Polio eradication achievable, imminent: Gates Foundation official

by Nour Salman ABU DHABI, 23rd October, 2018 (WAM) — The UAE is an important partner and long-term contributor of the polio eradication programme, having supported the delivery of vaccines to protect the most vulnerable and hard-to-reach children in Pakistan, director of the polio eradication programme at the Gates Foundation, has said.

The country has also supported polio outbreak vaccination efforts in Afghanistan, Somalia, Ethiopia, Kenya and Sudan, according to James Wenger.

The UAE and the Gates Foundation are currently considering the launch of a new research institute based in Abu Dhabi that will focus on translating research and data on disease burden into actionable policy across the region, Wegner revealed in an interview with Emirates News Agency, WAM.

“We look forward to leveraging Abu Dhabi’s unique talents and assets to accelerate progress on key global health issues, including polio eradication,” he added.

Ending polio through eradication will improve the lives of the world’s most vulnerable children and ensure that no child or family has to live with the devastating effects of polio ever again, Wenger emphasised, adding, “We are up against some big challenges in the places where polio still exists: conflict, insecurity, mobile populations and remote villages have made it difficult for health workers to reach all children with vaccines.”

The Strategic Advisory Group of Experts on Immunisation (SAGE) 2017 Global Vaccine Action Plan assessment report revealed that there continues to remain a need to intensify global efforts to promote immunisation and to address systemic weaknesses that limit access to life-saving vaccines.

Despite this, Wenger believes that polio eradication is achievable and imminent. “Polio’s shrinking geographic territory and increasing levels of immunity everywhere show that we can achieve success as long as we continue high-quality immunisation campaigns and maintain commitment from donors and political leaders,” he added.

When asked on how organisations, like the Gates Foundation, and donor countries like the UAE, cooperate further to address such issues, particularly to assist outlier countries, Wenger said, “Diverse global leaders and stakeholders, including His Highness Sheikh Mohamed bin Zayed Al Nahyan, Crown Prince of Abu Dhabi and Deputy Supreme Commander of the UAE Armed Forces, have demonstrated strong commitment to polio eradication, most recently committing US$30 million in new funding for the Global Polio Eradication Initiative, GPEI, in 2017.”

The polio eradication programme director affirmed, “In the last mile of the polio eradication effort, we need affected countries to demonstrate strong political leadership and donors to make sustained financial commitments to the programme. The Gates Foundation remains committed to working with partners like His Highness Sheikh Mohamed bin Zayed to finish the job.”

According to WHO/UNICEF estimates of immunisation coverage, DTP3 coverage remains at 85 percent in 2017, leaving 19.9 million children vulnerable to vaccine-preventable diseases. Commenting on the strategies applied to ensure achieving the goals of the GPEI, Wenger said that strong immunisation systems are critical to delivering the polio vaccine and maintaining high population immunity against poliovirus and other infectious diseases.

He went on to say that Sheikh Mohamed bin Zayed has also been a historic supporter of global disease elimination programmes, extending his generous support to Guinea worm eradication campaigns and strengthening broader immunisation efforts.

In 2017 alone, thanks to UAE funding to GPEI through its Pakistan Assistance Programme, UAE-PAP, almost 13 million children were repeatedly vaccinated during polio immunisation.

This funding, Wenger explained, combined with the direct UAE-PAP funding to Pakistan, resulted in more than 96 million doses of polio vaccine delivered to children under five in the 66 highest-risk districts supported by UAE-PAP and a 98 percent reduction in the number of children paralysed in the four high-risk priority provinces.

“The UAE is also hosting the upcoming Gavi, the Vaccine Alliance Mid-term Review in December. The review will provide an opportunity to evaluate the Alliance’s performance halfway through the current strategic period 2016-2020, celebrate partner successes and attract new partners, particularly in the Middle East, and outline the future vision of the Gavi model,” Wenger said.

When asked about the importance behind eradicating polio, Wenger said that a child with paralytic polio suddenly develops limpness and weakness in the muscles of some part of their body, most commonly the leg(s). “The paralysis is usually permanent, and the child will be left with a life-long handicap. In the worst cases, the paralysis affects the muscles that enable the child to breathe, and if there is no hospital support, they will die.”

Wenger noted that Polio is caused by a virus that enters through the mouth and multiplies in the intestine. “While it only causes irreversible paralysis in 1 in every 200 children infected, any infected individual – typically under five years old – can shed the virus through their stool into the environment for several weeks, where it can spread rapidly through a community, especially in areas of poor sanitation.”

Children used to be paralysed by polio in nearly every country in the world, Wenger explained, “but we’ve seen remarkable progress against the disease in the past 30 years.”

In 1988, there were 350,000 cases of polio in 125 countries globally. So far this year, there have been just 20 cases of wild polio in two countries, Afghanistan and Pakistan. “This progress is very encouraging, but we are still missing children in some of the hardest-to-reach parts of the world. To get to zero, it’s critical that we reach all children with polio vaccines,” he continued.

“Through the polio programme we’ve been able to reach children in the farthest corners of the world,” Wenger elaborated, adding that to complement routine immunisation, the programme uses a number of strategies to reach children everywhere, including house-to-house vaccination campaigns, National Immunisation Days, vaccinating at markets and cross-border points and outreach to internally displaced people in formal and informal camps.

In many areas, the polio programme is also using its expertise to improve routine immunisation programmes, through monitoring the effectiveness of the programmes, training programme personnel, and identifying vulnerable populations.

To build trust in and knowledge of polio vaccination, the programme maintains active partnerships with traditional and religious leaders, women’s associations, polio survivor groups and others to help ensure community buy-in for campaigns and for routine immunisations.

“By vaccinating every last child and strengthening disease surveillance globally, even in countries that only have a fading memory of polio, we can stop the spread of the disease,” Wegner affirmed.

Oral polio vaccine, OPV, is the primary tool we use to protect children and its widespread use has helped to eliminate over 99 percent of polio cases worldwide, he explained. “Because OPV can stop the person-to-person spread of the virus, it’s a vital tool to achieve eradication. Because it’s an oral vaccine, it’s also easy for health workers to administer and can be used on a large scale,” he added.

According to Wenger, if enough children in a population take OPV, the virus will disappear from that population, and if enough children in the world take the vaccine, the virus can be eradicated – once and for all.

Wenger also emphasised that rather than focusing on an end date to eradicate polio, it’s important to focus on overcoming the final barriers to eradication. “There’s still a lot of work to be done, but I remain confident that we will be able to surmount these challenges and end polio for good.



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