African leaders and developmental partners working on the eradication of polio have been urged not to relent on their achievements in ending polio on the continent.

This advice was given on Wednesday by the World Health Organisation (WHO) at the Regional Committee for Africa in Brazzaville.

The committee meeting, which began on Monday, is the highest decision-making body on health in the region and involves ministers of health from the Member States of the WHO African Region.

It meets once a year to review critical health issues affecting the continent and to advise on appropriate strategies to improve health outcomes.

Speaking on the milestone which has been achieved in polio eradication on the continent, WHO Regional Director for Africa, Matshidiso Moeti, said WHO is confident that soon the agency would be trumpeting the certification that countries have, once and for all, kicked polio out of Africa.

Three years on

August 21 marks the third year of no wild polio case notification in the continent.

47 countries in the WHO Africa Region are yet to be certified polio-free because of the polio case detected in Nigeria in August 2016.

The case was detected in Borno State, at the verge of the country been certified free of wild polio. Since then, Nigeria had embarked on rigorous polio vaccination campaign.

It is expected that if no case is detected by March 2020, the country and region might get the Wild Polio free certification.

With the ongoing trend, WHO is optimistic that the region will soon qualify as the continent passes a milestone threshold of three years with no case of wild poliovirus detected.

WHO in a press statement made available via its website said: “this three-year landmark sets in motion a comprehensive evaluation process by the Africa Regional Certification Commission to determine if the entire WHO African Region of 47 countries indeed can be declared to have eradicated wild poliovirus.

“Certification that the WHO African Region is free of wild polio is expected in early 2020,” the statement said.

The statement said if the evaluation process proves the wild virus is gone, Africa will join four of the WHO regions – the Americas, the Western Pacific, Europe and South-East Asia – in holding this distinction.

Currently, only three countries globally – Nigeria, Pakistan and Afghanistan are yet to be cleared of wild polio cases.

If Nigeria scales through by 2020, it will leave only the WHO Eastern Mediterranean region still working to stop the virus.

In her remarks, Ms Moeti praised the continent’s resilience and strong commitment to stopping the virus in overcoming the tough challenges.

“The path to eradicating polio in Africa has been a monumental effort of multinational coordination on an unprecedented scale, providing vaccinations to hundreds of millions of children and conducting immunization campaigns in some of the most remote locations in the world, with vigilance and exhaustive surveillance to timely detect outbreaks, including among people on the move,” she said.

“It has involved men and women volunteering in the thousands, sometimes putting themselves in harm’s way, some even sacrificing their life for this work.”

Ms Moeti also noted that “these successes would not have been possible without the incredible perseverance of countries and partners in the Global Polio Eradication Initiative who have mobilised the financial and technical resources to get the job done.”

Today’s acclaim came buttressed with caution for lingering challenges to immunisation coverage that are needed to protect communities from the rare non-wild polio strains that can emerge when a population is not thoroughly immunised.

Reaching every last child with life-saving vaccines as well as strengthening surveillance and routine immunisation across the region will be essential to sustain the progress against wild polio and other strains, she said.

Nigeria’s cases

Since the last wild polio case was detected in Nigeria on August 21, 2016, the government has organised more than a dozen supplementary immunisation campaigns with oral polio vaccine, worked on strengthening routine immunisation, improved its polio surveillance networks and deployed innovative strategies (market vaccination, cross-border points and outreach to nomad populations) to reach more children with polio vaccines.

Speaking at the World Press Conference on “Three years without Wild Polio Virus case in Nigeria”, in Abuja on Wednesday, the Executive Director, National Primary Health Care Development Agency (NPHCDA), Faisal Shuaib, said Nigeria has commenced the process for its certification as a polio-free country.

“There is no doubt that three years without a case of Wild Polio Virus is a historic milestone for the Polio eradication programme in Nigeria and the global community.

“We recall the seeming success between 2014 -2016 in the fight against the Wild Polio Virus that was truncated by the resurgence of the Wild Polio Virus in August 2016.

“The Federal Government of Nigeria through the National Primary Health Care Development Agency (NPHCDA) and development partners took the setback in their strides and mounted a globally acclaimed rapid and aggressive outbreak response.

“Mr President immediately released N9.8billion and charged the programme to look for more viruses and contain the outbreak within the shortest possible time. The result is what we are marking here today – 3 years of being WPV-free,” Mr Shuaib said.

Last effort

With the declaration of the last wild poliovirus in Nigeria as a sub-regional public health emergency of the Lake Chad Basin, polio workers from Cameroon, Chad, Niger and Nigeria painstakingly mapped the many islands of Lake Chad and travelled hours by canoe to reach hundreds of settlements for the first time.

And they rolled out a new app-based electronic surveillance system called e-Surve to track the virus to its very last hiding places.

Despite the progress, a number of remaining challenges – including inaccessibility due to conflict and insecurity in some areas, variations in campaign quality, massive mobile populations and, in some instances, parental refusal – have prevented health workers from reaching all children everywhere with polio vaccines.

Sub-optimal routine immunisation coverage has remained a critical challenge in some countries.

As a result, outbreaks of circulating vaccine-derived poliovirus – a rare occurrence in communities with low levels of population immunity – are still possible in several countries across Africa.

Ms Moeti said the milestone on wild polio is a positive sign of progress across the continent, but our work is not yet done.

“We must remain vigilant in our immunisation and surveillance efforts: Every country must continue ensuring that it is closely looking for the virus and reaching every child with vaccines,” she said.