You are here: > > >

February 2006

Data as at 7 February 2006

Download: english | français

Headlines

Polio endemic countries hit all-time low of 4: number of countries with indigenous polio has dropped to 4, as Egypt and Niger have not had indigenous poliovirus for more than 12 months. The remaining endemic countries are Nigeria, India, Pakistan and Afghanistan.
Yemen: strong social mobilization leads to successful campaign in January.
Chad: a case was reported, with onset of paralysis on 7 December, from Mayo Kebbi Ouest Province, close to the border with Cameroon. It is the first case in west and central Africa since May. Genetic sequencing to determine the origin of the case is ongoing.
Somalia: case numbers are beginning to decline, but major security and other challenges and parents' refusals have limited access to children during immunization activities.
US$ 150 million funding gap for 2006: to fully implement polio activities planned for 2006, US$ 75 million is needed by March and an additional US$ 75 million is needed by July.

Country Focus

Nigeria

Extensive transmission of both type 1 and type 3 poliovirus continues in the northern part of the country. With 770 cases reported in 2005, Nigeria accounted for 40% of global cases. The southern part of the country is polio-free, as no indigenous polio transmission has occurred there in 2005 (the Lagos case from August was an importation from the north of the country).
The Supplementary Immunization Activity (SIA) schedule for the spring of 2006 includes National Immunization Days (NIDs) on 11-14 February and 11-14 March. Monovalent OPV type 1 registration has been finalized and submitted to the Nigerian National Agency for Food, Drug Administration and Control (NAFDAC), and will be used during the February NID in two states in the south, and two states in the north.
The primary challenge remains ongoing coverage gaps during immunization campaigns, in six key states in the north of the country (Bauchi, Borno, Jigawa, Kaduna, Kano and Katsina). The number of children who have not received any doses of OPV remains high (between 40% and 52%).
For 2006, the focus is on replicating the improvements achieved at national and state levels, at the district and ward levels to help ensure every child is reached during activities, and reduce the number of zero-dose children by 50% over the next six months.

India

The first cases of 2006 have been reported, with a type 1 and type 3 confirmed in Uttar Pradesh.
In India, thanks to renewed and strengthened ownership at the state-level, dramatic improvements in the quality of the SIA round in Bihar were noted during the January Subnational Immunization Days (SNIDs).
Surveillance medical officers (SMOs) from the southern states were re-deployed to Bihar and Uttar Pradesh for the January round, and will remain to assist during the February SNID.
The primary challenge remains ongoing and efficient transmission in key reservoir areas. For 2006, focus continues to be on reaching every child with mOPV, particularly newborns.

Pakistan

In 2005, 27 cases were reported, compared with 53 for the same period in 2004.
The primary risk to Pakistan's polio eradication effort remains restricted access due to insecurity in some areas of the country, most notably the tribal areas bordering Afghanistan in North West Frontier Province (NWFP), Balochistan, and areas in southern Punjab and northern Sindh.
For 2006, key to success will be to implement specific strategies to identify and reach missed populations in these areas.

Afghanistan

The primary risk to Afghanistan's polio eradication effort is difficulty in accessing children due to insecurity in Hilmand and Uruzgan - the only two remaining polio-infected areas of the country.
For 2006, key to success will be to implement specific strategies to identify and reach missed populations, particularly populations travelling between Afghanistan and Pakistan.

Niger

Niger was officially removed from the list of endemic countries, having not detected indigenous poliovirus transmission for more than 12 months. All reported cases in 2005 have been genetically linked to poliovirus circulating in northern Nigeria.
The primary challenge remains potential importations from neighbouring Nigeria. The focus for 2006 will be on maintaining high population immunity.

Indonesia

The country launched an SNID on 27 January, in Aceh, parts of north and south Sumatra, Lampung, Banten, East Java and Madura. Initial anecdotal feedback suggests overall good quality, with particular improvements noted in Banten province (where no polio has been reported in more than 3 months).
Finalization of the 2006 SIA schedule is ongoing with the government. With strong improvements in curbing the outbreak in the second half of 2005, conducting an adequate number of high quality campaigns in 2006 will be key to success.

Horn of Africa

In Somalia, 177 cases have been reported since the outbreak began there in July 2005.
All areas of the country which are currently infected (Mogadishu, Lower Shabelle, Hiran and Sool) are major security risks, and accessing all populations is extremely challenging. Continuing to work with local staff and communities, and identifying all windows of opportunity to gain access (including high level advocacy, and corridors of peace for humanitarian interventions) are essential to success in Somalia.
In Ethiopia, the most recent case had onset of paralysis on 6 December, from Oromia province. The next NID will be held on 17 February, and additional SIAs may be necessary. It is extremely important to stop transmission in Ethiopia as soon as possible.
In Yemen, the NIDs held on 29-31 January were of extremely high quality. More than 36,000 vaccinators aimed to reach 3.8 million children under the age of five years. Of note has been the strong social mobilization work, focusing on extensive mass media communications and megaphone-miking across villages and towns.
A primary challenge remains limiting further spread of polio within the Horn of Africa. Focus for 2006 will be on increasing access to all populations in Somalia, and ensuring a sufficient number of high-quality campaigns are held in Ethiopia and Yemen.

Angola

Angola's most recent polio case had onset of paralysis on 13 November 2005, the first case in the country since September. The planned response to the case is a SNID, targeting 3 provinces with monovalent OPV, scheduled for 3-5 March.
The primary challenge remains potential ongoing, low-level transmission and subnational surveillance gaps. Focus for 2006 will be to further increase population immunity levels and strengthen disease surveillance at the subnational level.

The state of polio eradication

In 2005, the world moved several critical milestones closer to polio eradication, including the successful introduction of the powerful new monovalent oral polio vaccines, visible progress in the hardest endemic areas and an end to west and central Africa's epidemic (outside Nigeria/Niger).
Only 4 countries are still polio-endemic - an all-time low: Nigeria, India, Pakistan and Afghanistan. Egypt reported its last poliovirus in an environmental sample in January 2005, and Niger's cases were all importations from Nigeria.
Eleven previously polio-free countries reported polio cases in 2005 (Somalia, Yemen, Indonesia, Sudan, Ethiopia, Angola, Mali, Cameroon, Chad, Eritrea and Nepal).
The necessary tools to eradicate polio are now in place. Stopping polio transmission can be completed rapidly, except in Nigeria. Nigeria will need at least an additional 12 months to finish the job, due to a 12-month suspension of immunizations in 2003-04.

The remaining challenges to a polio-free world are:

Primary challenge: Breaking the final chains of polio transmission in the endemic countries.
Acute challenge: Quickly stopping polio outbreaks in previously polio-free countries.
Cross-cutting challenges:

Maintaining funding and political commitment;
Addressing low routine immunization rates in polio-free countries;
Ensuring sufficient vaccine is available.

Polio eradication will only succeed if the necessary funds are made available, and with strong political commitment in polio-affected countries. More than 10 million children will be paralysed in the next 40 years if the world fails to capitalize on its US$4 billion global investment in eradication.