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Africa is free of polio after decades-long battle

Africa is free of polio after years of trying to eradicate the virus, the World Health Organization has declared.

The landmark achievement comes after decades of campaigning and vaccination programmes across the continent.

No cases of polio have been diagnosed in Africa in four years — the threshold to certify eradication of the crippling virus. The last case was detected in 2016 in Nigeria, where vaccination efforts had been hampered by Boko Haram jihadists.  

Professor Rose Gana Fomban Leke, chair of the African Regional Certification Commission for Polio eradication, called it a ‘historic day’ for the continent.  

Poliomyelitis – the medical term for polio – is a contagious virus which attacks the spinal cord and causes irreversible paralysis in children, sometimes within hours.

It paralysed 75,000 children a year in Africa in the 90s, when efforts to eradicate the virus were stepped up.

A working life-long vaccine wiped out the disease in developed countries like the US and UK but the illness has carried on for years in poorer parts of the world. 

Polio now joins smallpox in the list of viruses that have been wiped out in Africa — ‘one of the greatest achievements in public health history’, the WHO said. It now only exists in Afghanistan and Pakistan.

There are, however, still rare cases of polio among Africans who haven’t had the vaccine because virus fragments in the jab can pass in the faeces of someone who has been vaccinated then mutate and eventually infect unprotected people.  

In other promising developments, the WHO claims Africa’s Covid-19 outbreak may have finally passed its peak. More than one million cases and 28,000 deaths have been recorded across the continent since the pandemic began. 

Poliovirus is typically spread in the faeces of an infected person and is picked up through contaminated water or food. 

While there is no cure, the disease can be prevented through the administration of a simple and effective vaccine.

Vaccinating people to prevent them from becoming infected thus breaks the cycle of transmission and eventually eradicates the virus in the wild. 

It was endemic — meaning it circulated constantly in the population — around the world until a vaccine was found in the 1950s. 

But this remained out of reach for many poorer countries in Asia and Africa. 

In 1996, African leaders committed to eradicate polio during the 32nd Ordinary Session of the Organization of African Unity in Yaoundé, Cameroon. 

At the time, polio was paralyzing an estimated 75,000 children, annually, on the continent. 

Since then, eradication efforts have prevented up to 1.8million children from crippling life-long paralysis and saved 180,000 lives, the WHO says. 

The last case of polio in Africa was detected in 2016 in Nigeria, where vaccination efforts had been hampered by Boko Haram jihadists. More than 20 workers involved in the campaign lost their lives.

The independent Africa Regional Certification Commission (ARCC) for Polio Eradication officially declared that Africa is free of wild poliovirus, following the eradication of smallpox 40 years ago. 

It comes after an exhaustive, decades-long process of documentation and analysis of polio surveillance and immunisation programmes across 47 countries. 

Dr Matshidiso Moeti, the WHO’s regional director for Africa, said: ‘This is a momentous milestone for Africa. Now future generations of African children can live free of wild polio.

‘This historic achievement was only possible thanks to the leadership and commitment of governments, communities, global polio eradication partners and philanthropists.

‘I pay special tribute to the frontline health workers and vaccinators, some of whom lost their lives, for this noble cause.’

‘This is one of the greatest achievements in public health history,’ WHO chief Tedros Adhanom Ghebreyesus co-wrote in an article in Al Jazeera.

‘Delivering polio vaccines to every child in the African region and wiping out the wild virus is no small feat, and the human resources, skills and experience gained in the process leave behind a legacy in how to tackle diseases and reach the poorest and most marginalised communities with lifesaving services,’ said Dr Tedros and Holger Knaack, president of Rotary International. 

They said as recently as 2012, half of all globally recorded cases of wild polio virus were in Nigeria — the last country in the region to rid itself of the virus.

While the eradication of wild poliovirus from the WHO African Region is a major achievement, 16 countries in the region are currently experiencing circulating vaccine-derived poliovirus (cVDPV) outbreaks.

At least 177 people have been diagnosed with vaccine-derived polio this year, the BBC reported. 

This form of the disease can spread among people who have not had the jab but live close to people who have.

The polio vaccine uses a damaged form of the virus to trigger an immune response in people who get the jab, and those damaged viruses are eventually passed out of the body in faeces.

In some rare cases it is possible for the viruses to mutate and become infectious again, and they can then trigger illness in people who are not vaccinated and come into contact with the faeces or contaminated water or food. 

This cannot happen if everyone is vaccinated, but coverage is around 95 per cent in Africa meaning many people remain unprotected. 

It is among those unprotected people, living close to others who have had the vaccine, that the vaccine-derived polio cases occur.

But Africa has now eliminated all strains of ‘wild’ polio, which means there are no naturally-occuring strains of the virus circulating in people. 

The vaccine-derived infections are significantly less common than wild ones would be if there was no vaccine. 

Because of global efforts to wipe out the disease – efforts costing some $19 billion over 30 years – only two countries (Afghanistan and Pakistan) have recorded cases of wild polio this year. Between them, 87 cases have been diagnosed. 

Dr Tedros said: ‘A surge of resources and effort is needed to ensure that the world uses this critical window of opportunity to protect all children in Afghanistan and Pakistan in the upcoming low season, during which there is a natural decline in cases of the polio virus.’

He said vaccination programmes had been paused in those countries during the Covid-19 pandemic.

It comes as WHO chiefs claim Africa may have passed the peak of its Covid-19 outbreak.

WHO Africa regional director Dr Moeti told a conference of African health ministers yesterday that numbers of new cases were declining, but warned against complacency to avoid a second wave.

‘We are seeing that we have had what seems to have been a peak, and now we have the daily numbers of cases being reported overall in the region going down,’ she said during an online meeting.

But there are still a few countries, such as Namibia, experiencing increases in daily cases.

Africa has recorded nearly 1.2million cases and at least 28,000 deaths since the virus arrived on the continent on February 14.

South Africa has more than half of those infections and is the fifth worst-hit country in the world.

While numbers of cases and deaths are also declining, Health Minister Zweli Mkhize cautioned that ‘our biggest worry is whether in fact this is the first surge and there might be another one’.

‘We have gone past our apex, our surge, but if you look at Spain it started showing a surge after a long lull,’ he told the same meeting.

Dr Moeti lauded African leaders for taking ‘extremely courageous, difficult decisions’ to ‘avert the catastrophe foretold in early projections of how this virus would affect the African region’.

There had been fears that Africa’s poor health systems would collapse under the weight of the pandemic. 

But the situation continues ‘to be very grave’, Dr Moeti warned.

Many governments are starting to lift the lockdown rules imposed to limit the spread of the virus which means ‘increase vigilance is required’.  

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