Opinion: COVID-19 should not derail polio eradication efforts - Devex

Posted: 29 Oct 2020 04:39 AM PDT

A child receiving polio vaccine in the rural village of Sono Solangi, Pakistan. Photo by: UNICEF

On Aug. 25, the African continent marked four years without a single case of wild polio and was officially certified as wild polio-free. Such a remarkable milestone would not have been possible without strong and consistent United States leadership and global partnerships. With Africa now free of this deadly scourge, the fight against polio has narrowed to Afghanistan and Pakistan, the two remaining countries with wild polio transmission.

The global war on polio is led by the Global Polio Eradication Initiative, which for years has received funding and technical guidance from the Centers for Disease Control and Prevention and the U.S. Agency for International Development. This support has contributed to a drop in polio cases by 99% over the past 30 years — from 350,000 reported cases in 1988 to 176 in 2019.

During that same time, U.S. investments in GPEI have helped avert 18 million cases, saved 1.5 million lives, provided 9 billion doses of oral polio vaccine to children, supported the vaccination of 220 million children multiple times a year, and trained 2 million vaccinators to support polio campaigns.

Failing to eradicate polio now would open the door to a resurgence of this disease, which in 10 years could paralyze up to 200,000 children a year.

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American polio investments have also brought a range of public health benefits to low- and middle-income countries beyond polio eradication. GPEI has built a strong disease surveillance system around the world equipped with labs and trained personnel able to collect, analyze, and disseminate information about infectious diseases. GPEI has also trained health workers in a bid to close one of the largest gaps in Africa's health care system.

In addition, GPEI has reached remote, marginalized, and conflict-ridden communities that were previously inaccessible, training thousands of social mobilizers — mostly women — from within those communities to use their position of trust to increase vaccine acceptance. GPEI has detected and responded to other outbreaks on the continent, stopping diseases such as cholera, measles, and meningitis at the original source.

How the eradication of wild poliovirus from Africa can guide the COVID-19 response

Networks, expertise, and infrastructure built around polio campaigns have contributed to a stronger public health system across Africa and are currently being used to tackle the pandemic.

Most notably this year, the polio program has yielded enormous benefits in the global fight against COVID-19. The global disease surveillance network built by the polio program is now being utilized to detect coronavirus cases, provide lab testing, and streamline data management and information sharing.

GPEI's emergency operations centers are helping governments coordinate public health responses. GPEI has also sent thousands of staff around the world to provide education about the virus, conduct contact tracing, and train new health workers.

Shifting GPEI resources was critical in helping many countries respond to the pandemic, but it has come at a cost to polio eradication efforts. Polio vaccination campaigns were put on pause in March 2020, and roughly 50 million children in Afghanistan and Pakistan alone did not receive polio vaccines. The suspended campaigns have meant polio cases have returned to districts in these countries that were previously polio-free.

In August, GPEI was able to resume vaccination campaigns, but the program now faces a daunting challenge. In Pakistan, GPEI initially reached 780,000 children under the age of 5 who live in the country's most at-risk districts. However, even with nationwide campaigns scheduled, UNICEF estimates that up to 1 million children in Afghanistan could miss out in cases where door-to-door vaccination is not possible.

If these children are not reached with vaccines, GPEI risks jeopardizing 30 years of progress against polio. Failing to eradicate polio now would open the door to a resurgence of this disease, which in 10 years could paralyze up to 200,000 children a year.

As a result of consistent U.S. investments over the last 30 years, we are closer than ever before to eradicating polio from the face of the earth. Such a milestone would be only the second time in history that we have completely wiped out a human disease, after smallpox eradication. Now is not the time to drop the ball.

This year, as in past years, I led the effort with Senator Reed, D-R.I., to secure $237 million in U.S. funding to strengthen polio eradication efforts. Based on the previous year's appropriations, I am optimistic about a positive outcome in fiscal year 2021.

A strong, well-funded GPEI is essential to winning the fight against polio and maintaining strong health systems that benefit people around the world.

To find out more about the Global Polio Eradication Initiative and its work to respond to polio and other disease threats, visit polioeradication.org.

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Story of the drop: what's inside a polio vaccine that prevents up to 3 million deaths every year - DAWN.com

Posted: 28 Oct 2020 12:52 AM PDT

Oral and inactivated types of vaccines use a live strain of the poliovirus to build antibodies and improve overall immunity.

Poliomyelitis, often identified as polio, is a crippling disease that remains preventable but entirely incurable around the globe. Till date, the only two vaccines available to the world for prevention against the wild virus are oral polio vaccines (OPVs) and inactivated polio vaccines (IPVs).

While some positive cases remain asymptomatic, others have reported fevers, stomach pains, sore throats, nausea, stiff necks, and headaches.

The disease is also known to travel from person to person via contaminated water.

According to the WHO, every year, immunisation campaigns help keep up to 3 million children under the age of five from dying of the disease that causes bone-related deformities.

How does the virus attack?

The live poliovirus attacks the human body by replicating itself first in the intestines; it then journeys all the way to the brain and spinal cord through blood.

Polio is known to cause paralysis when the virus is successful in reaching and attacking the nervous system.

In order to prevent this disease from leaving about 18 million people paralysed, two key vaccines were developed and made available in the 1950s; these are commonly known as inactivated polio vaccines (IPV) and oral polio vaccines (OPV).

Since discovery, the oral polio vaccine, which is a cheaper and more widely used solution in the developing world, has been administered through liquid drops via the mouth, while the inactivated polio vaccine, now the only form of polio vaccine used in the US, is given in the form of a series of shots.

**What are polio vaccines really made of?**

The early 1950s witnessed a remarkable advancement in the discovery of vaccines at the hands of Dr. Jonas Salk and Dr. Albert Sabin.

In what is seen as a near-miraculous milestone in the history of epidemics, these vaccines were successful in ridding nearly the whole world of the crippling virus.

To put together the oral polio vaccine (OPV), a mixture was created out of three live, attenuated poliovirus strains.

In order to keep the human body free of virus, the OPV builds antibodies in the blood against all three types of poliovirus, which shield the nervous system when an attack takes place and produce an immune response by lining the intestines, which are the first and preferred home of the poliovirus when inside the human body.

This response of the OPV makes it one of the most widely acknowledged solution to barring person-to-person transmission of the wild virus.

While the OPV was produced by weakening strains of the poliovirus, the IPV, or inactivated polio vaccine, purified the virus and then killed it with a chemical called formaldehyde.

To prevent paralysis, an IPV stops the wild poliovirus from reaching the brain and spinal cord, instead of lining the intestines.

Both methods of immunisation gained popularity due to their widespread success around most parts of the world, but the polio shot is more commonly preferred as it contains a dead virus that does not carry the ability to replicate, which is a key requirement for the disease to cause paralysis.

This widespread preference is rooted in the oral vaccine's inability to reduce side effects to zero.

It is said that in one of every 2.4 million recipients, the weakened virus strains carried in the OPV cause paralysis.

However, many countries around the world continue to use OPVs as these are relatively affordable, easy to use and good at building and maintaining immunity.

Widespread use of IPVs outside the US, in the developing world per se, has been difficult as these vaccines bring along high costs with an inability to assure biocontainment required for production.

Source: historyofvaccines.org

It is believed that the poliovirus has continued to attack humans for millions of years. Evidence of a crippling disease causing various bone deformities that appear polio-like in nature has lived through Egyptian carvings since the 1400s.

The disease was largely uncommon before mid of 1800s.

Have a look at this:

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It was in the 1900s that the wild poliovirus gained strength and turned into an epidemic.

In the recent times, following the 2000s, polio has been reduced to an endemic with strongholds in Pakistan and Afghanistan, with much larger numbers of active cases being reported as vaccination campaigns are faced with numerous challenges due to the coronavirus pandemic.

Pakistan is currently running a countrywide immunisation campaign aiming to vaccinate 40 million children this year, out of which around 32 million have already been successfully vaccinated across 130 districts.

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