Global, Collective Efforts Necessary To Eradicate Polio Once And For All, Say WHO Officials

By Nour Salman AMMAN/GENEVA, (UrduPoint / Pakistan Point News / WAM - 24th Oct, 2019) World Health Organisation, WHO, officials have said that global collaborative efforts by governments and civil society are necessary to reach a polio-free world.

Michel Zaffran, Director of the Global Polio Eradication Initiative, GPEI, at WHO, said, "Polio is a highly infectious and epidemic-prone disease, and it will not stay confined, it cannot be controlled."

"It must be eradicated completely; otherwise it will keep spreading to re-emerge in countries which are already polio-free," he added.

Zaffran made his remarks on World Polio Day, marked annually on 24th October.

WHO recognises that failure to adopt strategic approaches to eradicating polio could lead to as many as 200,000 new cases of the virus inflicting individuals per annum. "We know from mathematical modelling that failure to eradicate polio now, would lead to the global resurgence of the disease, and within ten years, we would again see 200,000 children paralysed all over the world, each and every year," the GPEI Director warned.

"This would be a humanitarian catastrophe that must be avoided at all costs," he stressed.

When asked to comment on what needs to be done to avoid a resurgence of poliomyelitis, Zaffran told the Emirates News Agency, WAM, "The good news is that we have all the tools at our disposal to eradicate polio, and countries still affected by the disease are really intensifying their efforts. It’s within our own hands to achieve success."

Wild poliovirus now circulates only in parts of Pakistan and Afghanistan. This World Polio Day, the Global Commission for Certification of Poliomyelitis Eradication, GCC, is expected to declare poliovirus type 3, WPV3, as globally eradicated.

Commenting on this announcement, Hamid Jafari, WHO’s Director for Polio Eradication in the Eastern Mediterranean in Amman, Jordan, said, "This is a tremendous achievement," adding that this is the second of the three types of wild poliovirus to have been globally eradicated.

"Only wild poliovirus type 1 remains in circulation, in just two countries worldwide," Jafari told WAM. "Africa has not detected any wild poliovirus of any type since September 2016, and the entire African Region is eligible to be certified free of all wild poliovirus next June," he added.

The eradication of WPV3 "shows us that the tactics are working, as virus types and their individual family lines are being successfully knocked out," Jafari enthused.

He went on to note that new strategies are helping reach the most vulnerable populations, particularly in the remaining reservoir areas. "New tools, including a brand-new vaccine, are being developed, to ensure the long-term risk of vaccine-derived polioviruses can be comprehensively addressed," he continued, adding, "But these tools and tactics only work if they are fully funded, and fully implemented."

When commenting on WHO’s collaboration with partner countries, Jafari said, "We continue to work with all countries to try to address infectious disease threats, and ensure strong health systems, all with the aim of achieving Universal Health Care."

He then highlighted UAE efforts in eradicating infectious diseases, particularly in conflict areas, adding that collaboration, engagement and support of partners such as the UAE is "crucially important".

Commenting on the Emirates Polio Campaign underway in Pakistan, Jafar said, "The support of [the] UAE remains critical for the vaccinators to reach children in some of the most insecure areas of Pakistan."

Jafari added, "It shows what can be achieved when governments and civil societies work jointly together towards a common cause."

"The polio programme has really shown that every child can be reached, with enough political and societal will. That is the nature of an eradication effort: you have to reach every single child; otherwise, you will not succeed," he affirmed.

Jafari went on to reiterate that tools and tactics to eradicate polio are available, "but they only work if they are fully implemented and fully financed."

This November, the ‘Reaching the Last Mile Forum’, hosted by His Highness Sheikh Mohamed bin Zayed Al Nahyan, Crown Prince of Abu Dhabi and Deputy Supreme Commander of the UAE Armed Forces, will take place in the nation’s capital, Abu Dhabi.

Events like the Reaching the Last Mile Forum are "so critical to the global effort [to eradicate polio]," Jafari said, adding that it is "really a chance for the global community to recommit our collective efforts to a polio-free world."

Through on-the-ground efforts in Pakistan, and the UAE’s commitment to assistance GPEI and Gavi, the country is working to eliminate polio globally. Sheikh Mohamed bin Zayed has personally committed US$168.5 million to global efforts to eradicate polio.

"Together," Jafari added, "the partners of the Global Polio Eradication Initiative - WHO, Rotary International, the US Centres for Disease Control and Prevention, UNICEF, the Bill and Melinda Gates Foundation and Gavi, the Vaccine Alliance – stand ready to support this global effort."

According to UNICEF, 19.4 million children under one year of age worldwide did not receive the three recommended doses of the DTP vaccine in 2018. That is the equivalent of one in ten children, a core issue in the fight to eradicate polio.

When asked to comment on what are the causes that stall global vaccine coverage rates, Zaffran said, "There are many reasons why children are not vaccinated against diseases such as polio.

"It could be related to lack of infrastructure, lack of planning, inadequate vaccine management, vaccine hesitancy, insecurity, and hard-to-reach populations."

"Poliovirus does not care about any of those reasons; it is just very good at finding the unvaccinated child. But we have to care because it allows us to target our outreach strategies in the most effective manner possible," he explained.

While in-roads have been made in strengthening routine immunisation coverage, through cooperation with various partners, "more needs to be done," Zaffran stressed.

He added, "We are increasingly working with routine immunisation programmes to address low vaccination coverage rates, particularly among the most vulnerable communities."

"If we know what the real challenge is, in a given area, then we can put in place area-specific operational plans to overcome those challenges. And that is what we are trying to do," the GPEI Director continued.

Zaffran went on to provide an example of a response conducted to a polio outbreak in a very remote area in Papua New Guinea last year. He explained that in addition to implementing the outbreak response, the Papua New Guinea Government, with partners such as Gavi - The Vaccine Alliance, WHO and UNICEF, decided to use the outbreak response as an opportunity to reinvigorate the routine immunisation programme.

"In other words, to actively address the very root cause which led to the outbreak in the first place," he explained, adding that lasting infrastructure was put in place, building on efforts deployed to respond to the outbreak.

"This is really becoming the model for how outbreak response will be run going forward," Zaffran noted.

When asked to comment on social stigmas that may prevent the immunisation of children, Zaffran said, "For the most part, I would say that vaccine acceptance levels by parents in the remaining endemic countries is very strong."

According to the GPEI Director, in Pakistan, less than 1.5 percent of parents refuse vaccination. "That does not mean that we are reaching 98.5 percent of children. But it does mean that if a child is missed, it is probably due to other operational reasons, rather than vaccine hesitancy or resistance issues," he explained.

"If you compare such rates to Switzerland, where I am based, hesitancy rates are approaching 10 percent," he said, noting that even if individuals do not see the effects and dangers of the disease, it is "a dangerous mistake to make" to not undertake the necessary precautions.

"We have all the tools needed," Zaffran reiterated. "It’s up to us to mobilise the necessary political and societal will to overcome any barrier to reaching every last child, no matter where they live."