Second round of house-to-house immunization campaigns prioritizes previously un-reached children, but funding shortfall and civil unrest threaten final outcomeDAKAR/HARARE, 18 November 2004 - At a crucial stage of the global polio eradication effort, the second round in a series of massive cross-border polio immunizations starts this week in 24 African countries. The house-to-house campaigns follow a successful first round held last month.
Vaccinators plan to reach every child under five years old - even more than the 80 million immunized during the last round - and to focus on children in remote, hard-to-reach or minority communities. In the first leg of the drive, from 8-12 October, vaccinators were able to reach approximately 90 per cent of children under five in many participating countries. Vitamin A, which can reduce child mortality by over 20 per cent and prevent blindness, will also be administered with the polio vaccine in several countries.
The coordinated regional drive faces an immediate threat from conflicts in west and central Africa and a critical funding shortfall for essential activities early next year.
Concern is paramount for children in Cote d’Ivoire, where conflict has forced a postponement of the immunization drive. Polio recently re-established its grip on the country, following the importation of a virus in January 2004 originating in Nigeria. Since then, wild poliovirus been confirmed as the cause of paralysis in 15 Ivorian children. With the health system battered by political instability and routine immunization averaging at only 45 per cent, thousands more are at risk.
The upsurge in violence in the country and the resultant increase in cross border movements as the population seeks safe havens could carry the virus into countries neighbouring Cote D’Ivoire.
Nations bordering all conflict-affected countries are being urged to strengthen polio surveillance and make special plans to immunize children who are difficult to reach, along borders or wherever there is high population movement. Meanwhile humanitarian agencies and local communities in Cote d’Ivoire are doing what they can to protect vaccine stockpiles until the campaigns can be re-started. When parts of the country lost electricity during recent violence, communities worked together to keep generators running and send tanks of fuel to remote villages to keep storage facilities cold, thus saving thousands of doses of vaccine.
Although it is premature to calculate the impact of the October rounds, positive signs include a decrease in the number of cases reported per week. Despite being in the high season for polio infection, Burkina Faso has had no cases since April; Benin has had none since June. Increases are notable in the Central African Republic, Sudan, Côte d'Ivoire and Chad.
The continuing reach of the immunization drives is being curtailed by a funding shortfall of US$200 million dollars for the coming year – of which $35 million is needed urgently in order to carry out low-season campaigns in the early part of 2005.
Despite the situation in Cote d’Ivoire, African governments are hopeful that these immunization drives – the largest ever internationally co-ordinated activity in peacetime - will bring polio back under control in the region. Since Africa now has 86 per cent of all the world’s polio cases, stopping polio here is key to the global eradication effort. Traditional and community leaders have contributed to the success in curbing the recent outbreak.
The immunization efforts are supported by the Global Polio Eradication Initiative: the World Health Organisation, Rotary International, the U.S. Centers For Disease Control & Prevention and UNICEF.
Vivian Fiore, Rotary International: +1 847 866 3234; email@example.com
Steven Stewart, US CDC: +1 404 639 8327; firstname.lastname@example.org
Sona Bari, WHO Geneva: +41 22 791 1476; email@example.com
Claire Hajaj, UNICEF New York: +1-212-326-7566; firstname.lastname@example.org
For further information on the Global Polio Eradication Initiative, please see www.polioeradication.org