Rtn. Dr. Md. Hemayatul Islam Arif
Introduction
World Polio Day, observed annually on October 24, serves as a poignant reminder of the global fight against polio, a highly infectious viral disease that once devastated millions of lives. While the world has made significant strides towards eradicating polio, the fight is far from over. In 2024, as we reflect on the achievements of past efforts, we are also reminded of the urgent need to reach every last child, especially in regions where polio remains endemic or where vaccination coverage is insufficient.
The journey to eradicate polio has been long and challenging, but it is one of the greatest public health achievements in human history. Global collaboration through organizations like the World Health Organization (WHO), Rotary International, UNICEF, the Bill & Melinda Gates Foundation, and local governments has brought us to the brink of eradication. However, polio still poses a threat, and World Polio Day 2024 offers an opportunity to reflect on how far we’ve come and to re-energize efforts to ensure no child is left vulnerable to this disease.
The Impact of Polio: Why Eradication Matters
Poliomyelitis, commonly known as polio, is caused by the poliovirus, which spreads primarily through contaminated water and food. It mainly affects children under five, leading to irreversible paralysis in some cases and death in more severe instances. Before the introduction of vaccines in the 1950s, polio was one of the most feared diseases in the world, responsible for paralyzing or killing hundreds of thousands annually.
Even though polio has been eradicated in most parts of the world, it remains endemic in two countries: Afghanistan and Pakistan. Outbreaks can still occur in countries with low vaccination rates, posing a risk of resurgence. For those who survive polio, the long-term effects include physical disabilities, social stigma, and economic hardships, especially in low-resource settings. The goal of global polio eradication is not only to save lives but also to prevent suffering and reduce the economic burden associated with polio-related disabilities.
Progress in Polio Eradication
Since the launch of the Global Polio Eradication Initiative (GPEI) in 1988, there has been a dramatic reduction in polio cases. At that time, polio was endemic in 125 countries, and the virus caused around 350,000 cases of paralysis each year. Thanks to the widespread use of the oral polio vaccine (OPV) and later, the inactivated polio vaccine (IPV), the number of polio cases has decreased by more than 99%. In 2023, there were fewer than 150 reported cases worldwide.
This progress has been remarkable, with large regions such as the Americas (1994), Europe (2002), and Southeast Asia (2014) certified as polio-free. However, the remaining challenges are the hardest to overcome. Polio transmission continues in Afghanistan and Pakistan due to a combination of factors, including insecurity, logistical difficulties, and resistance to vaccination. Recent outbreaks in other countries, such as Malawi and Mozambique, have highlighted the risk of re-emergence in areas with insufficient immunization coverage.
World Polio Day: A Day for Awareness and Action
World Polio Day, first established by Rotary International over a decade ago, is more than just a day of awareness. It serves as a rallying point for the global community to reaffirm its commitment to a polio-free world. The theme of World Polio Day 2024, “Reaching Every Last Child,” highlights the importance of ensuring that no child is left behind in the global vaccination efforts.
The observance of World Polio Day brings together healthcare professionals, advocates, governments, and international organizations to share stories of progress, honor the work of those on the frontlines, and discuss the remaining challenges. Importantly, it is also a day to raise awareness among the public and mobilize resources for ongoing vaccination campaigns and polio surveillance efforts.
Events on World Polio Day 2024 will include a mix of digital campaigns, fundraising initiatives, and educational seminars to inform the public about the importance of vaccination and the risks posed by complacency. Rotary clubs worldwide, along with GPEI partners, will host events aimed at generating awareness, fostering support, and encouraging donations to support the final push for eradication.
Challenges in the Final Stages of Eradication
While the end of polio is within sight, several critical challenges remain that could jeopardize eradication efforts if not addressed effectively. These include:
1. Insecurity and Conflict: In regions such as Afghanistan and parts of Pakistan, ongoing conflict and insecurity make it difficult to reach children with life-saving vaccines. Healthcare workers often face dangers in delivering services, and some communities remain inaccessible.
2. Vaccine Hesitancy: Misinformation and fear surrounding vaccines have led to increased vaccine hesitancy in certain regions, particularly in Afghanistan and Pakistan. In some cases, cultural and political opposition to vaccination campaigns has hindered progress.
3. Surveillance and Detection: Maintaining robust surveillance systems is crucial for detecting cases of polio, especially as we approach eradication. In regions where healthcare infrastructure is weak, underreporting can delay responses to new outbreaks.
4. Funding Gaps: The final stages of polio eradication are also the most expensive. Maintaining high levels of immunization, surveillance, and outbreak response requires sustained funding. Despite the significant investments made by governments and organizations like the Bill & Melinda Gates Foundation, funding gaps continue to be a major barrier to success.
5. Vaccine-Derived Polio: While the oral polio vaccine has been instrumental in reducing polio cases, in rare instances, the weakened virus in the vaccine can mutate and lead to vaccine-derived polio (cVDPV). This can happen in communities with low vaccination rates where the virus has the chance to circulate. Addressing cVDPV requires ensuring high immunization coverage and transitioning to the safer inactivated polio vaccine (IPV) in areas at risk.
Innovations and Success Stories
Despite the challenges, there have been several innovations and success stories in recent years that offer hope. New technologies, such as satellite mapping and mobile data collection, are helping health workers reach remote populations. These tools allow teams to identify unvaccinated children and target vaccination campaigns more effectively.
One of the most inspiring stories comes from Nigeria, which was once a polio-endemic country. In 2020, Nigeria and the entire African continent were declared free of wild poliovirus after years of tireless effort by governments, healthcare workers, and international organizations. This achievement was the result of improved surveillance, public awareness campaigns, and the heroic work of local volunteers, many of whom braved dangerous conditions to vaccinate children.
The Role of Communities and Volunteers
At the heart of the global polio eradication effort are the local communities and volunteers who have worked tirelessly to ensure children receive vaccines. Rotary International, one of the leading organizations in the fight against polio, has mobilized over a million volunteers worldwide. These individuals serve as advocates, educators, and vaccinators, often going door-to-door in difficult-to-reach areas.
In many regions, community leaders and healthcare workers have been crucial in overcoming vaccine hesitancy and misinformation. Their trust and relationships with local populations enable them to spread accurate information about the benefits of vaccination. Volunteers also help monitor for any signs of polio resurgence, reporting cases of acute flaccid paralysis, a hallmark of polio, to ensure quick responses to potential outbreaks.
The Future of Polio Eradication
As we look to the future, the success of global polio eradication depends on continued collaboration and commitment. Countries that have already eliminated polio must remain vigilant by maintaining high vaccination coverage to prevent re-importation of the virus. Surveillance systems must be strengthened to detect any cases early, and robust outbreak response plans need to be in place.
Moreover, the global community must continue to invest in research and innovation. Improved vaccines, such as the novel oral polio vaccine (nOPV), are being developed to address the challenges posed by vaccine-derived polioviruses. These vaccines have been designed to be safer and less likely to cause mutations that lead to cVDPV.
Lastly, it is crucial to address the broader issues that affect public health, such as poverty, education, and access to clean water and sanitation. Polio thrives in conditions of poverty, where children are more likely to be exposed to the virus and less likely to be vaccinated. By improving living conditions and healthcare infrastructure, we can create an environment where polio and other preventable diseases are less likely to take hold.
Conclusion: Reaching Every Last Child
World Polio Day 2024 is a chance to reflect on the incredible progress that has been made in the fight against polio. We are closer than ever to eradicating this devastating disease, but the final push will require renewed dedication and effort. The theme, “Reaching Every Last Child,” serves as a reminder that no child should be left unprotected from polio, no matter how remote or difficult to reach.
The lessons learned from the fight against polio offer valuable insights for addressing other global health challenges. Through community engagement, international cooperation, and innovation, we can not only eradicate polio but also build stronger health systems that protect future generations from disease. As we commemorate World Polio Day 2024, let us all commit to supporting the final steps towards a polio-free world, ensuring that every child, everywhere, is safe from this preventable disease.
Writer: Club Executive Secretary/Director (2024-2025), Club Learning Facilitator (2024-2025), Club President (2023-2024) & Member (2014 - Present) of the Rotary Club Rajshahi Central
