We can finish the job of Polio Eradication but, it will not be easy.
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This year, 2019, has been a challenging one for polio eradication. Though we have made incredible gains in recent years, the polio program has faced two critical challenges. First, an increase in wild poliovirus (WPV) cases in Pakistan and Afghanistan, the only two countries with detected WPV cases since 2016. And second, a large increase in outbreaks of circulating vaccine derived polio virus (cVDPV). The challenges present in Pakistan and Afghanistan that have led to an increase in cases include: low vaccination campaign quality, mobile populations, conflict and insecurity, bans on house-to-house vaccination in certain areas, and misinformation campaigns resulting in parental refusals. Weak routine immunization systems in communities around the world allows for the emergence of vaccine derived poliovirus and ongoing circulation. Outbreaks of cVDPV are now ongoing in 12 countries in Africa and Asia.
The polio eradication program has a history of adapting in the face of adversity and has used innovative strategies to ensure delivery of polio vaccines to children no matter the obstacles. For example, Nigeria detected four cases of wild polio in 2016 after two years of zero cases. In response, the program increased and improved vaccination campaigns and surveillance networks, implemented innovative strategies (e.g., market vaccination, cross-border points and outreach to nomadic populations) and strengthened routine immunization. Another example is the WPV outbreak that occurred in Syria and Iraq during 2013–2014. The importation of a poliovirus strain circulating in Pakistan resulted in 38 polio cases, including 36 in Syria and two in Iraq. Response efforts included the development and implementation of an integrated response plan for strengthening acute flaccid paralysis surveillance and synchronized mass vaccination campaigns by eight national governments in the Middle East. These efforts facilitated interruption of the outbreak within six months. The polio eradication program will use these lessons and others to respond to the increase in WPV and cVDPV cases.
Despite 2019’s challenges, we also celebrated major strides this year in the effort to rid the world of this incredibly debilitating disease forever. First, the Region of the Americas celebrated 25 years of being polio-free. Second, the certification of the eradication of wild poliovirus type 3 occurred– it is only the third virus that causes human disease to be eradicated. With both WPV types 2 and 3 eradicated, only wild poliovirus type-1 remains in circulation. These major milestones demonstrate the commitment and ability of the polio program to endure and adapt to challenges in the push to reach every child and end the scourge of polio forever.The tireless efforts of health workers, local governments, volunteers and global partners have contributed to preventing more than 18 million cases of paralytic polio and saving the lives of over 1.5 million people. As efforts continue to eradicate polio, these numbers will only increase further and ensure that no child ever needs to face polio again.
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