Polio Eradication (PEP)

Polio is a crippling and potentially fatal infectious disease. There is no cure, but there are safe and effective vaccines, which given multiple times can protect a child for life. Eradicating polio requires immunizing every child until transmission stops and the world is free of all forms of poliovirus.

In 1988, the Global Polio Eradication Initiative (GPEI) - of which WHO is a founding member - set out to eradicate polio all over the world. The mission required mass vaccination, reaching every child. At that stage, it was estimated that 350,000 children around the world were paralyzed by polio each year.

In the African Region, tremendous progress has been made in polio eradication over the last decades. The region's geographic size, cultural diversity and logistical challenge, not to mention insecurity, displacement and pockets of vaccine refusal have shaped Africa's polio response, driving innovative solutions to reaching all children with the vaccine.

Thanks to the dedicated efforts of health workers, traditional and religious leaders, parents, Rotarians and country leaders, African nations have immunized hundreds of millions of children with polio vaccines, strengthened polio surveillance networks to detect any lingering traces of the virus, and implemented strategies to immunize hard-to-reach children.

Today, the fight continues against all forms of poliovirus. A rare vaccine-derived version of the poliovirus is affecting African countries with low immunization coverage, particularly among remote communities and those experiencing migration or conflict. Renewed efforts are underway to rid Africa of all remaining vaccine-derived polioviruses.

Over the years, the polio eradication program in the African Region has developed the technical expertise, disease surveillance and community networks and logistics capacity to respond to other diseases, and is often the first response to disease outbreaks, including the Ebola outbreaks in West Africa (2014) and DRC (2019).

What we do

To achieve the global certification of polio eradication, the GPEI Polio Endgame Strategy lays out three main pillars for achieving a world free of all polioviruses: Eradication (through immunization and disease surveillance), Integration and Containment.

Eradication

Routine immunization: The backbone of polio eradication is achieving high vaccination coverage among children. The best way to realize this is to add the oral polio vaccine (OPV), given in three doses to national routine immunization schedules. This level of coverage must be maintained, even after countries are declared polio free, because the virus can be re-introduced by cross-border travel and hesitancy around the vaccine.
Supplementary immunization: Does not replace routine immunization but catches children who, for various reasons, have been missed and are either not immunized or only partially immunized. It also boosts the immunity of children who have already received the full vaccination.
Targeted mop-up campaigns: Even with routine vaccination and supplementary immunization some children are still left un- or under-protected. To reach these remaining children, volunteers go door-to-door to administer the vaccine, in what are known as mop-up campaigns.
Disease surveillance: Active surveillance is central to the whole polio eradication initiative. Across the African Region a network of dedicated laboratories, virologists and field surveillance staff at each level play a role in the chain of surveillance.

Integration

Over the years, the polio eradication programme has developed extensive tools, infrastructure, knowledge and best practices in immunization, disease surveillance and outbreak response, as well as a vast network of human resources and wide geographic access. Polio resources have contributed tremendously to responding to humanitarian emergencies and diseases outbreaks across the African region.

Certification and containment

In order to certify the African Region as free of wild polio, a formal standardized process of certification is followed where all countries are required to meet strict criteria across immunization, disease surveillance and containment. Containment includes the destruction of polioviruses in laboratories, biosafety and biosecurity requirements for laboratories, vaccine production sites, or any other facility that handles or stores eradicated polioviruses, to minimize the risk of polio viruses being released into the community.