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Celebrating victory: The story of how Egypt defeated the polio virus, once and for all

© Pirozzi/UNICEF Egypt/2005
Doses of Oral Polio Vaccine (OPV) are dispensed at Health Centres and clinics.

By Serene Assir, 3 March 2008
Cairo, EGYPT

For the past two years, Egyptian children have reaped the massive benefits of an intensive, collective effort to render the country polio-free. Though efforts to defeat the infectious virus were ongoing for decades, it was not until recent years that the struggle to overcome the disease once and for all came to a head.

“When I was a child, practically every school in Egypt’s vulnerable areas had at least one boy or girl who suffered polio-induced paralysis,” said Dr Ibrahim Barakat, Executive Manager for the Egyptian Ministry of Health’s Expanded Programme for Immunisation, adding that polio was endemic here for 3,000 years. “That this is no longer the case is a dream come true.”

While reported cases in the early 1990s were still in the hundreds, by 2002 the number had been crushed to seven. Then in 2004, there were none. The last sample of the virus to be found in the environment through the now routine sewage surveillance was in January 2005. Egypt has been clear since.

According to Barakat, it was a combination of international support and a fundamental change in strategy in Egypt that led to the transformation and eventual success of efforts to overcome the disease. Following the turn of the millennium, UNICEF, WHO, USAID, Rotary International and the Government of Japan worked together to provide, each in their own, mutually enforcing way, financial and technical support to the Government of Egypt.

As for the Government of Egypt, Barakat added that commitment was forthcoming from the highest political levels to the grassroots. The Ministry of Health’s transparent approach to efforts to combat the disease was also critical. “The commitment allowed us to plan at a micro level,” he said, explaining that the conduction of door-to-door campaigns played an integral role.

© Noorani/UNICEF Egypt/2007
Vaccination and awareness raising teams go door-to-door in villages and towns across the country.
Meanwhile donor support and increased government determination meant that the number of vaccination teams deployed during campaigns rose from 13,000 to 50,000 per campaign. Between 2000 and 2007, 26 immunisation campaigns were executed, while routine vaccination continued. And although up until 2000, it was children up to four years of age who were vaccinated, that age quota was raised to five years. Central to ensuring that the campaigns were effective were UNICEF-led social mobilisation efforts. According to Marwa Karrout, who started to volunteer with UNICEF-backed NGO Youth Association for Planning and Development (YAPD) in 2004 “our physical presence on the field and the relations we developed over time with villages boosted people’s support and confidence.” Karrout said. Like any victory, freeing Egypt from polio has had the added effect of raising confidence among policy-makers and implementers in the system they developed to fight the disease. “Our work was so well-planned that we now use it as a model to combat other diseases,” Barakat said. Thus, "Polio eradication will continue to be one of the significant public health success stories that Egyptians will be proud of for a long time" said Dr. Sahar Hegazi, UNICEF Egypt Program Communication Specialist. "The reason for this success is that everyone worked hard towards one common goal. It became a social movement that prevailed at all levels to achieve this goal." She added. But although much has been achieved, efforts have not ceased, particularly in the area of surveillance, said UNICEF Egypt Health Officer Dr Essam Allam. “Awareness campaigns on the primal importance of immunisation are still being conducted, particularly in the most vulnerable areas. In addition, we need to keep testing sewage samples across the country, because that is how we can find out whether the virus has survived in our environment,” Allam added. Today routine immunisation coverage in Egypt stands high at approximately 95 percent. For children and youth, not only does this mean growing up in a safer environment, where the risk of preventable disease is lower than ever, now families across the country can feel safe, knowing that their child can grow up strong and ready to face life... Read more

 

 
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