How to Eradicate Polio? Funds+Vaccines+Access+Equity+Enthusiasm!

Polio was supposed to be eradicated 22 years ago – but we face serious challenges in getting there. That Global Polio Eradication Initiative (GPEI) hopes to raise $4.8 billion at the World Health Summit in October to support immunization of 370 million children each year for the next five years and global surveillance for polio and other diseases in 50 countries. The G7 and other high-income donor countries have an opportunity to help eradicate polio, but the prospects are uncertain.

Piecemeal and purely technical solutions will not suffice to eradicate polio. Unless we address other, more political and structural challenges – and do so in a synchronous manner – our collective impact will be far less than intended.

The virus remains endemic in only two countries — Pakistan and Afghanistan — but recently Malawi and Mozambique have also emerged. Furthermore, the evidence that recent cases of vaccine-induced polio in New York, London and Jerusalem originated abroad offers a stark reminder of how viruses can spread in this era of globalization.

To eradicate polio, every child in every household must be vaccinated, but that is no easy task. For example, millions of children in Afghanistan still cannot be vaccinated against polio for a number of security and political reasons. The Taliban’s 2018 ban on door-to-door polio vaccination resulted in about 3.3 million children not being vaccinated against polio. The Taliban have since lifted the ban, but insecurity in the country has worsened over the past year and continues to prevent health workers from reaching children.

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Katherine Wu from The Atlantic is right when she states that eradicating a virus requires “a near-perfect synchronization of vaccine supply, access, equity, political will, public enthusiasm, and more.” When smallpox was finally eradicated in 1979, it was only after decades of global vaccination campaigns that reached almost every corner of the world. And even then, it required constant vigilance from public health officials to prevent outbreaks. The same goes for polio eradication.

So, in the current context, is near-perfect synchronization possible for polio eradication? It can be with the right approach and the necessary resources.

The politicization of public health

Even if a vaccine is distributed worldwide, it can only be effective if people are willing to get vaccinated and make it a priority. And that willingness will only come if there is trust in the vaccine and the institutions (e.g. governments) responsible for its distribution. Unfortunately, the historical politicization of public health, the increasing divergence in immediate priorities between the Global North and Global South, and the anti-vaccination movement fueled by the COVID-19 pandemic have made the relationship between communities and public health workers even more strained. This is further exacerbated by misinformation being spread through social media on a global and local scale. Although polio has been plagued by misinformation from its inception and has become a massive political issue in many countries, particularly because of the confusion surrounding the term “vaccine-derived polio”.

Humanitarian Access

Even before the COVID-19 pandemic, major global health players were working to eradicate wild poliovirus worldwide by the end of 2018. However, these efforts have been severely hampered by war, violence and humanitarian crises. The communities most in need of humanitarian assistance are often the hardest to reach. in the Syria For example, more than 6.8 million Syrians have had to flee their country and 6.9 million people have been internally displaced due to conflict since 2011, making it difficult for health workers to reach them. In addition, conflict zones are often also areas with fragile health systems. As a result, children in these regions are particularly vulnerable to disease and almost impossible to reach, as illustrated by the estimated 23% of zero-dose children in humanitarian crises. These problems have been amplified and exacerbated by the increase in (approximately 36) humanitarian crises worldwide and donor fatigue resulting from the COVID-19 pandemic. Without overcoming structural barriers and improving support for health workers and flexibility for humanitarian organizations, these children will continue to be left behind.

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donor fatigue

When a major disaster strikes, the support of the international community is both important and encouraging. However, this support often wanes over time as people return to their everyday lives, donor countries turn to other priorities and invest less in the long-term recovery process. Known as donor fatigue, this phenomenon can have devastating consequences for charities that rely on continued financial support for their operations, as well as for the ultimate beneficiaries of the assistance. In the case of polio eradication efforts, this can create “immunity gaps” that allow the virus to circulate and spread across borders. The current donor fatigue for humanitarian crises and other appeals outside of Ukraine poses a major challenge to polio eradication efforts. Unless urgent appropriate action is taken, vaccination recovery programs and continued efforts to achieve polio eradication will become one more distant target.

workforce fatigue

An inadequate and overwhelmed workforce can cause failure in any industry, and the healthcare sector is no exception. Unfortunately, this is a long-standing issue that is finally getting the attention it deserves in the context of future pandemic preparedness.

In the case of polio eradication efforts, there are existing challenges related to Safety and security of healthcare workers In humanitarian crises and conflict situations, adequate human and financial resources have been tightened by the pandemic, which has led to an increase in mental and physical illness among health workers. A recent study found that during the pandemic, 23 to 46 percent of health and care workers reported symptoms of anxiety; 20 to 37 percent suffered from depressive symptoms and burnout in health and care workers between 41 and 52 percent. Additionally, during the pandemic, countries have had to advance the twin goals of COVID-19 vaccination and maintaining routine vaccination, which has also put a tremendous strain on those who supply vaccines – particularly in the more remote and marginalized communities.

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call to action

Piecemeal and purely technical solutions will not suffice to eradicate polio. Until we address other, more political and structural challenges outlined above – and do so in a synchronous manner too – our collective impact will be far less than intended.

The fight to eradicate polio has been going on for many years and requires a concerted and more honest, realistic effort from all concerned. Complacency and insufficient funding will be a major challenge to reach 370 million children annually and our collective success over the next five years.

Let’s use the collective experience and intelligence of humanitarian actors, advocates, governments, local workers and donors alike to solve problems and recommit to polio eradication by 2025.

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