Angola’s Re-Match Against Polio Underscores the Urgency of Global Eradication

There have been many amazing success stories in the global campaign to eradicate polio. This past month adds another—Angola marked a full year without a new case of polio. Angola’s accomplishment is the latest evidence that we are extremely close to ending polio forever. Earlier this year, the World Health Organization (WHO) announced that India had gone a year without a new case of polio—a remarkable accomplishment considering its size and population. A sustained global public health effort over the last 24 years has led to more than a 99 percent reduction in polio cases and only 650 new cases in 2011.

Polio is a formidable foe and Angola is one of the world’s poorest nations with numerous health challenges to tackle, which makes Angola’s achievement especially noteworthy. After eliminating its own poliovirus over a decade ago, Angola persistently fought to stop transmission of polio virus imported on several occasions from outside the country. The last importation of the polio virus took several years and over 30 polio vaccination campaigns to stop the transmission.

Angola’s experience with polio is a stark reminder that countries that have eliminated polio within their borders are not safe from a new polio outbreak until the entire world is free of this vaccine-preventable disease. An impoverished country of 18 million in southwestern Africa, Angola originally defeated polio in 2001 despite decades of civil war, showing that polio can be eliminated under challenging circumstances. Angola remained free of the disease until 2005, when polio returned due to cross-border transmission. Porous borders and water and food contamination—key ways polio spreads—are especially big challenges in countries like Angola. But new outbreaks can occur in any country, including China and Tajikistan last year, and will continue to be a threat everywhere if the world does not ensure that we eradicate polio.

Angola’s leaders and citizens deserve a lot of credit for their determination to eliminate polio not just once, but twice. This is no easy or inexpensive feat, especially for poor countries like Angola, which must use limited resources for many other pressing health priorities to re-tackle polio. Angola, which now shoulders 90 percent of the operational costs of these campaigns, succeeded because of a deep commitment among government officials at all levels and the involvement of community and religious leaders, NGOs, and volunteers. Officials deployed huge vaccination campaigns involving thousands of health workers and volunteers going door-to-door, positioned on main streets, and canvassing markets. In Cazenga – one of the poorest municipalities – volunteers were each assigned to stay in contact with 10 families to ensure that they received regular checkups and vaccinations.

Like all 125 countries that have gotten rid of polio since 1988, Angola’s leaders and citizens also deserve the global resolve needed to ensure that no country ever has to go back and re-do the hard, expensive work that’s already been done to protect their children from polio. This will ensure that these countries can focus their resources on other pressing health priorities.The only way we can achieve this monumental goal is for all countries to take responsibility for making the world polio free. This means:

• We need to increase political will in existing and new donor countries to fill the Global Polio Eradication Initiative’s existing funding gap of almost $1 billion through 2013, and to commit to funding the GPEI for the long term until the job is done.
• Endemic countries—Afghanistan, Nigeria and Pakistan—where polio transmission has never been stopped must continue their strong political commitment to do everything they can to protect their children and the world’s children from polio.
• Countries such as Angola and India need to remain vigilant, continue dispensing the polio vaccine and improve routine immunization to ensure their children stay protected from vaccine-preventable diseases.
• Polio eradication partners such as the WHO and UNICEF must work on improving vaccination campaigns and protect every child with the polio vaccine.

We must not let go of the idea that we can ensure that all the world’s children will be safe from polio and on their way to protecting all children from vaccine-preventable diseases. I know I don’t.