The Lancet in one recent editorial, click for the full text, sends the alarm saying that, I quote, the epidemiological situation is concerning. COVID-19 temporarily halted the Global Polio Eradication Initiative (GPEI)'s immunisation campaigns, putting over 80 million children at risk. Consequently, outbreaks of circulating vaccine-derived poliovirus (cVDPV) tripled from 2019 to 2020, with over 1100 children paralysed. Paralysis caused by wild poliovirus in Malawi in late 2021 marked a return of the virus to Africa. In 2022, cVDPVs have been detected in wastewater in some industrialised countries. Nigeria has faced a large outbreak of 415 cVDPV cases. Vaccination rates are dwindling. Global polio immunisation rates fell to 80% in 2021, the lowest rate in 14 years.
GPEI's immediate concern is money. At a pledging event in October in Germany, it will ask for US$4·8 billion from partners and donor countries, and for political commitment to eradicate polio by 2026. The strategy for 2022–26, if funded, will see the vaccination of 370 million children annually and continued surveillance for polio and other diseases in 50 countries. But will donors be willing? Among economic instability, cost-of-living crises, and concerns over fragmentation of global health financing, governments might not see polio as important.
The GPEI has done indisputable good. Since its launch in 1988, it has overseen a 99·9% reduction in the global incidence of polio, saved more than 1·5 million lives, and spared an estimated 16 million people from paralysis. Two of the three serotypes of wild poliovirus (types 2 and 3) have been certified as eradicated worldwide. These are huge achievements. But the GPEI faces clear challenges that once again threaten the viability of the eradication programme. One thing is certain: a global resurgence of polio would be disastrous for health of children and adults.
The foreseen dangers would be regressive in countries such as India. Regrettably, the immunisation coverage is uneven and lower then 60%. As the article points out the pandemic disrupted primary health services and diverted resources of staff and equipment. Therefore, UNICEF needs to continue its support and advocacy to immunization and renew its relationship with Rotary International and other donors.
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