Billions of dollars to eradicate polio

As the world adapts to the idea of ​​coexisting with the coronavirus for the foreseeable future, the World Health Organization is planning to eradicate another tragedy that has already been going on for thousands of years. Poliovirus..
global Polio The Eradication Initiative, a public-private partnership led by governments and health organizations, announced on Wednesday a $ 5.1 billion plan to eradicate polio by 2026.
Polio can paralyze or even kill people who suffer from polio. For decades, this initiative has sought to achieve a polio-free world by immunizing all children against the virus, but with limited success.
Many countries have dealt with sporadic outbreaks of polio before the emergence of the colonavirus, but pandemics have brought about some. Polio vaccination program It stopped for at least a few months, exacerbating the trend. The number of polio cases in 2018 was 138, compared to 1,226 last year.
There was also a nice news. In August, African countries were declared free from wild poliovirus and left Afghanistan. Pakistan It is the only country where polio is endemic. And in November World Health Organization Gave the first emergency permit to a new person vaccine It promises to minimize the occurrence of polio.
“It’s time to stop the spread and ensure that we can achieve a polio-free world,” said John Bertefille, director of the Polio Eradication Branch. Centers for Disease Control and Prevention, Is one of the partners of the Global Initiative.
Previous efforts to eradicate polio have been hampered by lack of funding and lack of political commitment.
Vertefeuille said the new strategy includes policies aimed at increasing political involvement while taking pandemics into account. It includes two important goals: integrating polio programs with other health care programs and focusing on areas with chronically low immunization rates. The plan also outlines communication strategies to ensure vaccine supply and increase vaccine acceptance.
Planners consulted with more than 40 civil society organizations, academic institutions and donors to help eradicate polio and integrate it with other health issues.
Attempts to engage local communities who are hesitant or even hostile to vaccines are “easy to say and difficult to carry out, but at least in my opinion it is heading in the right direction,” the study said. Dr. Walter Orenstein, Deputy Director of the Center, said the former Director of the Emory Vaccine Center America‘Vaccination program.
Orenstein was optimistic about the new strategy as a whole, especially about the tactics of combining polio with other health programs to gain political support.
“Eradication is a very strict goal. One infection is too many,” he said. But the new plan “clearly shows that they are taking into account the lessons learned.”
From March to July last year, polio vaccination campaigns were suspended in more than 30 countries, resulting in an increase in unvaccinated children and an increase in vaccine-derived polio epidemics.
Currently widely used oral polio vaccines contain attenuated viral strains. Children immunized with this vaccine can transfer the virus to the environment via feces. From there, it can infect unprotected people. When the virus is transferred from an unvaccinated person to another, genetic alterations can return it to a form that can cause paralysis.
About 90% of polio epidemics are the result of poliovirus induced by this vaccine. In 2020, more than 1,000 cases were detected in 29 countries. This is a much higher number than usual. The new oral vaccine, introduced in November, is designed to stabilize the virus more genetically and is believed to minimize the risk of vaccine-induced cases.
“This is not a silver bullet that solves all of our problems. For the vaccine to work, we still need to reach people,” said Simona Zipulsky, WHO adviser on polio eradication. I am. “But we feel that it really helps to stop these outbreaks sustainably.”
The new vaccine is approved for emergency use only, and qualified countries need to work on monitoring its safety and efficacy. It has already been distributed more than 20 million times.
The initially devastating wild poliovirus epidemic now occurs only in Pakistan and Afghanistan. Since 2018, vaccination campaigns have missed about 3 million children in Afghanistan. Taliban Prohibition of home-to-home vaccination. Most of the outbreaks in Afghanistan in 2019 and 2020 occurred in these regions.
“Understanding how they can be accessed through dialogue with them remains an important focus of the program,” Vertefeuille said, referring to the Taliban.
In Pakistan, the Pashto-speaking community near the Afghan border makes up about 15% of the country’s population, but more than 80% of wild-type polio cases. Since 2018, the number of cases has increased due to the hesitation of vaccines and false information disseminated through social media.
“These problems have certainly been around for a long time. With the suspension of Covid-19, the number of cases increased fairly dramatically and very quickly,” Vertefeuille said.
The polio eradication program focuses on immunizing hard-to-reach communities in both countries and training older female healthcare professionals who have successfully convinced caregivers to vaccinate their children.
The global initiative has set up two teams to respond to outbreaks within 72 hours. One is in the eastern Mediterranean region (composed of 21 countries, including Pakistan and Afghanistan), and the other is sub-Saharan. AfricaThis strategy also includes the Minister of Health in the eastern Mediterranean region, requiring governments to focus on polio from peers rather than from global health organizations.
“Eradication remains a top priority for health,” said Dr. Faisal Sultan, Pakistan’s Special Assistant to Health. “We look forward to working with our international partners to create a polio-free world.”
Nigeria, another country where polio is endemic, was declared eradicated in June last year after tackling some of the same challenges. The involvement of political leaders at all levels of government, including having grandchildren vaccinated on television, has turned the tide.
In order to revive polio as a top priority, despite competing health issues in these financially difficult countries, authorities have said that programs to quell polio are also to stop Covid-19 and other illnesses. It emphasizes that it can be used. Just in case”.
During the coronavirus pandemic, more than 31,000 polio workers in more than 30 countries watched Covid-19, tracked contacts, distributed supplies for hand hygiene, medical personnel and frontline workers. Focused on training.
In Pakistan, the Polio Institute has provided coronavirus testing and sequencing, and the polio phone line has become a national information center for information about Covid-19. Polio workers trained nearly 19,000 health care workers and hired 7,000 religious leaders and 26,000 influential people.
In Nigeria, healthcare professionals tracked Covid-19’s healthcare needs using data systems and analytics configured for polio. Polio employees were equally helpful during the Ebola epidemic in Nigeria.
In Pakistan and Afghanistan, polio vaccination was bundled with the distribution of other vaccines and other health essentials such as vitamin A and anthelmintic tablets. Children vaccinated against polio are too young to receive the coronavirus vaccine, but polio workers can combine vaccination efforts with the delivery of the Covid-19 vaccine.
At the same time, the turmoil over the Covid-19 vaccine is affecting polio vaccination campaigns, said Melissa Corkum, senior manager of UNICEF’s polio outbreak response. “We spend more time teaching and communicating with parents and caregivers at the front door,” she said.
In Nigeria, the first country to introduce the new polio vaccine, vaccination campaigns “launched almost in parallel with the deployment of Covid-19. In fact, they took place on the exact same day in slightly different regions. It may have happened, “said Zipursky.
Polio workers faced many questions and concerns about the two vaccines and emphasized the need to have the right information in place. “It was a really good lesson.”