#PolioOut
What’s the Chop?
In a momentous twist for public health in 2020, the African Regional Certification Commission has announced the eradication of Polio from Africa. But are we celebrating too soon?
I don’t know much about Polio.
Like our 2020 monster, it’s a virus that spreads from person to person. Unlike our 2020 monster, however, it is first contracted through contaminated food and water. The ‘wild poliovirus’ — as it’s called in medical circles — usually affects children under the age of five, and can often lead to permanent paralysis within hours of contracting it. A vaccine was first discovered in 1952, and as the Americas and Europe were being declared polio-free in the 1990s, it was coming into full force in Africa. In 1996 alone, it paralysed more than 75,000 kids on the continent.
To put it into perspective, if one child in a region has the poliovirus, every other unimmunised child in that region is at risk; so, the Africa Regional Certification Commission (ARCC) requires that over 95% of a population’s children be immunised for the virus to be considered eradicated.
Why has it taken so long to be eradicated in Africa?
The virus had petered out in most African countries by 2012/2013 — Nigeria and Somalia were the holdouts, and this was caused by a bunch of factors. For starters, there were many misconceptions about getting the polio vaccine — some people thought that it would lead to infertility or AIDS. Then, there was the massive problem of insecurity in both countries — terrorist activities by Boko Haram in Northern Nigeria and al-Shabab in Somalia made many regions harder to reach, and led to the displacement of thousands of people, complicating vaccination efforts. In fact, Boko Haram was actively anti-vaccination and took responsibility for killing ten polio-vaccine health workers in 2013.
Thanks to the work of so many NGOs, initiatives, and even polio survivors, which combined sensitisation with extending the coverage of their vaccination drives, no new cases of the poliovirus have been reported in Africa since 2016.
So, why aren’t we celebrating?
We don’t mean to put a dampener on this milestone. However, Polio hasn’t been eradicated from the world — the virus still exists in Pakistan and Afghanistan — and that makes its re-entry into Africa quite possible. Plus, even though the actual poliovirus has been declared ‘eradicated’, new cases linked to the vaccine have been reported in Africa.
Wait. You’ve lost me.
Vaccine-derived polio is literally as the name implies. It is contracted by children who haven’t been vaccinated from those who have. This is because like all vaccines, this one contains elements of the virus it is designed to combat, however, the oral version (unlike the injection) contains a live but weakened strain. And this oral version is what is used in lower-income countries because it’s cheaper and easier to administer. On the plus side, vaccine-derived polio is quite rare; the downside is, it is apparently as dangerous as the poliovirus. Cases have been recorded in 16 African countries, with 177 new cases this year alone.
Wow. So, what happens now?
Honestly, it’s more of the same things that have been happening over the past few decades, but on a more intensive level — education and sensitisation; and active vaccine drives to reach children in under-immunised regions. The WHO also has a rapid response team that is deployed when an outbreak is confirmed. Unfortunately, the arrival of COVID-19 has put a dent in that plan, because reduced access to unimmunised children heightens the risk of an outbreak.
Your Takeaway.
We are in the middle of a pandemic, so there’s certainly a lot that can be learnt from the era of the wild poliovirus. Clearly, there’s a potentially long road ahead, even after a vaccine is discovered — the threat of multiple strains, and the work to get the vaccine to all corners of developing nations and curb the spread. The unfortunate likelihood is that poor countries may be at the lower end of the ladder when Western-developed vaccines are rolled out; it is therefore up to our governments to develop holistic and effective response strategies in advance. Ultimately, however, this achievement is also a brilliant reminder that these things — pandemics, epidemics, the polios, the coronas, the 2020s — will not last forever.
What can I do?
Try not to get COVID-19 fatigue; continue to follow the necessary guidelines — wear your mask, maintain social distancing, wash your hands regularly. Evidently, these viruses take a while to be fully eradicated.
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