Polio timeline towards global eradication
《 Click to see polio endemic countries and timeline.
11 August, which was last week, marked one year without any new polio case in African continent. So, is Africa free of polio? Well not so fast. It’s too early to bring the subject to a close.
Since World Health Assembly launched Global Polio Eradication Initiative(GPEI) in 1988, the number of polio-endemic countries dropped from 125 to 3 countries to this day, namely Nigeria, Afghanistan, and Pakistan. Has the progress been fast enough? The answer is no. It could’ve been faster and it should have. The initiative called for a total wipe-out of the disease by year 2000. Still 20 countries remained polio-endemic at the targeted date.
Even though it’s only 3 countries that are affected at this moment, poliovirus can break out anytime in now polio-free countries under the existence of poliovirus somewhere in the world. It can be imported from an infected country or be derived from the live virus from the vaccine in rare cases. The complete eradication followed by post-eradication effort can only stop the outbreak ever.
GPEI has developed the polio eradication and endgame strategic plan 2013-2018. The nice chart below is the timeline of the plan I retrieved from GPEI. The terms might be confusing, but stick with me I’ll explain.
- A break of war or social disruption. In 2013, Syrian crisis has displaced a large number of people and disrupted health programmes. Not only did it make the virus control difficult, it also allowed the virus to spread and reappear. Natural disaster could factor as well.
- Insufficient supply of appropriate vaccine or delay in distribution. Polio vaccine is fragile. In 2010, volcano in Iceland erupted. Among the grounded cargo due to cloud of ashes were 15 million doses of vaccine bound for West Africa. The risk was the fragility of the vaccine and the spread of the disease caused by the delay.
- Insufficient fund. The total amount of money that the 2013-2018 strategic plan requires is $5.5 billion. The contribution as of 2014 was $2 billion, which makes the funding gap of $3.5 billion. But the funding gap can be as low as $494 million if all the projection meets the demand.
For meeting each milestone and eventually achieving the goal, the role of governments in both polio-endemic and polio-free countries is crucial. Strengthening routine immunisation along with reliable surveillance all should be guided and well-maintained by national governments as well as independent bodies that monitor and advise on activities. With the effort, the number of infected countries fell to 3. But it’s not just about number 3. A number of potential cases of children paralysed by the virus can be prevented by the complete eradication. All the effort is worthwhile.
International development organisations and NGOs are all looking for effective interventions to alleviate chronic poverty in Africa. Is cash transfer headache or breakthrough?
No, we can’t just blame on lack of ownership for the failure if it had been -sort of- anticipated during the project building process.