West and central Africa is on the brink of the largest polio epidemic in recent years

Jun 23 2004

Epidemiologists of the Global Polio Eradication Initiative today issued a stark warning that west and central Africa is on the brink of the largest polio epidemic in recent years.

The warning follows confirmation today that a child was paralyzed on 20 May by polio in the Darfur region of the Sudan, a country which had not seen the disease in more than three years. The virus is closely linked genetically to poliovirus endemic to northern Nigeria, which has spread through Chad in recent months.

Epidemiological data show that transmission of wild poliovirus continues to accelerate at an alarming rate in the region. In addition to the re-infection of the Sudan, five times as many children in west and central Africa have been paralyzed by polio so far in 2004 compared to the same period in 2003. 197 children have been paralyzed in Nigeria, following the suspension of polio immunization campaigns in northern Nigeria late last year.

"There is no question that the virus is spreading at an alarming pace," said communicable disease expert Dr David Heymann, the World Health Organization's Representative for Polio Eradication. "The fact that the Sudan is now re-infected is concrete evidence of the need to support a massive immunization response right across west and central Africa." Heymann stressed the re-infection of the Sudan is the latest setback to the strong progress Africa had achieved in eradicating polio. "At the beginning of 2003, only two countries in sub-Saharan Africa were polio-endemic. Today, however, Africa accounts for nearly 90% of the global polio burden, with children now paralyzed in ten previously polio-free countries across the continent."

Epidemiologists fear that a major epidemic this autumn (during the polio 'high season') would leave thousands of African children paralyzed for life. Children are particularly vulnerable in west and central African countries, surrounding Nigeria, as less than half of children in the region are routinely immunized against a series of diseases, including polio. In response to this threat, they recommended plans to hold massive, synchronized immunization campaigns across 22 African countries in October and November, aiming to reach 74 million children. These campaigns could avert a public health tragedy.

Recognizing that the northern Nigerian state of Kano remains the epicentre of the outbreak, federal and state authorities have been working to resolve a local controversy over the safety of the polio vaccine which had led to the suspension of campaigns in that area. In May 2004, Kano state authorities publicly announced to the world's press that polio immunization activities in the state would soon be restarted.

"These campaigns could avert a public health tragedy," said Carol Bellamy, UNICEF Executive Director. "But to be effective they must have strong, grass-roots support. The first priority should be to increase community participation in polio activities throughout the region. Many families still need re-assurance, in the wake of rumours spreading out of northern Nigeria, about the safety of the polio vaccine."

"So many Africans in so many corners of this continent have risked - and in some tragic cases lost - their lives to bring polio to the verge of eradication," said Jonathan Majiyagbe, President of Rotary International, and himself a native of Nigeria. "All of Africa must now work together to ensure that every child is immunized and protected forever from this devastating disease."

With a global investment of US$ 3 billion since 1988 for the eradication effort, including more than US$ 600 million committed by Rotary International, responding to this looming epidemic will require an additional US$ 100 million, of which US$ 25 million is urgently required by August for the first campaign.