ARCC calls for urgent action to stop all forms of polio virus in Africa – Malawi

Group makes recommendations to address both the WPV1 outbreak in South East Africa and variants in Sub-Saharan Africa

As Southeast Africa continues to ramp up its efforts to stop an outbreak of wild polio virus type 1 (WPV1) that Malawi in FebruaryThe Africa Regional Certification Commission for Polio Eradication (ARCC) – the independent regional advisory body guiding Africa’s eradication efforts – called for urgent action to stop all forms of polio virus affecting the continent, be it wild or variant.

At its biennial meeting on June 6, the ARCC assessed regional epidemiology and praised the commitments of governments in Malawi, Mozambique, Tanzania and Zambia to launch a series of emergency response campaigns in response to the detected WPV1 in February. With two campaigns already underway, further activities planned for later in the summer will also focus on Zimbabwe participating in the sub-regional response efforts to outbreaks. The campaigns are supported by partners of the Global Polio Eradication Initiative (GPEI), notably WHO, UNICEF, BMGF, US CDC, GAVI and local Rotarians, and by the Africa Rapid Response team.

The ARCC has made four key recommendations to ensure that the outbreak can be stopped quickly, namely:

  • implementing plans to improve campaign quality, based on lessons learned and quality responses from the first two rounds;
  • assessment of WPV1 risks for older age groups and, where appropriate, expansion of target groups for further response to outbreaks;
  • to further expand and strengthen sub-national surveillance sensitivity to more clearly assess the potential spread of this outbreak and ultimately verify that the outbreak has successfully stopped; and,
  • conducting supervisory assessments in all five participating countries. Commenting on the response to the outbreak and the group’s deliberations, ARCC Chair Professor Rose Leke said: “Countries should be reminded that wild polio virus is endemic in Afghanistan and Pakistan, and Southeast Africa is now infected. The risk of polio virus re-introduction or re-emergence is high, and the best thing countries can do to minimize the risk and impact of polio is to boost immunity levels and sensitivity to sub-national surveillance.”

Countries, supported by GPEI partners, are also stepping up efforts to stop some outbreaks of poliovirus variants in the region, particularly in Nigeria, the Democratic Republic of the Congo (DR Congo) and other areas. To counter this development, the ARCC encouraged partners and countries to prioritize the novel new oral polio vaccine type 2 (nOPV2) to areas of highest risk.

“New OPV type 2 is an important new tool,” continues Professor Leke. “But at the same time, it has to reach the children it wants to reach. Variant polioviruses cripple children and affect their families and communities in the same way that wild polioviruses do, and must therefore be responded to with the same urgency and political commitment and oversight.”

Professor Leke and the ARCC members underlined the importance of building routine immunization capabilities and surveillance sensitivity, both of which are critical in combating a wide range of infectious diseases, including COVID-19 on the continent† According to Professor Leke, “The decline in routine vaccinations in the region is of particular concern and puts the most vulnerable children at increased risk of diseases such as polio.” As a result of the Covid-19 pandemic, an immunization and surveillance gap has emerged in many African countries as health workers have been restricted from routine activities by social distancing restrictions. While national oversight activities have been renewed, persistent gaps remain at the sub-national level. The various outbreaks in Africa in 2022 show that surveillance and routine immunization activities need to be improved.

In its closing remarks, the ARCC noted with appreciation critical milestones achieved, including the recent successful closure of 32 outbreaks from ten countries, at the end of the first quarter of 2022, which clearly shows that outbreak response strategies work if they are fully implemented and provided with the necessary resources. “We have the potential to achieve zero cases of polio,” concluded Professor Leke, “but only if we reach the remaining children with a zero dose. Let’s all focus our efforts on that, and when that happens, success will follow.”

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