Inside Africa: Getting Closer to a Polio-Free World
The fight to eradicate wild polio in the Africa region comes to an end after a three-decades-long international campaign to protect children from an “entirely vaccine-preventable disease.” The region was officially certified as wild polio-free in late August, though this does not include vaccine-derived polio. Even so, the certification is an important milestone for the global community looking to take out a disease that especially impacts children. Thousands of African children faced paralysis, sometimes death, after outbreaks of polio. It is a disease that does not have a cure but can be prevented through mass immunizations, which were made available after vaccines were developed in the 1950s. This is what the late South African President Nelson Mandela recognized nearly 30 years ago, spurring the “Kick Polio Out of Africa” campaign which drew international support.
Mandela saw that in 1966, approximately 75,000 children were paralyzed every year. It was a long journey to eradicate wild polio. Over the years, it was often “one step forward, two steps back” with positive steps forward including mass immunizations led by the international community followed by outbreaks in some areas of the region including Nigeria and Niger in the years 2000 to 2010. At this time, the number of yearly cases were starting to drop, indicating that Africa was on the right track to eradicate wild polio, but it would still be another decade before all the work would really pay off. In 2000, some of the first multi-country synchronized campaigns to administer the vaccine took place in Western and Central Africa. Thousands of volunteers came together to vaccinate more than 76 million children.
In 2003 though, a boycott against the polio vaccine due to safety concerns led to a massive outbreak that spread across 20 countries in five years. Africa led the following campaign to bring the virus back in check, finally getting rid of wild polio this year. However, as indicated by the 2003 outbreak, it can quickly get out of control again if the region does not remain on top of immunizations and allows the people to become complacent with its newfound wild polio-free status.
Polio has brought together the global community in a way that the world has not really seen before. The Global Polio Eradication Initiative is among the largest global health initiatives organized, including government entities and private and public donors from all over the world. The World Health Organization, Rotary International, the Center of Disease Control and Prevention, the United Nations Children’s Fund, and the Bill and Melinda Gates Foundation are among the major partners coming together to eradicate polio worldwide. With the GPEI, only two countries, Afghanistan and Pakistan, are considered endemic. The initiative has not only organized massive immunization and education campaigns, it has coordinated donations and investments from governmental bodies which are geared toward maintaining surveillance and other polio-eradication efforts. More than 200 countries continue to be involved in the efforts, contributing more than $4 billion in international investments. Middle- and low-income countries particularly benefit from these investments.
Since the GPEI was established in 1985, most of its donations have come from the G7 countries, Canada, France, Germany, Italy, Japan, the United Kingdom, and the United States, and the European Commission. These donations make up approximately 38 percent of contributions GPEI received. The private sector and non-governmental donors make up the next largest contributors at 34 percent. Other contributors include non-G7 donors, the multilateral sector, and other diverse funding sources which represent how many different groups internationally have taken an interest in eradicating polio. They fund surveillance programs and immunizations on a routine or “mop up” basis, cleaning up after outbreaks. These programs take place in other regions besides Africa, though many of the at-risk countries are in Africa, like South Sudan, Sierra Leone, Madagascar, Liberia, Equatorial Guinea, Guinea, and Kenya. These countries continue to have a lower level of surveillance and immunizations than other countries. Even with the wild-polio free status, these countries remain at risk without the same level of polio-eradication efforts because of gaps in immunization, which put especially children in danger of outbreaks imported from other countries or variations of polio not yet eradicated. West and Central Africa remain particularly at risk even now. Until these countries, as well as in other regions around the world, the global community also maintains a certain level of risk as the virus could be reintroduced if the proper precautions are not taken.
The international effort to eradicate polio is not just the desire to improve global health. The world can also see massive economic benefits. By eradicating polio, countries can save on healthcare costs associated with caring for those infected. It also increases the workforce as fewer children are paralyzed after contracting polio. In 2010, GPEI estimated the global community could see $40 to 50 billion in economic benefits if wild polio is “interrupted” within five years, justifying the $4 billion in investments the initiative has seen over the last several years. Preventing millions of children from contracting the virus means savings in treatment costs and increases in productivity. GPEI did not quite make the five-year goal, so the economic benefits may be less that originally projected. However, the progress made to eradicate wild polio, especially in Africa, has ensured some level of benefits will be seen. As Africa quickly makes its mark on the world as an emerging global economic force, these efforts ensure that the region is doing what it needs to be doing to best utilize its potential workforce.
It is important to emphasize that while the eradication of wild polio in Africa is an important step in eradicating the virus on a global level, vaccine-derived polio remains an issue even where wild polio has been handled. Last year, Kenya, Mozambique, and Niger experienced an outbreak of vaccine-derived polio, a rare strain of polio that does not pop up often, but when it does, it impacts areas where wide-spread vaccination has not taken place. Isolated regions with weak immunization campaigns remain at risk, keeping “Kick Polio Out of Africa” and GPEI efforts necessary for the time being.
