African health leaders vow to keep polio eradication goal

Following a year in which Africa grappled with an escalating polio epidemic, ministers of health of the key affected countries today concluded that the spread of polio was slowing in most countries. They agreed to step up their vigilance and their vaccination programmes in order to meet polio eradication targets this year.

The 2005 eradication strategy for Africa, reviewed by Health Ministers of eight African countries at the World Health Organization’s headquarters in Geneva, involves a massive series of immunization campaigns across 25 countries, supported by strengthened polio surveillance.

The scale-up comes in the wake of a challenging year for the region, in which the number of African children stricken by polio doubled to 1037 (85 per cent of the global total). Cases began to rise during 2003 following a suspension of polio immunization activities in parts of Nigeria. The upswing rapidly reached epidemic proportions, propelled by low immunization rates across the region. The continent is further threatened by the swift spread of the epidemic in Sudan in late 2004 and the halt of immunization activities in Côte d'Ivoire due to civil unrest.

Some countries are still feeling the impact of the 2004 epidemic, particularly the Sudan, which went from zero to 112 cases in the last 9 months. The Sudan outbreak, which is a result of the spread of poliovirus originating in Nigeria, now threatens the polio-free Horn of Africa, the Democratic Republic of Congo, and the Gulf region as evinced by a recent case in Saudi Arabia. Authorities in the Sudan carried out an emergency campaign this week, which kicked off immediately after the signing of the North-South peace agreement.

Following resumption of polio immunization in Nigeria’s Kano state in mid-2004, Africa held the world’s largest series of immunization activities, synchronized across 23 African countries, reaching 80 million children. These campaigns have begun to rein in the epidemic. In northern Nigeria, independent monitoring shows that nearly 75 per cent of children were vaccinated against polio, the highest numbers ever for the area.

Côte d'Ivoire and the Sudan, as well as Burkina Faso, the Central African Republic and Chad now have re-established poliovirus transmission, meaning the virus has been circulating among the population for more than six months. Representatives of each of these countries attended the meeting in Geneva, together with Egypt, Nigeria and Niger.

Despite the setbacks, all the evidence looks promising for stopping polio transmission this year, the Ministers stressed. Similar mass campaigns previously stopped polio in nearly all countries across the region. Progress in Egypt eliminated all but one type of poliovirus, paving the way for the introduction of a new vaccine there that targets the single remaining type.

All the year’s activities will be lead by the African Union. At the upcoming African Union summit in Abuja (29-30 January) the continent’s heads of state are expected to announce a similar ramp-up of action and to vow to increase independent monitoring of immunization activities to ensure quality coverage.

The meeting in Geneva today was the one-year follow-up to the Geneva Declaration on the Eradication of Poliomyelitis, a 2004 pledge by polio-endemic countries to intensify their activities towards eradication. The 16-year Global Polio Eradication Initiative, a public-private partnership, has reduced the incidence of polio across the world by 99% since 1988. Endemic countries in Asia - Afghanistan, India and Pakistan - will examine their progress in a February meeting.

The Global Polio Eradication Initiative is spearheaded by WHO, Rotary International, the US Centers for Disease Control and Prevention and UNICEF. The polio eradication coalition includes governments of countries affected by polio; private foundations (e.g. United Nations Foundation, Bill & Melinda Gates Foundation); development banks (e.g. the World Bank); donor governments (e.g. Australia, Austria, Belgium, Canada, Denmark, Finland, Germany, Ireland, Italy, Japan, Luxembourg, the Netherlands, New Zealand, Norway, Russia, the United Kingdom and the United States of America); the European Commission; humanitarian and nongovernmental organizations (e.g. the International Red Cross and Red Crescent societies) and corporate partners (e.g. Sanofi Pasteur, De Beers).