The Horn of Africa is again polio-free, with Sudan, Ethiopia, Kenya and Uganda having reported no wild poliovirus cases for more than a year. Today marks a step towards the achievement of a major objective of the Global Polio Eradication Initiative's new strategy ? stopping polio in Africa.
The outbreak began in 2008, following the reappearance of wild poliovirus type 1 in the border area of southern Sudan and Ethiopia, and spread in early 2009 to the northern Sudanese city of Port Sudan, and to Kenya and Uganda. In total, 101 children were paralysed by polio in these four countries between 2 March 2008 and 30 July 2009. The cases in Port Sudan sparked particular international concern as it was from this area that, from 2004 to 2006, wild poliovirus type 1 spread to re-infect several countries, including Saudi Arabia, Somalia, Yemen and Indonesia.
A series of multi-country immunization campaigns, combined with the scale-up of technical support, and strong political engagement by the affected countries proved to be the backbone of the successful outbreak response.
The end of this outbreak is further evidence that the full and swift implementation of international outbreak response guidelines work. The new Global Polio Eradication Initiative Strategic Plan 2010-2012, recently adopted by the World Health Assembly, includes new measures to limit further international spread of polio and more rapidly stop new outbreaks. In this outbreak, some of these new approaches were applied; notably the Short Interval Additional Dose strategy, in which children are immunized at short intervals with type-specific vaccine to more rapidly raise population immunity levels.
The first milestone of the strategic plan calls for the cessation by mid-2010 of all polio outbreaks which began before this year. All eyes will also be on Angola and Chad to end transmission by the end of 2010. The threat of outbreaks remains a risk until transmission of wild poliovirus is stopped in all polio-affected countries, especially the remaining polio-endemic countries (Nigeria in Africa and Pakistan, India and Afghanistan in Asia). Importation of virus from such areas is currently responsible for ongoing outbreaks such as in Angola and Tajikistan, both of which have led to further international spread.
Of concern, financial constraints are forcing a reprioritization of further planned activities. As a result, Somalia and Ethiopia - where vaccination campaigns are necessary to protect gains - have had to delay activities to later in the year in order to free up international funding to support activities in areas with ongoing polio transmission.
Partners in the Global Polio Eradication Initiative are examining every possible option to mobilize additional resources, manage the cash flow, minimize any threat to progress made across the countries with importations of polio and meet the first milestone in the strategic plan. Achievement of the milestones will be monitored quarterly and assessed at end-2010 to determine if the GPEI is on track to meet its objectives.
Source: Global Polio Eradication Initiative (GPEI)
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