The Persisting Challenge of Polio EradicationMarch 6, 2014
Despite the persistent efforts by numerous global health organizations, statistics are proof that the world is not yet done with polio. Although the crippling virus has been eliminated from most countries around the world, stubborn pockets remain. According to reports from WHO’s Global Polio Eradication Initiative, the disease remains endemic in three countries – Nigeria, Pakistan and Afghanistan. In April 2013, the group issued a detailed report on steps they were taking to eliminate polio “for all time” by the year 2018. The comprehensive vaccination and monitoring plan is slated to cost around US $5.5 billion.
Still, 2018 is a few years away and in the meantime, this highly infectious disease persists. The burning question that is being asked is why the cure has remained elusive despite all the efforts that have been done.
It is important to remember there is no known cure for polio. This is an infectious disease and the only solution is prevention by vaccination. With these two those factors in mind, the only way to eradicate polio is to vaccinate enough children so that the poliovirus has no place to go.
Vaccines are the answer and though it seems like a simple, effective and affordable solution, the challenge lies in identifying, locating, and then reaching people of all ages who have not yet been vaccinated. This is proving to be more difficult than it appears. In several areas where polio still exists, highly mobile groups, such as nomadic livestock herders spread the disease as they travel from place to place. The dynamics involved in identifying, locating and reaching the source in such cases is very complicated. Add to it political unrest and armed conflict and this creates complex situations that makes access by vaccine workers at times dangerous, difficult and more often than not, just impossible. Such conditions are prevalent in parts of all three countries where polio still exists, making efficient vaccine delivery almost impossible. Public health infrastructure can also be spotty, if it exists at all.
Because each area presents a distinct set of obstacles, detailed and customised solutions need to be worked out for each individual situation. These strategies would need to include partnerships with community groups, local authorities, various local non-governmental organizations (NGOs) and traditional leaders. All of these are time-consuming endeavours in these countries where foreign aid workers are typically eyed with suspicion.
Setbacks on the Radar
Against the backdrop of all these issues, the setbacks in Somalia and Kenya show how far and how quickly poliovirus can travel. It also demonstrates how important it is to maintain high levels of immunity within populations. Strong surveillance is crucial to halt its spread.
According to Dr. Hamid Jafari, director of the Global Polio Eradication Initiative, setbacks can be expected to happen as long as the virus is alive, it will continue to move and when it lands in areas where sanitation and immunisation are not put in place, that is where obstructions usually take place. The key is being prepared to deal with the setbacks, while continuing to move forward. Both of these initiatives require funding and dedicated healthcare workers who are committed to the cause of global polio eradication.