Brief History of Polio on the African Continent
The African Region was officially certified wild poliovirus-free on August 25, 2020. The Centers for Disease Control and Prevention (CDC) has been the lead implementing partner for the United States’ efforts to eradicate polio for three decades, playing a critical role in assisting African countries and the continent in reaching this milestone.
According to a WHO statement, “The last case of wild poliovirus in the region was discovered in Nigeria in 2016. Polio eradication efforts have saved approximately 180,000 lives and saved up to 1.8 million children from crippling life-long paralysis since 1996.”
Unfortunately, the battle against polio is not over. Another strain of the virus, type 2, is still circulating in 16 African countries, including Cameroon and Nigeria, and has paralyzed over 170 children this year. Polio outbreaks are more likely to occur in communities with unimmunized children and poor sanitary and hygiene conditions.
What is Polio?
Poliomyelitis (polio) is a highly contagious virus-borne disease that primarily affects children under the age of five. Wild poliovirus cases have decreased by more than 99% since 1988, from an estimated 350 000 cases in 1988 to 22 reported cases in 2017. More than 16 million people have been saved from paralysis as a result of the global effort to eradicate the disease.
The polio virus spreads primarily through the faecal-oral route or, less frequently, through a common vehicle (such as contaminated water or food) and multiplies in the intestine, from which it can invade the nervous system and cause paralysis. It infiltrates the nervous system and can cause total paralysis within hours. Initial symptoms include fever, fatigue, headache, vomiting, neck stiffness, and limb pain.
One in every 200 infections results in irreversible paralysis (usually in the legs). 5% to 10% of those who are paralyzed die when their breathing muscles become immobilized. While there is no cure for polio, the disease can be avoided by administering a vaccine. A fully immunized population will be protected against all types of polioviruses.
The Fight Against Polio
The World Health Assembly established the Global Polio Eradication Initiative (GPEI) in 1988 with the goal of eradicating polio by the year 2000. Polio was endemic in 125 countries at the time, paralyzing 350,000 children each year. To vaccinate children all over the world, the GPEI collaborated across borders, forming partnerships and task forces. With 400 million children vaccinated each year, the global number of polio cases has decreased by 99% since its inception.
In 1996, at the height of polio cases in Africa, Nelson Mandela rallied governments against the disease and launched the Kick Polio Out of Africa campaign. Since then, 9 billion doses of the oral polio vaccine have been distributed to children across the continent, and the African region was declared polio-free on August 25, 2020, after four years of no recorded cases of wild polio.
African nations have immunized hundreds of millions of children with polio vaccines, strengthened polio surveillance networks to detect any lingering traces of the virus, and implemented strategies to immunize hard-to-reach children, thanks to the dedicated efforts of health workers, traditional and religious leaders, parents, Rotarians, and country leaders.
Polio Eradication on the African continent
A significant milestone for polio eradication and global health is expected in 2020: the certification of the WHO African Region as free of wild poliovirus. In 2019, Nigeria, Africa’s last polio-endemic country, went three years without detecting wild poliovirus, paving the way for the official regional certification process to be completed.
The Africa Regional Certification Commission (ARCC) has accepted documentation from 43 African countries for wild poliomyelitis eradication, with Cameroon, Central African Republic, Nigeria, and South Sudan remaining. Once the WHO African region has been certified as having eradicated wild poliovirus, five of the six WHO regions – representing more than 90% of the world’s population – will be free of the virus.
Over the last few decades, tremendous progress has been made in polio eradication in the African Region. Africa’s polio response has been shaped by the region’s geographic size, cultural diversity, and logistical challenges, as well as insecurity, displacement, and pockets of vaccine refusal, driving innovative solutions to reach all children with the vaccine.
Conclusion
Today, the fight against all types of poliovirus continues. A rare vaccine-derived poliovirus is wreaking havoc on African countries with low immunization coverage, particularly in remote communities and those undergoing migration or conflict. Redoubled efforts are being made to eradicate all remaining vaccine-derived polioviruses on the African continent.