Health and Healthcare Systems

How COVID-19 affected polio eradication and what we must do

FILE PHOTO: A girl receives polio vaccine drops, during an anti-polio campaign, in a low-income neighborhood as the spread of the coronavirus disease (COVID-19) continues, in Karachi, Pakistan July 20, 2020. REUTERS/Akhtar Soomro/File Photo

A girl receives polio vaccine drops, during an anti-polio campaign in Karachi, Pakistan July 20, 2020. Image: REUTERS/Akhtar Soomro/File Photo

Susanne Andreae
Head of Health and Healthcare Industry, World Economic Forum Geneva
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Healthy Futures

  • Sunday 24 October is World Polio Day.
  • While recent years have seen advancements in eradicating polio, COVID-19 has stalled these efforts.
  • The UN is preparing to vaccinate children under 5 in Afghanistan, after the Taliban recently agreed to the campaign.

Two years ago the world celebrated significant progress in ending polio. Thanks to a major global public health collaboration and mass vaccination efforts, the World Health Organization reported two of the three wild poliovirus strains had been eradicated.

Unfortunately, COVID-19 put a sudden hold to many of these advancements.

What is polio?

Polio is a life-threatening disease caused by a very contagious virus that only affects people. Its most severe symptom is paralysis, which can lead to permanent disability or death if the virus affects the muscles that help people breathe. Even people who contract polio as children and seem to fully recover can develop new muscle pain, weakness or paralysis as adults from post-polio syndrome.

There is no cure for polio, but the polio vaccine can protect people by preparing their bodies to recognize and fight the virus. Childhood vaccination against polio began in the 1950’s and has been the most effective tool in eradicating the disease.

How has COVID-19 affected polio efforts?

The past nearly 18 months have seen a significant backsliding in childhood vaccinations, as recent data from UNICEF suggest. About 23 million children missed out on their routine vaccinations in 2020, an increase of 3.7 million versus 2019.

Most concerning is the fact that most of these children have not received a single dose of vaccination, and many come from under-served communities, areas of conflict and remote regions with limited access to health. India and Pakistan are the two countries with the biggest increase in missed childhood vaccination, accounting for a total of 4 million missed doses.

A key reason for this increase has been the diversion of resources due to a strong focus on COVID-19. Poor awareness and vaccine hesitancy has hampered the progress of polio eradication in the two remaining countries with reported wild poliovirus cases, Pakistan and Afghanistan. Both countries have seen a spike in cases during 2020 after vaccination has been put on pause to protect communities from COVID-19.

At the same time, the pandemic also dramatically increased public awareness on vaccination and the public health benefits it can have. The emergence of WHO approved COVID-19 vaccines at unprecedented speed has drastically diminished mortality and morbidity in the vaccinated populations.

Since the resume of polio vaccinations in August 2020, both countries have the lowest reported cases of polio in 2021 in more than a decade. It's a positive step that the UN is preparing to vaccinate children under 5 in Afghanistan, including the more than 3.3 million who could not be reached since 2018, after the Taliban agreed to the campaign.

Wild poliovirus cases reported in the first eight months in Pakistan and Afghanistan
Wild poliovirus cases reported in the first eight months in Pakistan and Afghanistan Image: Nature

What needs to happen next to eradicate polio?

The world now needs to come together and rally behind the new Polio Eradication Strategy 2022-26 to get the eradication process back on track. Through a collective effort and strong global collaboration, the global health community can put the polio eradication program on a path to success.

According to Henrietta Fore, the Executive Director of UNICEF, “we will not allow the fight against one deadly disease to cause us to lose ground in the fight against polio and other childhood diseases.”

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