“Tomorrow, 24 July, Nigeria will reach an important milestone: one year without a single case of wild polio anywhere in the country,” is the opening line of a wonderful message I received in my inbox a few months ago from Oyewale Tomori, President, Nigerian Academy of Science.
Professor Tomori went on to say to say to the world; and the Global Polio Eradication community in particular, that there is still more to be done:
“Nigeria has come close to finishing polio in the past and then allowed the virus to make a comeback, leading to a resurgence of cases and the reinfection of multiple countries from Cameroon to Indonesia. Now is not the time for celebration or complacency. If my country is going to go two more years without a case and be certified polio-free, along with the rest of the World Health Organization (WHO) African region, we must strengthen vaccination campaigns, improve surveillance systems to detect polio outbreaks quickly, and stop circulating vaccine-derived poliovirus. The Nigerian government, international partners, health workers, and you and I must remain completely committed to this goal.”
Today, November 4th, 2015, I participated in a high level in worldwide teleconference briefing organized by Global Health Strategies. Presentations by Dr. Hamid Jafari, Director of Global Polio Operations and Research at the World Health Organization, and Professor Jon Abramson, Chair of the Strategic Advisory Group of Experts (SAGE) on Immunization enlightened a community of scientists, academics, policy advocates, and the polio survivor community, on the current status of the eradication campaign.
With Africa now notably free of new cases of wild polio, only in Pakistan and Afghanistan does polio remain to be conquered. It was heart-warming to learn that so many real milestones have been achieved, and that even though polio remains in conflict areas in these two countries, and along its shared border, and in what are referred to as “insecure areas,” much has been gained. The governments are both on board, in these countries and by training individuals from the areas of strife to immunize and educate, and having them return, rather than outside workers, there is enhanced success in completing immunization.
One major goal of the current eradication strategy, in addition to reaching every child who has yet to be immunized, is to replace the type 2 Oral Polio vaccine (OPV) which uses live polio virus, with a safer Inactivated Polio vaccine (IPV), which is killed polio virus. The speakers advised of the overall global plan and country specific plans to end the use of IPV by April 2016. This requires that enough alternate vaccine exists, that areas that are insecure can be reached, and that governments continue to keep a commitment to see polio eradicated from the planet. More funds are necessary to make this happen, and it’s anticipated that it may take another year, bringing the deadline for complete eradication to 2019 from 2018.
The funds collected door to door by the Marching Mothers was what made the dream of a polio vaccination reality. March of Dimes was established in Canada in 1951 specifically as a result of the scourge of polio, with the goal of raising funds to contribute to the research into a preventative vaccine. By 1955, Doctor Jonas Salk had successfully developed a vaccine and it was rushed to be manufactured at a variety of laboratories including Connaught Laboratories (now sanofi pasteur) in Toronto, Canada.
When there is no concern about eradication, about a sufficient supply of vaccine, there may yet be a concern about the ongoing storage in containment facilities of live virus, necessary only for research, and the manufacturing of vaccines. The WHO is compiling an inventory of all such sites, and will develop stringent criterion for countries to enact, requiring disposal or safeguarding of such virus. Global eradication in the next three years is possible.
Andria Spindel - President and CEO, March of Dimes Canada