The detection of poliovirus in the sewage samples from Gaza in July 2024 is a double trouble for the country, putting already war-ravaged thousands of people living in camps at risk of contracting the highly infectious disease that can cause deformities and paralysis.
Across Gaza, thousands of people have been killed and wounded, and many are estimated to be missing. The health system is no longer functioning with the raging acute diarrhoeal disease, respiratory illnesses and Hepatitis-A and food insecurity, making the children even more susceptible to the disease.
There are several other instances in the past where humanitarian crises have augmented the spread of polio, such as in 2017 in war-torn Syria, which left 74 children paralysed. In Somalia, a decade-long civil war resulted in the longest unbroken chain of variant poliovirus transmission globally, circulating since 2017.
Noteworthy to mention that since 2014, wild poliovirus has not been detected in Somalia, and 2020, the African continent was certified wild poliovirus-free. But in Somalia, where health infrastructure has been ravaged by conflict, poverty and climate crises, other strains of polio still threaten children.
The global health community is extremely concerned about the recent reports of wild polio infections in places like Gaza, Mozambique, and Malawi, as well as the detection of poliovirus in sewage samples in the US and the UK. These events highlight how shaky the gains won in the decades-long battle against polio are and raise the possibility of a recurrence.
One of the most noteworthy public health successes in recent history was India's 2014 polio-free certification. Once thought to be the disease's epicentre, the nation's triumph was made possible by intensive vaccination campaigns, close monitoring, and broad community involvement. Despite significant obstacles, such as a sizable and heterogeneous population, logistical difficulties, and isolated cases of vaccine reluctance, this result was achieved.
But the current state of the world is a clear reminder that there is always a chance that polio can reappear. Even in areas that have been polio-free for years, the enduring threat is highlighted by the discovery of poliovirus in sewage systems in wealthy nations like the US and the UK.
These recent incidents have important ramifications for India. Even though the nation has been polio-free for almost ten years, it could be risky to become complacent. Prioritizing high vaccination rates and thorough surveillance is still necessary, particularly in underprivileged communities that might be at risk of a possible recurrence.
Maintaining awareness and combating vaccination reluctance is critical, according to public health experts, especially as vaccine fatigue spreads over the world in the wake of the COVID-19 epidemic. To guard against any chance of the virus resurfacing, it is crucial to maintain robust routine immunization programs.
The rise in polio cases in war areas like Gaza and nations like Malawi and Mozambique highlights the negative effects of political unrest and poor healthcare systems, as well as vaccination coverage gaps. Sufficient funds to sustain comprehensive immunization programs and a renewed commitment to international collaboration are necessary to meet these obstacles.
To plan and finance polio eradication efforts, groups like the Global Polio Eradication Initiative (GPEI) are essential. However, robust political backing and collaborations between donor and recipient countries are crucial to their work. To overcome logistical obstacles and provide life-saving immunizations to every child, a sustained worldwide commitment is necessary.
Recent polio detections further underscore the need to combine polio vaccination campaigns with larger health measures. By applying the lessons acquired from the quick spread of COVID-19 vaccines, routine vaccination programs and surveillance systems can be strengthened. Advances in vaccine administration and the application of digital tracking for immunization coverage can also reinforce these initiatives.
The polio outbreak in several areas warns that previous public health successes need to be vigorously safeguarded. In addition to becoming a strong example for other countries, India's hard-won victory against polio reminds us to remain vigilant. Global solidarity, strong surveillance, and continuous immunization are essential to achieving and maintaining a polio-free world.
References:
Global Polio Eradication Initiative. Polio vaccination campaign to resume in northern Gaza. https://polioeradication.org/news/polio-vaccination-campaign-to-resume-in-northern-gaza/
Areesha Lodhi. Polio returns to Gaza: Where else has the virus re-emerged? Alzajeera. 2 Sept. 2024. https://www.aljazeera.com/news/2024/9/2/polio-returns-to-gaza-where-else-has-the-virus-re-emerged
Ghebreyesus T A. Children in Gaza are now at risk of polio as well as bombs – we need a ceasefire now. World Health Organization. 1 Aug 2024. https://www.who.int/news-room/commentaries/detail/children-in-gaza-are-now-at-risk-of-polio-as-well-as-bombs---we-need-a-ceasefire-now
Polio Eradication initiative. Somalia. Eastern Mediterranean Region. https://www.emro.who.int/polio-eradication/priority-countries/somalia.html
About the author:
Mr. Janmejaya Samal is the Associate Professor at SRM School of Public Health, SRM Medical College Hosptial and Research Centre, Kattankulathur. He has worked in numerous National and international organisations in several Indian states. He has over 15 years of experience in public health practice.