difference in mean scores between the micro-planning and projected census data on a number of <1 year (M = 26128, SD = 16828, micro-planning compared to M = 14154, SD = 4894, census, p < 0.05).

Conclusion.

Periodic household-based micro-planning, aided with the use of technology for validation remains a useful tool in addressing gaps in immunization planning, delivery and performance evaluation in developing countries, such as Nigeria with overestimated denominators.


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Poliomyelitis era in Trinidad from 1940 to 1972 and beyond: Implications for effective global health governance for its eradication | Journal of Family Medicine and Primary Care.

[Open Access] [Year : 2018 | Volume : 7 | Issue : 4 | Page : 664-670]

Abstract.

Background: Acute poliomyelitis (APM/polio) is a viral infection caused by the polio virus that continues to have a fascinating social and economic impact on countries throughout the world. Humans acquire the virus by close personal contact with transmission occurring through the fecal–oral route. The majority of poliovirus infections results in no illness or produces only self-limited symptoms, however in approximately 5% of infected patients flaccid paralysis of the limbs can occur and 1% can die. Although APM is no longer a feared disease mainly due to the development of effective vaccines, its eradication remains elusive.

Methods: The aim of this study is to review the historical impact of APM in Trinidad. A retrospective analysis of all cases occurring from 1939 to 1972 was undertaken. Data for the study were derived from two sources the Annual Statistical Reports of the Ministry of Health 1972–2000 and the epidemiological publications of the League of Nations Health Organization and the World Health Organization. 

Results: There were four outbreaks of APM in Trinidad 1941, 1942, 1954, and 1972. After the final outbreak in 1972, APM was eradicated not only from Trinidad but also all the countries of the Americas mainly through the effective use of the oral polio vaccine. 

Conclusion: Polio has brought together international agencies, governments, and the people to build an effective public health system around a common vision for health and wellbeing. The polio eradication and endgame strategic plan represents a major milestone in polio eradication developed by global polio eradication initiative. The initiative would still benefit from adopting some of the best practices in governance from other organizations in the global health sector.


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Persistent circulation of genotype D coxsackievirus A2 in mainland of China since 2008 | PLOS One.

[Open Access] [Received: June 28, 2018; Accepted: September 6, 2018; Published: September 20, 2018]

Abstract.

Coxsackievirus A2 (CV-A2) has emerged as an important etiological agent in the hand, foot, and mouth disease and herpangina pathogen spectrum because of its high global prevalence. In the present study, we investigated the evolutionary dynamics of CV-A2 circulating in China. We analyzed a total of 163 entire VP1 sequences of CV-A2, including 74 sequences generated from the present study and 89 sequences collected from the GenBank database. Phylogenetic analysis based on the entire VP1 nucleotide sequences confirmed the persistent circulation of the predominant genotype D in mainland of China since 2008. Cluster analysis grouped the sequences into two distinct clusters, clusters 1 and 2, with most grouped under cluster 2. After 2012, cluster 1 was gradually replaced by cluster 2. Results of Bayesian Markov chain Monte Carlo analysis suggested that multiple lineages of genotype D were transmitted in mainland of China at an estimated evolutionary rate of 6.32×10−3 substitutions per site per year, which is consistent with the global evolutionary rate of CV-A2 (5.82×10−3 substitutions per site per year). Continuous transmission and evolution of CV-A2 resulted in the genetic polymorphism.


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