Botswana begins massive emergency polio campaign

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The Minister of Health of Botswana today kicked off a massive emergency immunization campaign in the southern African nation of Botswana, following the re-introduction of poliovirus into the country from Nigeria in February. Prior to this, polio had not been seen in Botswana since 1991. This campaign is deemed critical to protect the country's children from further spread of the poliovirus.

"The massive effort being launched in Botswana today is testimony to Africa's commitment to getting polio eradication back on track and ending this terrible disease," said Jonathan Majiyagbe, President of Rotary International, addressing the Washington Press Club today. "Just eight years ago, in 1996, polio paralyzed more than 75 000 children across the continent. Last year, fewer than 500 cases were reported in Africa." Rotary International is one of the four spearheading partners in the Global Polio Eradication Initiative, and the first with a vision of a polio-free world.

From 10 to 14 May, approximately 2 600 vaccinators, district and national health supervisors and volunteers in Botswana will be involved in immunizing almost 200 000 children under the age of five years against polio. A second immunization campaign will take place from 14 to 18 June. UNICEF and the World Health Organization in Botswana are supporting the Government of Botswana, by supplying the oral polio vaccine, mobilizing communities, training health workers and ensuring that the refrigerated 'cold chain' equipment is in place to safely transport the vaccine to the children.

"The government has given priority to the campaign and has committed both human and financial resources - a total of US$ 1.2 million, of which US$ 710 000 is from the government," said the Botswana Minister of Health, Hon Lesego Motsumi, at the launch of the campaign. "I look forward to the day when no child in Botswana will be at risk from the life-long physical disability and mental anguish associated with this terrible paralytic disease."

Botswana stopped conducting mass polio immunization campaigns in early 2000, after recording its last polio case in 1991. This latest effort comes in response to a child infected on 8 February this year by a virus genetically traced to northern Nigeria. Botswana is the ninth previously polio-free country in Africa to become re-infected in the past 18 months, due to an ongoing outbreak of polio originating in northern Nigeria.

Despite the progress in Africa, Jonathan Majiyagbe of Rotary warned that the ongoing outbreak from Nigeria was a setback, and needed to be urgently stopped if polio is to be eradicated once and for all. "Importations such as we have seen in Botswana will continue to happen until polio is eradicated everywhere," he said.

The Botswana campaign comes one week before Majiyagbe will travel to the World Health Assembly in Geneva, to attend a meeting of the spearheading partners and health ministers of the remaining endemic countries, including Nigeria. Discussions will focus on strategies for stopping the outbreak and transmission of the virus in all endemic countries.

As US$ 25 million has already been spent on emergency campaigns in response to importations, further funds will be required in addition to a US$ 130 million funding gap the Initiative faces, for activities through 2005.

The Global Polio Eradication Initiative is spearheaded by the World Health Organization, Rotary International, the US Centers for Disease Control and Prevention and UNICEF. The poliovirus is now endemic in only six countries, down from over 125 when the Global Polio Eradication Initiative was launched in 1988. The six countries with indigenous wild poliovirus are: Nigeria, India, Pakistan, Niger, Afghanistan and Egypt.

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, France, Germany, Ireland, Italy, Japan, Luxembourg, the Netherlands, New Zealand, Norway, the Russian Federation , 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. Aventis Pasteur, De Beers). Volunteers in developing countries also play a key role; 20 million have participated in mass immunization campaigns.

Poliomyelitis ("polio") is a viral paralytic disease. The causative agent, a virus called poliovirus, enters the body orally, infecting the intestinal lining. It may proceed to the blood stream and into the central nervous system causing paralysis and muscle weakness.

Polio may be spread through contact with feces or through airborne particles. The first effective polio vaccine was developed by Jonas Salk, and inoculations of children against polio began in Pittsburgh, Pennsylvania on February 23, 1954. Through mass immunization, the disease was wiped out in the Americas, although it recently has re-appeared Haiti, where political strife and poverty have interfered with vaccination efforts. [1]

Young children who contract polio are likely to suffer only mild symptoms, and as result they may become permanently immune to the disease. Hence inhabitants of areas with better sanitation may actually be more susceptible to polio because fewer people have the disease as young children. People who have survived polio sometimes develop additional symptoms, notably muscle weakness, decades later; these symptoms are called post-polio syndrome.

The first medical report on poliomyelitis was by Jakob Heine in 1840. Karl Oskar Medin was the first to empirically study a poliomyelitis epidemic in 1890. The work of these two physicians has led to the disease being known as the Heine-Medin disease.

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