by Ryan Hyland
Rotary's goal of ridding the world of polio is within reach, global health experts said during the 2021 World Polio Day Online Global Update on 24 October. The 30-minute program, "Delivering on our Promise of a Polio-Free World," provided encouraging information about the progress and remaining challenges in the fight to end polio.
So far in 2021, only two cases of wild polio have been reported --- the lowest circulation of the disease ever --- with one infection each in Afghanistan and Pakistan, the two countries where polio remains endemic.
During a Q&A session, Dr. Hamid Jafari, director for the World Health Organization's Eastern Mediterranean Region, several factors. He said these include mass polio vaccination campaigns resuming after the interruption caused by the COVID-19 pandemic, the natural immunity induced by the wild polio outbreaks of previous years, and the restrictions on travel and population movement that also were due to the pandemic.
"This is truly unprecedented that we are seeing this decline simultaneously in the two countries," Jafari said.
He added that the low case count provides a window of opportunity for health workers, but cautioned that a resurgence of the poliovirus is possible since summer is the high polio transmission season. "So this is the time to really press hard in making use of the opportunity that presents itself now," he told Q&A host Jeffrey Kluger, editor at large for Time magazine.
Jafari also addressed the challenges of political change and security concerns in Afghanistan and explained that the polio program there is used to adapting operationally during uncertainty. "Currently we do see opportunities coming up as well, so that we may have access to all parts of Afghanistan for implementing mass vaccination campaigns," he said.
According to the WHO and UNICEF, nationwide house-to-house polio vaccinations will resume in Afghanistan in early November, providing access to children in areas where campaigns had been banned for the last three years.
"You know with the evolving situation in Afghanistan, it is of course very, very important that we partners maintain our neutrality and impartiality of the polio eradication program," Jafari added. "As always, we will continue to work with all parties."
Mohammad Ishaq Niazmand, chair of Rotary's Afghanistan PolioPlus Committee, echoed Jafari's sentiments in a video address with his counterpart for Pakistan, Aziz Memon.
Niazmand said of Afghanistan, "Rotary and our partners are working with all stakeholders to ensure that polio eradication remains a top priority, even in the midst of change. Work is underway to ensure that children have access to lifesaving polio [vaccines] and other childhood vaccines."
Memon, a Rotary Foundation trustee and chair of the Pakistan PolioPlus Committee, said Rotary continues to build trust with government, community, and religious leaders. "By bringing broader health services to children and families alongside polio vaccinations, we're ensuring better health care and greater vaccine acceptance," he said.
Strategies for the future
This year, the Global Polio Eradication Initiative (GPEI) announced a new five-year strategy for 2022-26 to end all polioviruses, including tackling the persistent transmission of circulating vaccine-derived poliovirus. Rotary and our GPEI partners identified the remaining obstacles to polio eradication and developed approaches to reaching the goal. The plan aims to achieve and sustain a polio-free world through a focus on implementation and accountability while using innovative methods and tools.
This is truly unprecedented that we are seeing this decline simultaneously in the two countries.
Dr. Hamid Jafari\ Director for WHO's Eastern Mediterranean Region
The emphasis will be on decreasing the response time to any outbreak, increasing vaccine demand, increasing access to health care and vaccines, transitioning toward government ownership of vaccination programs, and improving decision-making and accountability.
"Some of the most polio-endemic communities are also the ones that suffer from [a] lack of basic health and civic services," Jafari said. The goal, he said, is a "better alignment and integration with other basic health and civic services in a way that the polio program is seen as a more integrated approach to vaccination."
He added that in some communities, children are still missed because of gaps in the way vaccination campaigns are conducted or because of vaccine hesitancy. "This new strategy speaks to engaging the communities with new approaches, new strategies, partnering with communities, [and] building new alliances with these communities," Jafari said.
The World Polio Day program featured global health experts addressing the new strategy's tactic of broadening distribution of a new vaccine to address outbreaks of cVDPV2, a circulating vaccine-derived poliovirus. This novel oral polio vaccine type 2 (nOPV2) protects children against polio while being more genetically stable and less likely to regain strength and cause the vaccine-derived polio. It has already been introduced in several African countries, including Benin, Chad, Liberia, Niger, Nigeria, Republic of the Congo, and Sierra Leone.
This novel oral polio vaccine "is a powerful example of the polio program's innovation to overcome the toughest challenges," said Simona Zipursky, senior adviser to the polio director of WHO. "Partners, scientists, and leaders from around the world made nOPV2 possible. This is the kind of collaboration that will help end polio for good."
This year's program included a powerful video of polio health workers in Afghanistan and Pakistan, as well as Rotary members sharing their World Polio Day projects and events to raise awareness for polio eradication.