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Angola steps up the fight to eradicate polio

In a recent interview, Bill Gates publicised the view of leading experts that polio could be eradicated throughout the world (bar possibly one country) within the next three years.

Over the coming weeks, Mr Gates promised there would be new announcements about donations towards the fight against polio, since the eradication campaign requires a billion dollars each year. In 2011 and 2012, there is currently a shortfall of around 700 million dollars for the campaign. With contributions from his own ‘Bill and Melinda Gates Foundation’, as well as from other donors, Mr Gates hopes to close that gap. He said the fight to wipe out the virus in the last few countries was an “acute situation” which needed money now, but this would be “the best investment that can be made”.

Polio attacks the nervous system and can cause lifelong paralysis within hours of infection. Young children living in areas with poor sanitation are most at risk, contracting the disease by ingesting faecal material. Twenty years ago, the disease was endemic in 125 countries and paralysed nearly 1,000 children every day. Now there are just four countries where polio is still endemic – India, Pakistan, Nigeria and Afghanistan – and there has been a 99 per cent reduction in cases since 1988. Last year, infections dropped to just 940 worldwide, compared to 1,600 in 2009.  But according to Mr Gates, though the battle against polio may be in its endgame, “this last part is the hardest”.

This is because new outbreaks can appear without warning, such as the one which killed 32 people in Angola last year. The country had succeeded in stamping out polio for three consecutive years until a new strain (prevalent in India) re-emerged in 2005 and spread through Angola, Chad, Namibia, the Democratic Republic of Congo and the Republic of Congo. By December, 476 cases had been reported throughout this central African region and authorities began stepping up immunisation programmes. The outbreak was likely to have been caused by the fact that many young men had never been vaccinated as children because of wars taking place in the region 15-20 years ago.

The Independent Monitoring Board (IMB) of the Global Polio Eradication Initiative (GPEI) now focuses on helping individual governments ensure the eradication of the disease in their own countries. Angola’s health system is still recovering from years of war and in 2009, only a third of infants were vaccinated against polio due to lack of manpower and capacity in the service. Nevertheless, the Angolan government has vowed to play its part in banishing polio from its borders. The IMB, along with the United Nations Children’s Fund (UNICEF) and partners including the Gates Foundation, have agreed to support the government’s efforts, which will include better surveillance of new cases, an accelerated immunization programme for children and a campaign to raise awareness of water treatment and hygiene. Jos Vandalaers, head of UNICEF’s global immunization team says that if the Angolan authorities can lead the programme, then outside agencies and donors can “fill the gaps”. Success in Angola is vital, because as Mr Vandalaers explains, “if we fail in one country, then the whole programme fails”.

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