By Ben Mills
Wild polio has now been declared officially eradicated in Africa, in a major milestone towards global elimination of the disease.
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Just under 25 years ago, poliovirus paralysed 75,000 children in Africa each year. However, thanks to extensive vaccination programmes covering 95% of the continent’s population, that figure was driven down rapidly over the course of just a few years. By 2000, there were less than 200 cases of the disease in Africa, and despite a resurgence of the virus in some areas, wild polio has now officially been declared eradicated in Africa. How has the continent achieved such a success, and what does this mean for the global fight to eliminate this deadly disease? Could Africa’s success even provide some hope in the ongoing worldwide effort to end the Covid-19 pandemic?
Positive news relating to a deadly disease is rare - this year more than most - but the official eradication of polio on the African continent has been hailed as a massive success and a major ‘milestone’ towards worldwide eradication of the disease. Considering the fact that poliovirus was widespread across the continent just a quarter of a century ago, this certainly seems like a huge achievement.
Although poliovirus has existed for millenia, major outbreaks in Europe and the USA in the 19th century led to the disease becoming endemic across many parts of the world. In the 1950s, the first vaccine against the disease was developed, which would go on to become a hugely useful tool in the global effort to eliminate the virus. By the early 2000s, cases had decreased significantly, with Europe being declared polio free in 2002, and North and South America having achieved the same status 8 years earlier. However, some hotspots of the virus remained, including in Africa and Asia.
A campaign of mass vaccination began in Africa in the 1990s, including a vaccination programme launched by Nelson Mandela in 1996 which intended to “kick polio out of Africa”. The programme has been widely successful with billions of doses of the vaccine being delivered. However, a resurgence of the virus in Nigeria caused by falling uptake of the vaccine provided a major setback to the efforts to contain the virus across the continent. Cases were also reported in countries such as Somalia and Kenya as recently as 2013.
The return of endemic polio to areas of Nigeria led to significant challenges, while conflict and instability in the region made vaccinating the population particularly difficult. The presence of the militant group Boko Haram in areas of northern Nigeria put vaccination programmes in jeopardy, particularly after the killing of two health workers in the state of Kano. Also, the displacement of millions of people from the region as a result of the fighting made vaccination a challenge.
Despite these obstacles, Nigeria reported its last case of wild polio in 2016. In the summer of 2020, it was declared by the Africa Regional Certification Commission that wild polio had been eradicated from the continent, with only a handful of vaccine-derived cases now remaining. So what will be the impacts of this groundbreaking achievement?
Of course, the biggest benefit of eradicating polio in Africa will be that millions of people will now be protected from what is an often debilitating and deadly disease. Once a child has been vaccinated against poliovirus, they will be protected from the disease for life, meaning there will be fewer cases of paralysis and fatalities from the disease even if a resurgence was to occur. And with the virus now only remaining prevalent in one country (Pakistan), there is real hope that polio could be eradicated completely at some point in the near future - the World Health Organisation suggests that this effort is now 99% complete. With smallpox and rinderpest being the only two diseases ever eradicated in history, eliminating polio would be a momentous achievement for humanity.
The success of vaccination at eliminating polio in Africa also provides us with some short-term hope about the prospects of ending the ongoing Covid-19 pandemic. With a vaccine for the disease expected perhaps as early as next month, the eradication of polio through intense mass vaccination programmes could provide a template for ending the pandemic. The eradication of polio is a massive success for a continent that once suffered badly from this awful disease, and it will surely have positive impacts on humanity’s fight against infectious disease for decades to come.
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