Friday 25th September 2015- World Health Organisation: WHO Removes Nigeria from Polio-Endemic List

‘WHO announced today that polio is no longer endemic in Nigeria. This is the first time that Nigeria has interrupted transmission of wild poliovirus, bringing the country and the African region closer than ever to being certified polio-free.’

‘The Global Polio Eradication Initiative (GPEI), the public-private partnership leading the effort to eradicate polio, called this a ‘historic achievement’ in global health. Nigeria has not reported a case of wild poliovirus since 24 July 2014, and all laboratory data have confirmed a full 12 months have passed without any new cases.’

‘Polio, which can cause lifelong paralysis, has now been stopped nearly everywhere in the world following a 25-year concerted international effort. Polio remains endemic in only 2 countries – Pakistan and Afghanistan. The eradication of polio globally now depends primarily on stopping the disease in these countries. As long as polio exists anywhere, it’s a threat to children everywhere.’

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WHO Removes Nigeria from Polio-Endemic List

Nigeria reaches polio ‘milestone’ as disease declared to be no longer endemic- The Independent

Wednesday 2nd September 2015- BBC News: Children paralysed in Ukraine polio outbreak

‘Two children have been paralysed in the first polio outbreak in Europe for five years, according to the World Health Organization (WHO).

Both cases were in Ukraine where only half the children are fully immunised.

It is likely large numbers of other children have also been infected without developing symptoms.

The WHO said the risk of the virus spreading further in the country was “high” and that the outbreak needed to be rapidly controlled.

One of the paralysed children was four years old and the other just 10 months.

Both were from south-western Ukraine near the border with Romania, Hungary, Slovakia and Poland.

The outbreak started from the weakened form of the virus that is used in vaccination. Sometimes it can mutate and start to spread if immunisation levels are too low.

Oliver Rosenbaum, a spokesperson for the Polio Eradication Initiative at the WHO, told the BBC News website: “It is now a dangerous strain.'”

See:

Children paralysed in Ukraine polio outbreak

Sunday 12th July 2015- The Lancet: Threats to polio eradication in high-conflict areas in Pakistan and Nigeria: a polling study of caregivers of children younger than 5 years

Background

Elimination of poliovirus from endemic countries is a crucial step in eradication; however, vaccination programmes in these areas face challenges, especially in regions with conflict. We analysed interviews with caregivers of children living in two polio-endemic countries to assess whether these challenges are largely operational or also driven by resistance or misinformation in the community.

Methods

We designed and analysed polls based on face-to-face interviews of a random sample of parents and other caregivers of children younger than 5 years in regions of Pakistan and Nigeria at high risk for polio transmission. In both countries, the sample was drawn via a stratified multistage cluster design with random route household selection. The questionnaire covered awareness, knowledge, and attitudes about polio and oral polio vaccine (OPV), trust in vaccination efforts, and caregiver priorities for government action. We assessed experiences of caregivers in accessible higher-conflict areas and compared their knowledge and attitudes with those in lower-conflict areas. Differences were tested with two-sample t tests.

Findings

The poll consisted of 3396 caregivers from Pakistan and 2629 from Nigeria. About a third of caregivers who responded in higher-conflict areas of Pakistan (Federally Administered Tribal Areas [FATA], 30%) and Nigeria (Borno, 33%) were unable to confirm that their child was vaccinated in the previous campaign. In FATA, 12% of caregivers reported that they were unaware of polio, and in Borno 12% of caregivers reported that vaccinators visited but their child did not receive the vaccine or they did not know whether the child was vaccinated. Additionally, caregivers in higher-conflict areas are less likely to hold beliefs about OPV that could motivate acceptance and are more likely to hold concerns than are caregivers in lower-conflict areas.

Interpretation

Beyond the difficulties in reaching homes with OPV, challenges for vaccination programmes in higher-conflict areas extend to limited awareness, negative attitudes, and gaps in trust. Vaccination efforts might need to address underlying attitudes of caregivers through direct communications and the selection and training of local vaccinators.

See:

Threats to polio eradication in high-conflict areas in Pakistan and Nigeria: a polling study of caregivers of children younger than 5 years

Wednesday 22nd April 2015- World Health Organisation: Global vaccination targets ‘off-track’ warns WHO

‘Progress towards global vaccination targets for 2015 is far off-track with 1 in 5 children still missing out on routine life-saving immunizations that could avert 1.5 million deaths each year from preventable diseases.’

‘In 2013 nearly 22 million infants missed out on the required three doses of diphtheria-tetanus-pertussis-containing vaccines (DTP3), many of them living in the world’s poorest countries. WHO is calling for an end to the unnecessary disability and death caused by failure to vaccinate.’

‘In 2012, all 194 WHO Member States at the World Health Assembly endorsed the Global Vaccine Action Plan (GVAP), a commitment to ensure that no one misses out on vital immunization. However, a recent independent assessment report on GVAP progress rings an alarm bell… [as] only 1 of the 6 key vaccination targets for 2015 is currently on track – the introduction of under-utilized vaccines.

Many countries worldwide have experienced large measles outbreaks in the past year, threatening efforts to achieve the GVAP target of eliminating measles in 3 WHO Regions by end-2015.’

‘WHO estimates that today immunizations prevent between 2 and 3 million deaths annually and protect many more people from illness and disability.’

‘The Global Vaccine Action Plan envisions a world where everyone lives life free from vaccine preventable diseases by 2020. It set 6 targets for 2015:

Immunization against diphtheria, tetanus and whooping cough (DTP3)
Target: 90% immunization coverage against diphtheria, tetanus and whooping cough by 2015.
Gap: 65 countries

Introduction of under-utilized vaccines
Target: At least 90 low or middle income countries to have introduced one or more under-utilized vaccines by 2015.
ON TRACK

Polio eradication
Target: No new cases after 2014
Gap: 3 countries remain polio endemic

Maternal and neonatal tetanus: Global elimination by end-2015
Target: Eliminate maternal and neonatal tetanus
Gap: 24 countries

Measles elimination
Target: Eliminate from three WHO regions by end-2015
Gap: 16% of all children are not being immunized against measles

Rubella elimination
Target: Eliminate rubella from two WHO regions by end-2015
Gap: Half of all children do not receive the rubella vaccine’

See:

Global vaccination targets ‘off-track’ warns WHO

Tuesday 21st April 2015- World Health Organisation: WHO warns of imminent collapse of health care services in Yemen

‘WHO warns of an imminent collapse of health care services in Yemen. Health facilities are struggling to function as they face increasing shortages of life-saving medicines and vital health supplies, frequent disruptions in power supply and lack of fuel for generators. Lack of fuel has also disrupted functionality of ambulances and the delivery of health supplies across the country.

Power cuts and fuel shortages also threaten to disrupt the vaccine cold chain, leaving millions of children below the age of five unvaccinated. This increases the risk of communicable diseases such as measles, which is prevalent in Yemen, as well as polio, which has been eliminated but is now at risk of reappearing.

Shortages of safe water have resulted in increased risk of diarrhoea, and other diseases. “Over the past 4 weeks, national disease surveillance reports show a doubling in the number of cases of bloody diarrhoea in children below the age of 5, as well as an increase in the number of cases of measles and suspected malaria. High rates of malnutrition among women and children below the age of 5 have also been reported,” says Dr Ahmed Shadoul, WHO Representative for Yemen.’

See:

WHO warns of imminent collapse of health care services in Yemen

Monday 2nd March 2015- The Guardian: Pakistan jails 471 parents who refused to give polio vaccine to children

‘Hundreds of parents in north-west Pakistan have been arrested and jailed after refusing to give their children polio vaccinations, according to officials.

Feroz Shah, a spokesman for the district administration in Peshawar, said 471 people had been imprisoned in the city and surrounding villages under government orders on charges of endangering public security.’

Reasons for vaccination refusal included the fear of violence implied by the Taliban who prohibit vaccinations and have attacked health workers- as BBC News describes ‘In November four polio vaccination workers were shot dead in the south-west city of Quetta.’

Political involvement could be argued to deny the parental rights of the children’s families to decide whether their child is to be vaccinated or not, creating an ethical problem, as while the national safety of the region regarding the highly contagious nature of the polio virus is influential, does it excuse the government from depriving the patients’ parents of their say when it comes to their children’s safety, medically and socially?

See:

Pakistan jails 471 parents who refused to give polio vaccine to children– The Guardian

Pakistan arrests parents for refusing polio vaccine– BBC News

 

Thursday 19th February 2015- World Health Organisation: Immunization leaders call for increased political support for immunization in Pakistan

It has become apparent that childhood immunization in Pakistan is ‘at a crossroads and strong political will is required to ensure that the lives of millions of children are not put at risk’. Dr Seth Berkley, Chief Executive Office of Gavi, the Vaccine Alliance, Dr Ala Alwan, WHO Regional Director for the Eastern Mediterranean and Dr Geeta Rao Gupta, Deputy Executive Director of UNICEF are set to meet with leaders in Islamabad ‘to set out their concerns and offer their support to Pakistan moving forwards’.

‘Almost three million children miss out on a full course of the most basic vaccines every year in Pakistan, leaving them vulnerable to life-threatening diseases. Immunization coverage rates across the country vary widely with some districts seeing very few children protected against diseases, such as diphtheria, pertussis, tetanus, measles and bacterial pneumonia.

“Deaths among children under five years attributable to vaccine-preventable diseases constitute up to 25% of the total deaths among this age group in developing countries, including Pakistan,” said Dr Ala Alwan, WHO Regional Director for the Eastern Mediterranean. “Pakistan is not on track for achieving Millennium Development Goal No 4, which aims at reducing child mortality by two thirds by 2015. Increasing routine vaccination coverage will significantly contribute to reducing infant and child deaths and achieving MDG4.”’

‘“Pakistan has a choice to make for its children,” added Dr Berkley. “Routine immunization is the bedrock for access to vaccines against many illnesses, including polio, so by strengthening these systems Pakistan will be making an investment of political will which will benefit many generations to come.”’

See:

Immunization leaders call for increased political support for immunization in Pakistan