The group issues recommendations to address both the WPV1 epidemic in Southeast Africa and variants in sub-Saharan Africa
As Southeast Africa continues to intensify its efforts to halt the outbreak of wild-type poliovirus (WPV1) in Malawi in February, the African Regional Certification Commission for Polio Eradication (ARCC) has called on an independent regional advisory body to manage Africa’s eradication efforts. urgent measures to stop all forms of poliovirus affecting the continent, whether wild or variant.
In its mid-term review of regional epidemiology on 6 June, the ARCC commended the commitments made by governments in Malawi, Mozambique, Tanzania and Zambia to launch a series of emergency response campaigns in February in response to the WPV1. As two campaigns have already been implemented, other activities planned for later this summer will also involve Zimbabwe, which will take part in sub-regional efforts to respond to the outbreak. The campaigns are supported by Global Polio Eradication Initiative (GPEI) partners, in particular WHO, UNICEF, BMGF, US CDC, GAVI and local Rotarians, and the Africa Rapid Response team.
The ARCC made four key recommendations to help ensure a rapid cessation of the epidemic, namely:
- implementing plans to improve the quality of campaigns on the basis of experience gained and evaluating the quality of response from the first two rounds;
- WPV1 risk assessment for older age groups and, where appropriate, extension of target age groups for further response to the outbreak;
- further expanding and strengthening the sensitivity of sub-national surveillance in order to more clearly assess the potential spread of the epidemic and, where appropriate, to verify that the epidemic has been successfully stopped; and,
- conducting supervisory evaluations in all five participating countries. Commenting on the outbreak and the group’s actions, Professor Rose Leke, Chair of the ARCC, said: “Countries need to be reminded that wild poliovirus is endemic in Afghanistan and Pakistan and that South East Africa is now infected. The risk of re-introduction or re-occurrence of poliovirus is high and the best thing that countries can do to minimize the risk and consequences of polio is to strengthen the levels of immunity and sensitivity of sub-national surveillance. “
The countries, supported by GPEI partners, are also stepping up their efforts to halt a number of poliovirus outbreaks in the region, notably in Nigeria, the Democratic Republic of the Congo (DRC) and other areas. To combat this development, the ARCC called on partners and countries to prioritize the supply of a new oral polio vaccine type 2 (nOPV2) to the highest risk areas.
“The new OPV type 2 is an important new tool,” continued Professor Leke. “At the same time, however, he must reach the children he is to reach. Variant polioviruses paralyze children and affect their families and communities in the same way as wild polioviruses, and therefore need to be addressed with the same level of urgency and political commitment and oversight.
Professor Leke and members of the ARCC underlined the importance of building routine immunization skills and surveillance sensitivity, which are essential in the fight against a wide range of infectious diseases, including COVID-19 on the continent. According to Professor Leke: “The decline in routine immunization in the region is of particular concern and exposes the most vulnerable children to an increased risk of diseases such as polio. In many African countries, the Covid-19 pandemic has created a gap in immunization and surveillance, as health professionals have been restricted in their day-to-day activities by restricting social distance. Although national supervisory activities have been relaunched, persistent gaps remain at lower levels. Various outbreaks in Africa in 2022 show that surveillance and routine immunization activities need to be improved.
In its concluding remarks, the ARCC noted with appreciation the critical milestones reached, including the recent successful closure of 32 outbreaks from ten countries at the end of Q1 2022, clearly showing that outbreak strategies work well when fully implemented and secured. “We have the opportunity to achieve zero cases of polio,” Professor Leke concluded, “but only if we reach the remaining children with zero doses. Let us all focus our efforts on this, and if that happens, success will follow. ”
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