5 reasons why polio can be eradicated - World - ReliefWeb

5 reasons why polio can be eradicated - World - ReliefWeb
Fewer kids getting polio shots, says DOH - INQUIRER.net
Philippines update: Polio vaccine coverage, TB response and dengue epidemic - Outbreak News Today
This Is the Border Where Polio Still Thrives - VICE

Posted: 19 Aug 2019 06:53 AM PDT

Five core partners— Rotary International, World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC), United Nations Children's Fund (UNICEF), and the Bill & Melinda Gates Foundation— 20 million volunteers, over 2.5 billion children vaccinated, and an initiative spanning over 30 years across 200 countries.

These are the impressive numbers, people power, and the resources behind one of the biggest public-private partnerships in history: The Global Polio Eradication Initiative.

But why is polio eradication a global public health cause transcending generations, geographical boundaries, and socio-cultural constructs? Read on:

Poliovirus causes acute, non-persistent infections
The virus causes acute, short term infections, meaning that a person infected with polio can only transmit the virus for a limited amount of time. Prolonged infection with wild polioviruses has never been documented and in most cases infected people can only transmit the virus for 1-2 weeks.

Virus is transmitted only by infectious people or their waste Some diseases can be transmitted in a multitude of ways, which can make a disease an impossible candidate for eradication. But the poliovirus is typically transmitted just one way: through human waste. Eradicating polio is not an easy task, but the way polio is transmitted simplifies our ability to tackle the disease.

Survival of virus in the environment is finite Did you know there's just one strain of wild poliovirus that continues to infect humans? (There used to be three strains of poliovirus that regularly infected humans.) The wild poliovirus cannot survive for long periods outside of the human body. If the virus cannot find an unvaccinated person to infect, it will die out. This is why we have to keep every single child vaccinated—so the virus cannot find any humans to infect. The length of poliovirus survival varies according to conditions like temperature, and the poliovirus infectivity decreases over time.

People are the only reservoir Hundreds of diseases can be transmitted between insects, animals and humans. One of the things that makes polio eradicable is the fact that humans are the only reservoir. No poliovirus has been found to exist and spread among animals despite repeated attempts to document this.

Immunization with polio vaccine interrupts virus transmission Not only are there two safe and effective polio vaccines, but vaccination against polio generates herd immunity, which increases the percentage of the population that is immune to the disease.

Mass campaigns using oral polio vaccine, where all children in a specified geographic area are immunized simultaneously, interrupts wild poliovirus circulation by boosting population immunity to the point that transmission of polio cannot be sustained.

But what truly drives our conviction in numbers results. Since the world took up the cause of eradicating polio globally in 1988: we have eliminated polio from 125 countries and reduced the global incidence of polio cases by 99%; and, successfully eradicated certain strains of the virus.

There are now only 3 countries that have never stopped polio transmission. This marathon of a public health endeavour is in the last mile.

Fewer kids getting polio shots, says DOH - INQUIRER.net

Posted: 18 Aug 2019 04:23 PM PDT

The Department of Health (DOH) has reminded parents to complete the vaccination of their children, particularly against poliovirus, as the Philippines is in danger of losing its 19-year-old polio-free status due to the recent drop in oral polio vaccine (OPV) coverage.

"Complete vaccination is the best preventive measure against polio. All children under 1 year old should complete their three doses of OPV and one dose of the inactivated polio vaccine," Health Secretary Francisco Duque III said in a statement.

Polio is a fatal and disabling disease caused by poliovirus, which is transmitted when there is poor environmental sanitation and hygiene.

The Philippines has been declared polio-free since October 2000. It is, however, currently at high risk for poliovirus transmission, Duque said.

Open defecation persists

Over the past few years, vaccination coverage for the third dose of OPV has fallen below 95 percent, the target required to ensure population protection against polio, according to the health secretary.

He noted that the surveillance for the acute flaccid paralysis had been consistently poor and the practice of open defecation and poor sanitation had persisted in communities.

The Philippines is also at risk of infection with poliovirus from neighboring countries where it was recently found to have recirculated.

"[M]ost importantly, we risk the health and future of our children due to a disease [that] otherwise could have been prevented," he said.

The DOH has identified priority regions that need to strengthen preventive measures against polio.

Zero Open Defecation

It has planned measures to enhance polio prevention in Metro Manila, including intensified surveillance of children below 5 years old who developed sudden onset of muscle weakness or paralysis of the upper and lower limbs, and a polio immunization campaign for all children under 5 years old.

The department also called on all local governments to intensify the implementation of the Zero Open Defecation program and to strengthen the call for environmental sanitation and personal hygiene, such as frequent hand washing.

It reiterated its advisory that Manila Bay remained unsafe for swimming.

The synchronized polio immunization is expected to start in Manila by mid-August. It will expand to the entire metropolis and eventually to other priority regions. —Tina G. Santos

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Philippines update: Polio vaccine coverage, TB response and dengue epidemic - Outbreak News Today

Posted: 19 Aug 2019 05:04 PM PDT

By NewsDesk @infectiousdiseasenews

Polio

The Philippines has been declared polio-free since October 2000. However, the country is currently at high-risk for poliovirus transmission.

For the past years, vaccination coverage for the third dose of the Oral Polio Vaccine (OPV) has fallen below 95%, the target required to ensure population protection against polio; the surveillance on Acute Flaccid Paralysis has been consistently poor; and the practice of open defecation and poor sanitation have been persisting in communities.

Furthermore, the Philippines is at risk for importation of poliovirus from neighboring countries where the virus has recently been found to have recirculated. In response, the Department of Health (DOH) identified priority areas which need to strengthen preventive measures against polio.

"Unless we act quickly in putting our surveillance on alert to detect signs of poliovirus transmission, in strengthening our immunization program, and in improving environmental hygiene and sanitation, we risk losing our polio-free status. Most importantly, we risk the health and future of our children due to a disease which otherwise could have been prevented," Secretary Francisco Duque III emphasized.

Polio is a fatal and disabling disease caused by poliovirus, which is transmitted when there is poor environmental sanitation and hygiene. Complete vaccination is the best preventive measure against polio. All children under one year old should complete their three doses of OPV and one dose of the Inactivated Polio Vaccine.

DOH has planned measures to enhance polio prevention in Metro Manila. Among these measures are strengthened surveillance of children below 5 years old who developed sudden onset of muscle weakness or paralysis of the upper and lower extremities and a polio immunization campaign for all children under five years old.

DOH also called for all local governments to intensify the implementation of the Zero Open Defecation program and to strengthen the call for environmental sanitation and personal hygiene, such as frequent handwashing. Furthermore, DOH reiterated its advisory that the Manila Bay remains unsafe for swimming.

The synchronized polio immunization is expected to start in the City of Manila by mid- August 2019. After that, the immunization activity will expand to the entire National Capital Region and eventually to other priority regions.

Scanning electron micrograph of Mycobacterium tuberculosis, the bacteria that cause tuberculosis. NIAID

The Department of Health (DOH) together with the World Health Organization (WHO), United States Agency for International Development (USAID) and Global Fund formally recognized their commitment to completely eliminate tuberculosis (TB) by signing a joint pledge of support in a bid to take the Philippines off the list of countries with the highest TB burden in the world.

"For years, many Filipinos have suffered from TB. We all need to accelerate our efforts to end TB in the Philippines," said Health Secretary Francisco Duque III, speaking at the DOH-led National Coordinating Committee on TB.

According to a 2017 global report, approximately 581,000 Filipinos were diagnosed with active TB disease and 27,000 Filipinos were reported to have died of TB.

"TB is curable, and together we can prevent thousands of preventable deaths from TB." Secretary Duque spoke about the government's commitment to find and treat 2.5 million TB patients by 2022, a target that was pledged at the 2018 UN High Level General Assembly in New York City. He also mentioned that DOH shall be accountable and continue to work with its partners to make health systems more responsive to patient needs.

To highlight their shared commitment and responsibility, leaders of DOH, USAID, WHO and the Global Fund signed the joint pledge of support to implement a "business not-as-usual" approach to accelerate TB response. Development partners will continue to provide strategic packages of technical assistance, supplies, and human resources to fast track TB programming in the country. The U.S. government is also investing over 3 billion pesos in projects that support the National Tuberculosis Control Program.

"Today, USAID is reaffirming our commitment to strengthen the capacity of the Department of Health to accelerate, scale up and sustain the TB response," said USAID Acting Mission Director Patrick Wesner.

Dengue epidemic

The DOH's Epidemiology Bureau revealed that the 14,321 new dengue cases were reported from July 28 to August 3. Within this period, 46 deaths were reported.

The 188,562 cumulative cases reported from January 1 to August 3 this year was also higher than the 93,149 cases dengue cases recorded in the same period last year.

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This Is the Border Where Polio Still Thrives - VICE

Posted: 19 Aug 2019 12:29 PM PDT

This article appears in VICE Magazine's Borders Issue. The edition is a global exploration of both physical and invisible borders and examines who is affected by these lines and why we've imbued them with so much power. Click HERE to subscribe to the print edition.

One scorching Monday morning in April 2019, Shahzad Khan stood at the Rashakai toll plaza in Pakistan's northwestern Khyber Pakhtunkhwa province with a blue cooler slung over his shoulder. The toll plaza, which sits unassumingly on the broad, dusty lanes of the country's M1 highway, is a gateway to the rest of the province and Afghanistan, which is located just two hours away. As vehicles approached the kiosk, Khan raced up to them with his icebox of polio vaccines, under the protective eye of an armed police officer. Khan was stationed here with a mandate to administer the vaccine to every child under the age of five who passed through the porous borderlands between Pakistan and Afghanistan, two of only three countries in the world where the virus has not yet been eradicated.

Around 10 a.m., a small truck carrying a wedding party of several women wrapped in white chadors pulled up. Sharp, celebratory ululations rang out from the back of the vehicle. Khan and his fellow vaccinators moved quickly: The mothers cradled their young children near their chests, and the health workers circled the van and administered oral vaccination drops to each bawling child. As they rode off, the mothers waved their children's purple-stained fingers, the mark of a successful vaccination. The team was not always so lucky. "There are people who don't stop," said Khan, "but we can't really do anything about them."

The highly permeable border between Pakistan and Afghanistan represents one of the only places left in the world where new polio cases are being reported. So far in the first seven months of 2019, Pakistan has already logged at least 45 cases, while Afghanistan has 11. Transmitted primarily through fecal-oral contact, such as by the consumption of contaminated food or water, poliomyelitis was eradicated in the United States in 1979; in the decades since, a major international effort has been underway to uproot it from its last bastions. While these efforts have almost universally succeeded, in Afghanistan and Pakistan, health officials say the constant movement of people across the border allows children to fall through the cracks of vaccination campaigns.

Much of the traffic across the Afghanistan-Pakistan border occurs because it bifurcates the homeland of the region's Pashtun ethnic group. Marriage and tribal ties crisscross the border, as do an untold number of individuals who regularly enter Pakistan for work, medical services, or school. As people cross the border, some carry the polio virus from one country to the other. Health officials who monitor different strains of the virus through sewage and stool samples have been able to trace its path as it spreads along two main corridors—the northern route through eastern Afghanistan and Pakistan's Khyber Pakhtunkhwa province to its capital Islamabad, along which Khan was stationed, and a southern route from southern Afghanistan through Pakistan's Balochistan province to Karachi, the country's largest city.

"Pakistan and Afghanistan are considered one epidemiological bloc," said Carol Pandak, the director of the PolioPlus program at Rotary International. "It doesn't matter that there are two countries. There is a shared reservoir of virus." Where people don't obey borders, neither do viruses, making health officials mutually dependent in their fight against disease.

Shahzad Khan, far right, and a fellow vaccinator immunize a child at the Rashakai toll plaza in Pakistan

According to Pandak, extinguishing the virus partly depends on immunizing high-risk, mobile populations that move from one area to another. Normally, vaccinators carry out immunization campaigns by going door-to-door in settled areas, placing chalk markings on the door of each house they visit to reflect the number of children vaccinated that day. To reach more transient populations, health workers have established vaccination points at hundreds of "permanent transit posts" across the country. These range from highway stops like the Rashakai toll plaza to airports, bus stations, and bazaars—wherever transient populations like refugees, traders, and travelers congregate. Such permanent transit posts are made all the more essential by the fact that immunization against the polio virus requires multiple rounds of orally administered vaccinations and an injection, not just the single shot.

"Our borders are not closed," said Ujala Nayyar, a surveillance officer for the World Health Organization, which tracks the virus's movement. "Pakistan and Afghanistan are exchanging the virus with each other."

Administering the vaccine is not simply a logistical challenge, however. It is also deeply interwoven in long-standing political conflicts that, like the virus, have traveled back and forth across the border. After the Soviet Union invaded Afghanistan in 1979, the United States, Saudi Arabia, and Pakistan began to funnel money and arms to the mujahideen, a segment of which later became the Taliban—Afghan students who had come to Pakistan for their religious education and were willing to return home and take up arms. The group's success translated into political power across the border in Kabul, until it was toppled by the U.S.-led invasion of Afghanistan in 2001.

Since then, both Afghan and Pakistani Pashtuns have sought refuge across the border from military campaigns at home. In Pakistan, this has produced major refugee settlements for Afghans in Karachi and Islamabad. Despite periodic government expulsions, Afghan refugees have eked out a place for themselves in Pakistan's metropolitan centers and, depending on political tensions, sometimes return to Afghanistan to meet with their families after long periods of absence.

In recent years, the Pakistani government has responded to criticism that the permeability of those borderlands has facilitated the flow of militants by beginning a project of building 1,600 miles of fencing between the countries. It was in part that porousness that allowed Osama bin Laden to slip into Pakistan and evade immediate U.S. capture for nearly 10 years. As part of the effort to eventually apprehend him, the CIA used a fake hepatitis vaccination campaign as cover, going house to house to ferret out information. In recent years, the legacy of this duplicity is a paranoia that's hard to shake, complicating efforts to conduct an actual polio campaign in both Afghanistan—where the Taliban is resurgent—and neighboring Pakistan. Although the two countries synchronize immunization days each month, sending technical teams back and forth, for the past several years, the Afghan Taliban has intermittently suspended the vaccination program in key areas of the country. Most recently it has banned door-to-door vaccinations primarily in southern and eastern Afghanistan under the pretext that spies might be behind the project.

The Taliban's antivaccine stance has the potential to create its own deadly consequences. In Pakistan, there has been a fear of a spillover effect: health officials worry that unvaccinated Afghan children might end up in Pakistan, or children in Pakistan might travel to Taliban-controlled areas of Afghanistan where they would miss routine immunization. According to Aziz Memon, the chairman of the Pakistan National PolioPlus committee for Rotary International, missing even one dose of the required rounds of the vaccine will jeopardize a child's path to immunity against the virus.

A child shows his hand after being vaccinated in northwest Pakistan.

The problems raised by such suspicions extend well beyond border regions and transit posts, reaching into the heart of the country's settled areas. In the narrow, muddied gulleys of an Afghan refugee camp on the outskirts of Pakistan's capital, Islamabad, a 40-year-old polio vaccinator named Asiya Shazadi said that she plays a cell phone video, shared on government social media platforms, if she encounters resistance. Misconceptions about the vaccine are rife: Some residents believe the vaccine is made with pork or un-Islamic ingredients, and that it induces nausea or death.

Indeed, a mixture of religious and political fears have not only stoked parental resistance to vaccination but also directly endangered the lives of health workers. At the Rashakai toll plaza, Khan said that rumors still swirl among Afghans and Pakistanis that the vaccine is a Western project to sterilize Muslims. "We explain to them that it won't cause any disease and it's beneficial for children," he said. But like Afghanistan, Pakistan has been roiled by opposition to the vaccine, with militant groups openly pledging to attack vaccinators. In 2012, a Pakistani Taliban fatwa proscribed the vaccine, sparking a campaign of violence. This past April, several health workers and security officials were killed, pushing the tally to more than 90 since 2012.

Still, health workers like Shazadi have been able to build some trust with the communities where they work. She used to work as a teacher in the refugee camp; many of her students still recognized her when she knocked on their doors. Those relationships have been essential to the success of Pakistan's vaccination campaign, which has managed to whittle down cases from a high of more than 300 cases in 2014 to more than 45 today. Pakistan's team of a quarter million vaccinators are exclusively local and overwhelmingly female. Their gender allows them to enter domestic spaces that are off-limits to men, and the reliance on local vaccinators has helped calm suspicion about the vaccine being a foreign-backed project.

Asiya Shazadi, a polio vaccinator, visits an Afghan refugee camp on the outskirts of Islamabad, Pakistan, during a polio campaign this past April

Still, for health experts, Pakistan's halting polio eradication campaign has suffered setback after setback, with the target date for eradication shifting each year. "The way the polio virus is in Pakistan is completely out of control," said Nayyar. This year, Pakistan even exported a strain of the virus to neighboring Iran. Though it was detected only in sewage samples there and did not present in a human case, the event was worrisome because it indicated that Pakistan's uncontrolled borders were still allowing the virus to move, despite a stringent travel regimen that requires every traveler leaving Pakistan to brandish proof of vaccination at airports.

Sitting in the refugee camp, 35-year-old Khair Muhammad gave an honest assessment of the fears that come with the decision to vaccinate. "We know that the vaccine is good for our children," he said. During this year's April immunization campaign, however, Pakistani social media was afire with misinformation that the vaccine was poisoning children, sparking a public panic that saw a health facility in Peshawar attacked and destroyed by a mob. "My wife was scared," said Muhammad, whose family hails from Afghanistan's Laghman province. Despite their anxieties, they vaccinated all four of their children.

"The people from Afghanistan are understanding the problem and accepting the vaccine," said Muhammad Shah, a policeman who trailed behind the vaccinators in the refugee camp. As they stopped at one door, a vegetable-cart puller named Imanullah picked up his 1-year-old son, Rehmanullah. Imanullah, who goes by only one name, said he came to Pakistan from Tagab, Afghanistan, to earn money and work in the country. "We are happy here," he said. "We are giving the vaccine to children because it's good for their health."

As for polio, Imanullah believes both countries can vanquish the common threat. "I am praying that the polio virus will be eliminated soon, but God knows better than I do about when that will happen."

If you want more border stories, check out this additional package which explores how the borders that divide and surround Europe affect the lives of the people living near them.

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