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All of Africa Finally Declared “Free” of Wild Polio

by DailyHealthPost Editorial

Through decades of hard work and countless sacrifices, Africa has finally been declared free of wild polio, according to the Africa Regional Certification Commission!

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In a year dominated by news surrounding one particular disease, it’s easy for mainstream media to ignore or gloss over other medical and disease-related news. But this polio news is too big of a victory to ignore. The World Health Organization may have gotten some flack over their handling of the coronavirus pandemic but theirs’ and other organizations’ contribution to the eradication of wild polio cannot be understated.

What exactly is polio?

Polio or poliomyelitis is a virus that attacks people’s nervous systems. It easily spread from person to person, usually through contaminated water. As a neurological virus, it often leads to paralysis and in some cases – death if the paralysis affects the victim’s breathing muscles. 

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There are no effective cures for polio so the burden of defeating the disease fell on vaccines. Fortunately, good and very cheap vaccines with no significant side effects were effective enough to rid the continent of the disease. Most of the time polio affects children under five so it was important for kids all across the continent to be vaccinated as soon as possible.

There were three naturally-occurring strains of the polio virus with two of them already eradicated – one in 1999 and one in 2012. The last, strain called “wild polio” is the one that was also defeated recently with Nigeria being the last African country to finally defeat the virus.

Wild polio still exists worldwide, however, as Afganistan and Pakistan still have recorded cases. Until wild polio ceases to exist anywhere in the world, countries worldwide will still be at risk of contracting the disease again.

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There is a fourth strain of the virus too, which is vaccine-derived polio. There are 177 cases of it in Africa at the moment but this virus is different from the wild polio virus. It’s a polio virus that mutated from the oral polio vaccine and can spread through under-immunized communities.

This is the only significant side-effect of the wild polio vaccine but it pales in comparison with the millions of people who’ve suffered from wild polio until now. Since 1996 the oral wild polio vaccine has prevented an estimated 1.8 million cases of wild poliomyelitis.

How was this success achieved?

The fight against polio started all the way back in 1952. Since there was no cure, the first vaccines for the virus were developed back then by Dr. Jonas Salk. In 1961, Albert Sabin pioneered the oral wild polio vaccine that’s been used almost everywhere around the world to this day. 

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In the early days of spreading the vaccine, the progress was slow. By 1996 there were still 75,000 paralyzed children across all of Africa. It was then that Nelson Mandela launched the “Kick Polio Out of Africa” program. This program was crucial as it helped to mobilize millions of health workers all across Africa to go from one village to the next, delivering vaccines by hand.

The program was backed by many groups and institutions around the time, many of which had been working against the polio virus for decades before Mandela’s program was created. Since then, the fight against polio has become the biggest public-private partnership for public health in the world. 

A huge contributing factor, especially over the last decade, came from polio survivors who’ve worked tirelessly to inform their communities about the dangers of this virus. 

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Misbahu Lawan Didi, president of the Nigerian Polio Survivors Association says that survivors of the disease have played a huge role in convincing their countrymen of just how important the vaccine is.

“Many rejected the polio vaccine, but they see how much we struggle to reach them, sometimes crawling large distances, to speak to them,” Misbahu said. “We ask them: ‘Don’t you think it is important for you to protect your child not to be like us?'”

There were a lot of setbacks since 1996, most of them due to misinformation from religious leaders and anti-vax movements, as well as terrorist groups. Slowly but surely, however, health workers continued working and risking (and often losing) their lives to spread the vaccine to the most remote places on the continent. 

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Why did it take so long?

There are many problems when it comes to vaccinating an entire continent – some were clear and ever-present, others came quite unexpectedly and also slowed the progress.

The key issue was that many communities in Africa were very distant and difficult to reach. Not only that but even after going there, health workers often had problems convincing people why the vaccine was important.

Aside from these expected difficulties, the numerous insurrections, military coups, changes in government and policies, and so on, also contributed to the slowing of the progress. For example, several years ago Nigeria had gone through 2 years with no recorded polio cases. However, the Islamic Boko Haram insurrection in 2016 cut off a large portion of the country from health workers which made delivering the oral wild polio vaccine impossible for a long time. This, in turn, meant a new spike in polio cases and made Nigeria the last country in the continent to be officially cleared of the virus.

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Similar conflicts around the continent also contributed to the problem. The Boko Haram insurrection alone had displaced over 2 million people, making it even harder for health workers to do their job. 

Still, they persevered. 95% of the frontline were women and they managed to navigate the conflict areas through mountain routes or by boat through lakes and rivers such as Lake Chad. This allowed them to slowly but surely deliver the vaccine to even the most remote communities.

Even outside militant insurrections, mere rumors and misinformation also made the vaccinations more difficult. For example, in 2003 a number of Muslim religious leaders in Kano and other northern states declared that the polio vaccine included “anti-fertility agents”, designed to make Muslim women infertile. They believed this was an American plot to reduce Muslim communities. Extensive laboratory testing by Nigerian scientists dismissed the false accusations.

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Nevertheless, the damage was already done and the rumor persisted for over a decade. In 2013 nine female health workers who were vaccinating kids in health centers in Kano were killed in two separate shootings. Both incidents were credited to Boko Haram.

Because of many other problems like these, the vaccination efforts have taken over half a century – much more than they needed to. Still, this year’s success is to be celebrated.

Is polio gone forever?

As we’ve seen in recent years, anti-vax movements are fully capable of resurrecting long-gone and deadly diseases with nothing more than a Twitter account. So, technically, even if and when wild polio is defeated worldwide, there’s still going to be a danger of resurgence. But we’re not even there yet.

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With wild polio still actively spreading in Afganistan and Pakistan, a reemergence in African or other countries worldwide can be as easy as one tourist taking a trip there. That’s exactly what happened in Angola in 2005, for example. Despite the civil war that was still raging in the country at the time, health workers managed to defeat the disease in 2001, only for it to return from an unknown foreign source four years later. This is very much why institutions like the World Health Organization reaffirm that it’s very important for the vaccination efforts to continue. That, plus continuous surveillance efforts is the only thing that can prevent the reemergence of any strain of the poliomyelitis virus.

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