Conflict-affected countries in central Africa have joined forces to immunize every child under five against polio, in an unprecedented alliance against the crippling disease. But today health, humanitarian and political leaders warned that for all children to be protected, there must be respect for peace during this massive immunization campaign.
Today, President Joseph Kabila of the Democratic Republic of the Congo was joined in Kinshasa by senior representatives of Congo, Dr Gro Harlem Brundtland, Director-General of the World Health Organization (WHO), Dr Ebrahim Samba, WHO's Regional Director for Africa and UNICEF Regional Director for West and Central Africa Rima Salah at a special ceremony launching "synchronized" polio National Immunization Days (NIDs) in the region. The immunization activities involve close coordination between Angola, Congo, the Democratic Republic of the Congo and Gabon where health workers aim to immunize 16 million children in just five days.
"Your efforts are leading us to a historical milestone in international public health – the global eradication of the poliovirus," stressed Dr Brundtland at the launching ceremony. "Your success in the coming days in reaching every child with oral polio vaccine will be key in stopping transmission of this virus on the African continent, and around the world."
Tens of thousands of health workers and volunteers will be travelling door-to-door, boat-to-boat, market-to-market and camp-to-camp, vaccinating every child under five. Over 86 000 health workers will be delivering vaccine in the Democratic Republic of the Congo alone. Military observation force MONUC (Mission observateur des Nations Unies au Congo) is providing logistical support to fly polio vaccine around the country and medical teams are taking time out to provide technical support locally. By carefully coordinating the immunization activities between countries, children in especially remote regions, in densely-populated urban areas, in conflict-affected areas, in refugee camps and those crossing borders due to conflict and labour migration can be identified and immunized. Local health authorities are making special efforts at key border points to try to reach an additional 127 000 children, 90 000 of whom are in otherwise inaccessible areas of Angola.
"We know from experience that by synchronizing NIDs, many, many more children can be protected with polio vaccine," said Rima Salah of UNICEF. "Now we ask that health workers be given safe passage to reach each one of these children, wherever they live, in the coming days. Accessing children previously unreached by vaccination teams increases the possibilities of access to other health services.’
The central African region is considered one of the last bastions of the wild poliovirus. Transmission of the virus continues to be especially intense in Angola and the Democratic Republic of the Congo – which accounted for 40% of the cases in Africa in 2000. Poliovirus transmission in these countries continues to threaten polio-free countries in the region. For example, a virus imported from Angola into formerly polio-free Cape Verde caused a major outbreak in 2000.
Conflict continues to hamper progress in the region as it has destroyed health infrastructure and can prevent access to many areas. Despite this however, there has been marked progress in surveillance for the disease, and extraordinary efforts to reach all children have already been made. When the Democratic Republic of the Congo held its first full NIDs in 1999, health workers immunized more than nine million children. This access was facilitated by United Nations Secretary-General Kofi Annan’s call for a temporary ceasefire, or "days of tranquility" enabling vaccination teams to immunize children in areas affected by conflict.
Efforts such as these have enabled the Global Polio Eradication Initiative to succeed in reducing the number of polio endemic countries from 125 in 1988 to no more than 20 by the end of 2000. The goal of the Initiative is to completely stop transmission of the wild poliovirus, with global polio-free certification targeted for 2005.
The Global Polio Eradication Initiative is spearheaded by WHO, Rotary International, the U.S. Centers for Disease Control and Prevention (CDC), and the United Nations Children’s Fund (UNICEF).
"I applaud this unprecedented commitment of government leaders, UN agencies and volunteers who are making these synchronized NIDs a reality here in central Africa," said Carlo Ravizza, past President of Rotary International. "We owe it to the next generation to do all we can to respect peace, ensure worldwide commitment and mobilize enough funds to certify the world polio-free."
Rotary International, the volunteer arm of the global partnership, has 1.2 million members in 163 countries and is the leading private sector partner in the Initiative. So far the service club has contributed US$ 407 million to the effort since 1985, and will commit a total of US$ 500 million by 2005.
The most significant challenge to the Initiative now is closing a US$ 400 million funding gap of a total US$ 1 billion required through 2005.
In 2000, just 2881 cases of polio have been reported worldwide,* a 99% decrease from the 350 000 annual cases estimated in 1988 when the Initiative was launched. This reduction is partly due to synchronized efforts in several regions. Beginning in 1995, 18 countries of the Mediterranean, Caucasus and central Asian republics coordinated their polio eradication activities, in a collaboration known as Operation MECACAR, leading to a dramatic decline in the number of cases in that region. During the autumn of 2000, 76 million children in 17 west and central African countries were immunized over one week.
Besides Angola and the Democratic Republic of the Congo, the countries with continuing intense wild poliovirus transmission are Ethiopia, Nigeria and Pakistan. The remaining polio-endemic countries include: Afghanistan, Bangladesh, Benin, the Central African Republic, Chad, Côte D’Ivoire, Egypt, Ghana, India, Mauritania, Nepal, Niger, Somalia, and Sudan.
About Polio
Poliomyelitis (polio) is a highly infectious disease caused by a virus that mainly affects children under three years of age. It invades the nervous system and can cause total paralysis in a matter of hours. The virus enters the body through the mouth and multiplies in the intestine. Initial symptoms are fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs. One in 200 infections leads to irreversible paralysis (usually in the legs). Between five and ten per cent of people infected with polio die when their breathing muscles are paralysed.
As there is no cure for polio, the best treatment is preventive. A few drops of a powerful vaccine, given multiple times, protects a child for life.
The Global Polio Eradication Initiative is spearheaded by WHO, Rotary International, the U.S. Centers for Disease Control and Prevention (CDC) and the United Nations Children’s Fund (UNICEF). The polio eradication coalition also includes national governments; private foundations (e.g. United Nations Foundation, Bill & Melinda Gates Foundation); development banks (e.g. World Bank); donor governments (e.g. Australia, Austria, Belgium, Canada, Denmark, Finland, Germany, Italy, Japan, the Netherlands, Portugal, United Kingdom and the United States of America); non-governmental humanitarian organizations (e.g. the International Red Cross and Red Crescent movement) and corporate partners (e.g. Aventis Pasteur, De Beers). Volunteers in developing countries play a central role; ten million have participated in mass immunization campaigns.
* Note: Please see www.polioeradication.org for weekly updates of polio cases worldwide.