Conflict zones pose final threat to eradicating polio

A Pakistani health worker gives polio vaccine to a child at a neighborhood of Lahore, Pakistan, in 2015. (Credit: AP Photo/K.M. Chaudary)

Health organizations have all the right weapons to eradicate polio, but can’t deploy them because of wartime conflict in Nigeria, Pakistan and Afghanistan – the last three countries affected by the disease.

Two years ago, the World Health Organization (WHO) declared Nigeria – along with the rest of Africa – to be polio-free. This year, however, health officials there detected the resurgence of a strain of the poliovirus similar to that which plagued Nigeria back in 2011.

“This strain of polio has been circulating for five years,” said Centers for Disease Control and Prevention Director Tom Frieden at a polio event on Tuesday in New York. “It was lurking in areas where we did not have access, year after year. … Without the ability to know what’s happening, we can’t stop it.”

The three new cases of polio in Nigeria were discovered in children living in the northeast region of the country, Borno state, which the Islamic militant group Boko Haram has largely cut off from the rest of the world. According to NPR, it was only after military offensives by the Nigerian army that health officials were able to enter Borno state and find the three children paralyzed by the disease.

Health officials have since launched a massive campaign to vaccinate millions of children across four countries in West and Central Africa. But this year’s events have raised alarm that conflict zones are preventing complete eradication – which had seemed realistic for the last several years – from being achieved.

“I have to admit, when I was running for director-general of the World Health Organization, that I promised I would do my best to eradicate polio,” said the WHO’s Director-General Margaret Chan at Tuesday’s polio event. “I did not deliver.”

Chan added that this was, in part, why she ran for a second term in 2012. Still, over the course of her time in office at the WHO, the world has made enormous strides in vaccine coverage for the virus.

“Progress in eradicating polio is one of the greatest success stories of the past quarter century,” said Chan, adding that polio cases have decreased by 99 percent worldwide since 1988.

Before the disease resurfaced in Nigeria in August, there had been fewer than two dozen polio cases in 2016, contained to Pakistan and Afghanistan. For its part, Nigeria has gone from the country responsible for half of the world’s polio cases in 2012 to no cases by 2014.

Experts say vaccination efforts now need to be as diligent as ever if we are to see the end to polio in the last affected regions. A major challenge is that people fleeing conflict zones are likely to end up in areas where the wild virus exists, making it difficult for public health officials to know exactly where to target a response.

It will also be critical to continue detecting polio in the environment, health officials say, since only one in 200 people infected with the polio virus will develop the tell-tale symptoms of paralysis.

Three strains of the poliovirus have been found in the world; Type 2 and Type 3 are believed to be eradicated. In the effort to eliminate the disease completely, intensive vaccination campaigns are underway in Nigeria and will soon start in the neighboring countries of Chad, Niger, Cameroon and the Central African Republic to prevent further spread of the disease.

Lisa is attending U.N. Week as a United Nations Foundation Global Issues Press fellow.

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Lisa Nikolau

Lisa Nikolau is a Madrid-based reporter for Humanosphere, covering gender equality, indigenous rights and poverty in Latin America and worldwide. Find her on Twitter at @lisanikolau, email lisa.nikolau@humanosphere.org or see her latest work at www.lisanikolau.com