Somalia scores ‘historic’ polio-free achievement

 

 

A nomadic child in Somalia is immunized against polio. Health officials identified and mapped routes used by nomadic populations, and set up vaccination points at key gathering sites to ensure coverage of this highly at-risk group of children. Photo by World Health Organization/Ahmed Tajudin.

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In a triumph over violence, poverty, and poor infrastructure, Somalia has once again become polio-free. The Global Polio Eradication Initiative (GPEI) announced on 25 March that the East African nation hasn’t reported a case of polio since a year ago. Although it eradicated the disease in 2002, Somalia became reinfected in 2005 by poliovirus originating in Nigeria, resulting in an outbreak of 228 cases.

Innovative approaches tailored to conflict areas were pivotal in conquering polio in Somalia. More than 10,000 volunteers and health workers used several doses of monovalent vaccines to immunize children in insecure areas in a short period. With strong community support, the effort succeeded in reaching more than 1.8 million children under age five across one of the most dangerous countries on earth.

“This truly historic achievement shows that polio can be eradicated everywhere, even in the most challenging and difficult settings,” says Dr. Hussein A. Gezairy, director of the World Health Organization’s Eastern Mediterranean Regional Office.

One of Somalia’s volunteers and health workers is Ali Mao Moallim, the last person on earth to contract smallpox — the first disease eradicated worldwide — in 1977. Working with the World Health Organization, he has traveled extensively in his country to immunize children against polio and promote community support for immunization campaigns. “Somalia was the last country with smallpox,” he says. “I wanted to help ensure that we would not be the last place with polio too.”

“Somalia beat polio in the midst of more widespread conflict and poverty than that affecting Afghanistan and Pakistan,” says Dr. Maritel Costales, a UNICEF senior health adviser in New York, who cited the challenges of overcoming widespread insecurity and large population movements in a country with no central government. “But Somalia shows that when communities are engaged, children everywhere can be reached.”

Afghanistan and Pakistan, which together accounted for 5 percent of all polio cases in 2007, could be the first of the four remaining endemic countries — the other two are India and Nigeria — to end polio.

Consistent financial commitment continues to be crucial to polio eradication. Rotary International, the top private-sector contributor and volunteer arm of the GPEI, has contributed US$9.2 million for polio eradication in Somalia and $700 million worldwide since 1985. The global effort faces a shortage of $525 million for 2008-09, funding urgently needed to fight the disease in the remaining endemic countries and protect children in high-risk polio-free areas.

“Somalia clearly shows that the tailored tools and tactics of the intensified eradication effort are working,” says Mohamed Benmejdoub, chair of Rotary’s Eastern Mediterranean PolioPlus Committee. “A polio-free world is a feasible public health goal and a global public good. I urge governments across the world — and in particular the G-8 countries — to rapidly make available the necessary resources. Together, we can ensure that no child need ever again suffer the terrible pain of lifelong polio paralysis.”