January 28, 2021

A last effort to eradicate polio | Science

A last effort to eradicate polio | Science



No, the marked objective has not been achieved again. 2018 will not be the year in which the world celebrates the eradication of polio, as the international organizations and pharmacies that make up the Global Initiative for the Eradication of Poliomyelitis (GPEI, for its acronym in English), after breaching previous deadlines. But it is "very, very close" to achieve it and we must make a final "last effort". Because stopping when you are so close to the goal would constitute a potential disaster that could reverse decades of effort in a few years, experts warn.

"We have reached a point where we can not stop, because if we did we could very quickly, in just ten years, have more than 100,000 or 200,000 cases of polio a year," he warned. Michel Zaffran, director of the Polio Eradication Program of the World Health Organization (WHO), in a meeting with journalists on the occasion of the World Day of the Fight against Poliomyelitis that takes place this Wednesday.

So far in 2018, polio cases confirmed worldwide are limited to 20 in only two countries in the world, Afghanistan and Pakistan (where two other cases are pending investigation). Together with Nigeria, they are the three countries that the WHO qualifies as "endemic", but in the African nation two years ago no new cases were detected and it is very close to considering their certification, perhaps in "a couple of years" more, according to Roland Sutter, coordinator of the department of investigation and containment of polio of the WHO. If it goes so slowly, it is because all caution is little when it comes to fighting a disease as difficult and silent as polio, stressed all the experts at the meeting, face-to-face and virtual, organized by the pharmaceutical Sanofi Pasteur from Paris, the main manufacturer of the two reference vaccines against the disease: the oral and the injectable with inactivated virus.

They are, in any case, figures very far from those of 30 years ago, when the world set out to eradicate polio and launched the GPEI, a global alliance composed of national governments, the WHO, the International Rotary Association, the Centers for Control and Prevention of Diseases of the United States (CDC) and UNICEF.

So far in 2018, polio cases confirmed worldwide are limited to 20 in only two countries in the world, Afghanistan and Pakistan

In 1988, cases exceeded 350,000 in 125 countries. Twenty years ago, polio paralyzed 1,000 children every day, while in 2010 the total number of children paralyzed was 1,349, recalls the WHO.

Persistent challenges and a "hiding" virus

Studying the fight against polio now requires almost an exercise in geopolitics. Because the medical and logistical challenges that a combat like this demands, the political problems that remain the main impediment to eradicate this disease, after having widely overcome, although with many difficulties, religious prejudices or taboos, something that has been achieved by working closely with local religious and political leaders. If there are areas in Nigeria to which the thousands of volunteers who are the front line of the vaccination front – and often the main victims of the conflicts – have not yet arrived it is, above all, due to the presence of the terrorist group Boko Haram. Persistent conflicts in Afghanistan, threatened both by the Taliban and by the Islamic State, and the constant flow of migrations with the also problematic neighbor Pakistan, with which it forms an "epidemiological block", make it difficult to eradicate polio, which only it persists in very localized areas in these countries.

"If we have not managed to eradicate (polio) it is because it hides in the most inaccessible areas of the world and it's dangerous to vaccinate there", Zaffran summarized the situation. And because it is not so easy, he admitted, to end a disease so widespread only less than a generation ago. "What we do is something that has not been done before, we have never managed to eradicate a disease so prevalent in the world," he said. Yes, there is the precedent of smallpox, whose eradication was declared in 1980. "But that was a visible disease, you could see who was infected and thus determine where the virus was and proceed to vaccination to prevent it from spreading," he explained. the WHO expert. Polio, on the other hand, "spreads silently and the virus is hidden", which is why it is so important, the experts insisted, to vaccinate "every child in every population bag" there is, however remote or dangerous it may be. area.

A tiring, dangerous and often frustrating task, yes, but fundamental, experts emphasize. And, also, with clear economic advantages: according to Harvard professor Kimberly Thompson, who leads the initiative Kid Risk, focused on evaluating the benefits of health policies, what the world would save if polio eradication is achieved ranges from "40,000 to 50,000 million dollars". A figure taken, he explained, to "save eight million children from this disease" and, therefore, not only avoid the costs of their treatment, but also add the benefits of their productivity as human beings not affected by the terrible disabilities that they can cause polio.

It's just needed, Zaffran insisted, a final push. "We can finish this work, we can eradicate polio and enjoy a free world" of this virus so that "nobody, ever again, is afraid of contracting this terrible disease". A legacy, he said, that deserves to skip once more, for a year or two more, any deadline.

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