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Millions of Children in Central Africa Vaccinated Against Polio

Hillary Mayell
for National Geographic
July 10, 2001
 
Thousands of health-care workers and volunteers came by air, by boat,
and on foot. They spread out across four countries of central
Africa—into villages, refugee camps, border crossings, and urban
centers—to immunize 16 million children against polio.

The
aim was to inoculate every child up to the age of five in Angola,
Congo-Brazzaville, the Democratic Republic of the Congo, and Gabon
during a five-day campaign that ended July 9.



According to early reports from the World Health Organization (WHO), which co-sponsored the event, the campaign appeared to come close to meeting its goal.

"Overall, preliminary results look very encouraging, but the final results won't all be in for another two weeks or so," said WHO spokesperson Claudia Drake. She added that estimates from preliminary results suggest that in Gabon, for example, the campaign reached nearly 90 percent of the children that had been targeted for vaccination.

The inoculation blitz, which involved about 250,000 health workers and volunteers, moves an ambitious campaign known as the Global Polio Eradication Initiative one step closer to attaining its goal of eliminating polio by 2005.

Limited Health Services

Poliomyelitis is a crippling disease that mainly affects children under the age of three. The international campaign to extinguish the virus was launched by WHO in 1988, when wild poliovirus was considered endemic in 125 countries.

Today, fewer than 20 countries are considered polio-endemic. The Western Hemisphere was declared polio-free in October 2000.

Yet polio is highly infectious, and some of the highest rates of transmission in the world have been found in Central Africa. According to WHO, Angola, Congo-Brazzaville, and the Congo account for 70 percent of all virus-confirmed polio cases in Africa.

Ongoing civil strife in some areas of those countries has made it difficult to reach children to deliver the vaccination. The fighting has also disrupted local health-care services.

At the same time, mass migration—either to avoid conflict or to find work—means that the wild poliovirus freely crosses borders. Gabon, for instance, is considered polio-free, but its population is at risk of transmission because of cross-border migration from polio-endemic countries.

Operating in War Zones

WHO recommends that children receive four oral polio vaccine doses by the age of one, as part of basic immunization coverage. Its main strategy for providing vaccination services has been to organize nationwide National Immunization Days.

During these campaigns, all children up to five years old are given two to three doses of the oral polio vaccine one month apart, regardless of their prior immunization status. To effectively halt transmission of the disease, a participating country must implement the immunization program for at least three consecutive years.

Because of the high polio risk in Central Africa, WHO expanded the scope of the immunization program to synchronize vaccination efforts in the four countries—a major task of coordination.

President Joseph Kabila of the Democratic Republic of the Congo and Kofi Annan, the Secretary General of the United Nations, both appealed for warring factions in the four countries to lay down their arms to allow health-care workers safe passage. Mohammed Jalloh, a spokesperson for UNICEF, said early reports indicate that, for the most part, groups engaged in conflict observed the so-called "days of tranquility."

To administer the next doses of the oral polio vaccine, WHO is coordinating synchronized follow-up days of national immunizations, scheduled for August 9 to 13 and September 13 to 17.

"The same 16 million children will be targeted for polio immunization, with the additional administration of Vitamin A in the second round," said Drake. Vitamin A is known to lower childhood mortality and prevent blindness.

While much progress has been made, the battle is not yet won.

"Just recently, the Global Polio Eradication Initiative announced that the eradication of polio is 99 percent complete," said Vivian Fiore, a spokesperson for Rotary International, which is one of the major sponsors of the initiative.

"In spite of this success, the remaining one percent poses the greatest challenge," she said. "Accessing all children in conflict areas, closing a U.S. $400 million funding gap, and maintaining political commitment in the face of a disappearing disease are the major obstacles that must be overcome."

The Global Polio Eradication Initiative is spearheaded by the World Health Organization, the United Nations Childrens Fund, the U.S. Centers for Disease Control and Prevention, and Rotary International.
 

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