‘Dangerous moment:’ huge effort begins to slow down polio after Malawi case

By Jennifer Rigby

(Reuters) – The world is in a ‘dangerous moment’ in the fight against diseases such as polio, said a senior official of the World Health Organization as efforts begin to vaccinate 23 million children in five African countries following an outbreak in Malawi.

In February, Malawi declared its first case of wild poliovirus in 30 years when a three-year-old girl in Lilongwe district was paralyzed as a result of her infection.

The case caused alarm because Africa was declared free of wild polio in 2020 and there are only two countries in the world where it is endemic: Afghanistan and Pakistan. Pakistan marked a year without cases in January 2022.

“This is a dangerous moment,” Modjirom Ndoutabe, polio coordinator for WHO Africa, told Reuters in a telephone interview from Brazzaville, Republic of the Congo.

“Even though there is one country in the world with polio, all the other countries are in big trouble.”

Ndoutabe said the coronavirus pandemic and lockdowns had slowed efforts to vaccinate children against other diseases such as polio, and also affected surveillance.

According to the Gavi Vaccine Alliance, childhood vaccination services in the 68 countries it supports fell by 4% by 2020, representing 3.1 million more “zero-dose” children probably unprotected from childhood diseases such as polio, diphtheria and measles, and 3 million more under children . -immunized children than in 2019.

“This is a tragedy,” Seth Berkley, CEO of Gavi, said in an interview with Reuters. “The challenge is to get it up again.”

In Malawi, where polio vaccine coverage is high – over 90% in most districts – rates fell during the pandemic by 2%, according to Janet Kayita, WHO Head of Malawi. She said the baby who was paralyzed had a dose of the polio vaccine at birth, but not the other doses needed for full protection.

Kayita said surveillance had become more markedly affected. The case is linked to a tribe that circulated in Pakistan’s Sindh province in 2019, meaning it does not affect Africa’s polio-free status. But teams are now struggling to answer how it arrived in Malawi and how long it spread undetected.

Polio, a highly contagious disease that spreads mainly through fecal contamination, is used to kill and paralyze thousands of children annually. There is no cure, but vaccination brought the world close to ending the wild form of the disease.


In an effort to prevent recurrence in Africa, nearly 70,000 vaccinators will go door-to-door in Malawi, Mozambique, Tanzania, Zambia and Zimbabwe to give all children under the age of 5 the oral polio vaccine in a $ 15.7 million campaign funded by the Global Polio Eradication Initiative, the WHO said in a statement Friday.

The first round, which begins on Monday, will target more than 9 million children, followed by three more rounds aimed at reaching everyone under the age of 5, regardless of their vaccination status, to boost immunity, Kayita said.

Efforts have also been stepped up to track down any cases associated with the Malawi eruption and to monitor sewage transmission. So far, no other related cases have been found.

Vaccine-derived polio, a form of the disease that results from incomplete vaccination coverage, is more widespread globally, and recent outbreaks have raised concerns about how the coronavirus pandemic may have affected vaccination coverage.

Israel is battling an outbreak of vaccine-derived polio, the first since the 1980s after a case was discovered in Jerusalem last week. Nearly 12,000 children have since been vaccinated.

Ukraine reported its first vaccine-derived polio case in five years last year, but the urgent efforts to curb the outbreak were halted after the Russian invasion on 24 February.

Complete vaccination protects against both forms of the disease, and a focus on it will stop both the outbreak in Malawi in months and all forms of polio in Africa by 2023, said Ndoutabe, who described his grief when he first heard about the setback in Malawi. the case. .

“But we did not stay in this sadness. We had to act quickly,” he said.

(Report by Jennifer Rigby; Edited by Michele Gershberg and Frank Jack Daniel)

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