The number of countries with indigenous polio has dropped to an all-time low of four, as polio eradication efforts enter a new phase involving the use of next-generation vaccines targeted at the two surviving strains of virus.
In 2006, monovalent vaccines, aimed at individual virus strains, will be the primary platform for eradication in all remaining polio-affected areas, announced the core partners in polio eradication - the World Health Organization (WHO), Rotary International, the US Centres for Disease Control (CDC) and Prevention and UNICEF, enabling the eradication drive to hone in on poliovirus types 1 and 3.
This new phase was announced alongside the confirmation that indigenous poliovirus has not circulated in Egypt and Niger for over 12 months. This is the first time in three years that the number of polio-endemic countries has fallen, leaving Nigeria, India, Pakistan and Afghanistan as the only countries that have never stopped indigenous polio transmission, informs a WHO release.
"Polio has been endemic in our country for all of recorded history. The best tools of our age finally defeated this enemy who has been with us from pharaonic times," said Egyptian Minister of Health Dr. Hatem Mostafa El-Gabaly.
Monovalent vaccine targeted at the type-1 poliovirus circulating in Egypt was used during vaccination campaigns there in May 2005.
Unlike Egypt, where the challenge to eradication was highly efficient polio transmission in crowded cities, Niger faced a sparse population, some of it nomadic, scattered over a vast country with a heavily-travelled border with Nigeria, the world's largest reservoir of poliovirus. Multiple immunisation campaigns in Niger were painstakingly planned to ensure children were being vaccinated even in the remotest and border areas. In 2005, the nine polio cases reported in Niger were all the result of importations over this border.
The success in Niger and Egypt is the result of intense efforts in 2004-05 to halt Africa's polio epidemic and fast-track the introduction of monovalent polio vaccines into selected areas. The number of cases of polio in India and Pakistan in the last quarter of 2005 also fell by more than half compared with the previous year, due to more effective immunisation strategies and the use of monovalent vaccine, added the release.
"To fully exploit these new tools, government commitment in Nigeria must remain high at all levels to ensure that all children are vaccinated," said Jonathan Majiyagbe of Kano, Nigeria and past President of Rotary International, which has contributed more than US$ 600 million and countless volunteer hours to a polio-free world.
Ninety per cent of polio cases in Nigeria are concentrated in just eight of the country's 37 states.
In addition to mass immunisation with monovalent vaccines in the four endemic countries, large-scale campaigns with these vaccines will take place in 2006 in eight countries, including Somalia, Indonesia and Yemen to stop recently imported polioviruses. Critical to the success of these campaigns is a US$ 150 million shortfall which must be filled as rapidly as possible. The eradication effort requires a further US$ 425 million for the 2007-2008 period.