By Kemo Cham
Three decades after the World Health Assembly passed a resolution to eradicate wild polio virus in the world, Africa attained the milestone last week.
The World Health Organization (WHO) region, comprising 47 countries, was declared free of the most common strain of the virus that causes debilitating experiences for its victims, on Tuesday, August 25.
Prof. Rose Gana Fomban Leke, who chairs the African Regional Certification Commission (ARCC) for polio eradication, made the formal declaration, thus: “Today is a historic day for Africa. The ARCC is pleased to announce that the region has successfully met the certification criteria for wild polio eradication, with no cases of the wild poliovirus reported in the region for four years.”
WHO Africa Regional Director, Dr Matshidiso Moeti, presided over the declaration in a ceremony held via a zoom conference attended worldwide by participants that included the WHO Director General, Dr Tedros Adhanom Ghebreyesus and the President of Nigeria, Mohammadu Buari.
Nigeria was the last country on the continent to be declared free of the virus.
“This is a momentous milestone for Africa. Now future generations of African children can live free of wild polio,” said Dr. Moeti.
Polio, also known as poliomyelitis, is a highly infectious disease caused by a virus that attacks the nervous system and causing paralysis. Children are the most vulnerable to the disease.
The virus is transmitted from person-to-person mainly through faecal matter, making children under five years more susceptible to contracting it.
According to WHO, one in 200 infections of the polio virus leads to irreversible paralysis. And between five and 10 percent of all those who are paralysed by the virus die, according to the agency, as a result of their breathing muscles getting immobilised.
Like in almost all global pandemic or epidemic, Africa was one of the most affected by polio, a disease that once paralysed about 75,000 children on the continent every year.
There are two strains of the polio virus: the wild polio virus and the circulating vaccine-derived poliovirus (cVDPV).
The wild polio virus is further divided into three serotypes: Type 1, Type 2 and Type 3. Type 2 was declared eradicated in September 2015 and Type 3 was declared eradicated in October 2019, leaving Type 1, which is more virulent, as the only remaining wild poliovirus, which is now only present in Pakistan and Afghanistan.
In 1988, the World Health Assembly adopted Resolution 41.28, declaring a global crusade to eradicate the wild polio virus, as part of the larger goal of eradicating polio in the world, marking the launch of the Global Polio Eradication Initiative (GPEI).
The GPEI is championed by national governments, with support from WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC), UNICEF, and other key partners including the Bill & Melinda Gates Foundation and the Global Alliance for Vaccine and Immunization (Gavi).
The Africa region also launched its ‘Kick Polio out of Africa campaign. The late South African president and anti-apartheid icon, Nelson Mandela, launched that landmark campaign, 24 years ago in 1996.
Tuesday’s landmark achievement is a culmination of a lot of efforts and collaboration between African governments, local and international development partners and the people of the continent, said UN officials during the event.
Dr Ghebreyesus said the day represented a day for celebration and hope, pointing out that it held a lot of lessons and inspiration for the world to deal with other pressing public health issues like the ongoing Covid-19 pandemic.
“This is possible only with the power of collaboration,” he said in a live video address delivered from the WHO headquarters in Geneva.
UNICEF Executive Director, Henrietta H. Fore, described it as a “wonderful milestone” made possible only with collaboration among activists, governments and healthcare workers.
Also on the video link was Nigerian President Mohammadu Buari, who singled out health workers, among other partners that include the international funders, for praises for the achievement.
Nigeria was the last country in Africa to be declared polio free, leading to the certification ceremony for the continent last week.
The virus persisted in the country due to denial by religious extremists who have been waging war in the West African country.
As deadly as it is, Polio is a vaccine preventable disease. But Islamists in Nigerian made it difficult for children to be vaccinated. While the Boko Haram insurgency made it impossible for vaccinators to be deployed, some states operating under Islamic law in the northern part of the country refused children to be vaccinated, on the basis of public misconception that it is a western ploy to sterilise their women.
Consequently, after a major progress against the disease, an outbreak emerged in Nigeria in 2016 and subsequently spread to 20 countries in the next five years.
Mr Buari said he was happy that he didn’t have to pass on the problem to his successor.
"This certification is, therefore, a personal fulfillment of that pledge to not only Nigerians, but to all Africans,” the Nigerian leader said via video link from Abuja.
"It is heartwarming to note how the strong partnership between the Global Polio Eradication Initiative and Governments of African countries worked tirelessly and collaboratively to deliver this success," he added.
Amidst the celebrations, there were warnings that the war against polio was hardly over.
With Africa’s achievement, five of the WHO’s six regions, representing over 90 percent of the world’s population, have now eliminated wild polio.
Africa will still have to deal with the cVDPV strain, which causes the same symptoms as the wild polio virus and also infect people in areas where there is only partial vaccination.
WHO data show that as of last year, there were 320 cases of cVDPV across the Africa region. Experts are warning that this could rise in 2020 due to the ongoing coronavirus pandemic,
The 320 cases of cVDPV are in 16 African countries. Sierra Leone is not one of them, but its neighbor Guinea is. Also part of the list Angola, Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Côte d'Ivoire, the Democratic Republic of the Congo, Ethiopia, Ghana, Mali, Niger, Nigeria, Togo, and Zambia.
A country can only be certified polio-free when they go 12 months without any cases of the virus.
The onus is on everyone involved in the crusade “to work further until polio in all its forms is gone,” said Nigerian billionaire, Alhaji Aliko Dangote, who, alongside Bill Gates, where recognized among the hosts of philanthropists and campaigners for their support to the polio eradication cause.
Mr Gates re-emphasised the need to focus on eradication of the virus in its two remaining strongholds: Pakistan and Afghanistan.
Like Nigeria, religious extremism and unrests in the two Asian countries have prolonged the circulation of the polio virus in these two countries.
“Until Polio is gone everywhere, it can still come back,” said Gates, who pledged his continued commitment to global efforts to rid the world of public health issues, including polio.
“Eradicating polio should still remain a priority and it should be for African governments,” Gates, who made his fortune from computer manufacturing, stressed.
Polio is the second disease to be eradicated since smallpox 40 years ago in 1988.
The GPEI’s goal now is to stop the cVDPV strain, under its ‘Strategy for the Response to the Type 2 Circulating Vaccine-Derived Poliovirus 2020-2021’. The plan is to focused on working with affected and at-risk countries to control outbreaks across the continent.
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