Africa’s wild polio-free status to be determined in August

Africa has been on a serious fight against Polio for some years, and recent Nigeria and Cameroon were announced Polio free by the World Health Organization.

Meanwhile, Africa’s wild polio-free status is set to be determined in August by the Independent Africa Regional Certification Commission (ARCC), which is responsible for certifying the eradication of wild poliovirus in the World Health Organization (WHO) African Region, the UN health agency has said.

WHO in a statement released on Friday said the commission is set to make its final decision about the region’s wild poliovirus status in August.

Africa’s wild polio-free status will be determined based on the field verification visits over the past year and on the critical analysis of the documentation of the polio surveillance, immunization, and laboratory capacity presented by the governments of Cameroon, Central African Republic, Nigeria and South Sudan.

The commission had on Thursday validated the four countries’ documentation that indicates their wild polio-free status.

WHO Regional Director for Africa, Matshidiso Moeti, said that the achievement by Cameroon, Central African Republic, Nigeria and South Sudan is a major step towards the eradication of wild poliovirus in the African Region.

“As the continent struggles with COVID-19 (C19), this milestone shows that when leaders, partners, health workers and communities come together we can triumph over the most difficult health challenges.”

If the region is certified in August, it would be the fifth of the six WHO regions to be declared free of wild polio.

Polio certification

So far, the WHO Africa region has not been declared polio-free because of the last incident of wild polio detection in Nigeria in 2016.

The last wild poliovirus-caused paralysis was detected in August 2016 in Nigeria, while the last environment sample with traces of the wild poliovirus was detected in Kaduna State from a sewage sample collected in May 2014.

However, the African Region became eligible to be certified free of wild poliovirus, in August 2019, after Nigeria, recorded no new cases of wild poliovirus for three consecutive years.

This is the requisite period for any country to be certified polio-free.

According to the UN agency, the commission had already accepted the documentation of the other 43 countries in the region.

The ARCC members are charged with reviewing certification documentation from all 47 countries in the WHO African Region and verifying the absence of poliovirus in the presence of certification-standard surveillance.

The Chairperson, ARCC, Rose Leke, said they are satisfied with the documentation that the four countries have presented.

“We are reviewing updated reports from the other 43 countries in the WHO African Region and we anticipate that by August 2020, we will deliver our final decision on the region’s certification status of wild poliovirus eradication,” she added.

Meanwhile, Faisal Shuaib, Executive Director of the National Primary Health Care Development Agency (NPHCDA), in a tweet at @drfaisalshuaib described the documentation as historical.

“Amazing moment in history to have had our polio-eradication documentation accepted by (ARCC); the Nigeria team led by NPHCDA and partners demonstrated evidence of our polio-free status.

“Nigeria achieving a Wild Polio Virus-free status today, is significant on multiple fronts.

“I look back at the incredible leadership that has brought us here.

“Apart from President Muhammadu Buhari, GCFR, the two most important people who have made it possible due to their financial and technological contributions have been Mr. Aliko Dangote and Mr. Bill Gates.

“Thanks for this unquantifiable gift to Nigeria,” he said.

The spokesperson of WHO in Nigeria, Charity Warigon, in response to an email from PREMIUM TIMES on Friday said the official declaration of Nigeria as a polio-free country is yet to be made by the global health agency.

She said the completion of the documentation exercise implies that “Nigeria has successfully stopped the circulation of wild poliovirus within the country.”

Ms. Warigon said the official declaration should be made during the WHO regional committee for Africa meeting in August.

“Yesterday, Nigeria’s documentation for wild poliovirus free status was accepted by the Africa Regional Certification Commission for polio eradication (ARCC),” she said.

“This implies that there is no indigenous circulation of the wild poliovirus in Nigeria. Put differently, Nigeria has successfully stopped the circulation of wild poliovirus within the country.

“However, we expect a formal announcement of the certification of eradication of wild polioviruses in the African region to be made later in 2020, possibly, during the WHO regional committee for Africa meeting in August, to be attended by all 47 ministers of health.”

Polio

Poliomyelitis (polio) is a highly infectious viral disease, which mainly affects young children.

The virus is transmitted from person-to-person, spread mainly through the fecal-oral route or, through contaminated water or food and multiplies in the intestine, from where it can invade the nervous system and can cause paralysis.

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

This is why WHO and other international partners have intensified efforts across every country to rapidly boost immunity levels in children and protect them from polio paralysis.

Not yet over

Although Nigeria has successfully interrupted the wild poliovirus, a new cause for concern, is a new form of polio known as Circulating Vaccine- derived poliovirus circulating in some countries in Africa.

Currently, 12 African countries in the WHO African Region, namely: Angola, Benin, Cameroon, Central African Republic, Chad, Democratic Republic of the Congo, Ethiopia, Ghana, Niger, Nigeria, Togo and Zambia are experiencing the outbreak.

WHO Africa said the scale of ongoing circulating vaccine-derived polio outbreaks is a battle the region is striving to win.

Vaccine-derived polioviruses are rare, but these viruses are sometimes found in severely under-immunized populations living in areas with inadequate sanitation.

Ms Moeti said efforts are underway to urgently address the circulating vaccine-derived poliovirus outbreaks, also within the context of polio eradication is a Public Health Emergency of International Concern.

Ms Moeti said WHO, UNICEF, Rotary International, the US Centers for Disease Control and Prevention, the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance, will continue to support governments in their efforts to stop the ongoing circulating vaccine-derived poliovirus outbreaks, including by implementing a new response strategy.

She said the aim is to ensure that no child anywhere in Africa will ever again be paralyzed by any poliovirus – wild or vaccine-derived.

“Even though they are not wild polioviruses, such rare strains – which can emerge in areas of low population immunity – also paralyze children, it stated.

“With the COVID-19 pandemic, mass immunizations across the region has been postponed until further notice, which hinders outbreak response activities.”

The polio eradication program in the African Region, in addition to its support to the COVID-19 response is working with countries to ensure the continuity of essential disease surveillance activities as well as planning the resumption of immunization and outbreak response in compliance with the guidance to stop COVID-19 transmission.

Also, Ms. Warigon said the key message is that, despite the historic acceptance of Nigeria’s complete documentation, this is not the time to take the foot off the pedal, with regards to the polio eradication initiative.

“In order to sustain the gains, a lot more needs to be done to increase and sustain routine immunization coverage with adequate structure for continued vigilance (surveillance),” she added.

Ayooluwa Joshua