In 2011, there were over 130 cases of polio reported in the country (five times the number in 2010), from 29 infected districts according to figures from the Global Polio Eradication Initiative (GPEI) at the World Health Organization. Since cases have now been reported for five years, Chad has been categorised as a “re-established transmission country”.
Chad’s government is committed to fighting the outbreak and stamping out polio within its borders once more. In 2010, President Idriss Deby, received the Rotary ‘Polio Eradication Champion’ award for his engagement with polio eradication efforts in Chad. When presented with the award, the President affirmed “we will not let down our guard [and] we are remaining steadfast and multiplying our vaccination campaigns”.
Across such a large and poor nation as Chad, the fight is not an easy one. The country’s health system struggles to implement international vaccination guidelines and around a fifth of children regularly miss out on supplementary immunization activities. To ensure effective protection against polio, children require four doses of the oral vaccine over a six to twelve month period. When the outbreak of the poliovirus re-occurred in Chad, the medical response was not sufficiently rigorous to stop further transmission over a broad area. A spokesperson for the GPEI told IRIN “it is not to do with insecurity or lack of infrastructure”, but rather that local authorities “continue to miss too many children”.
To address the situation and in conjunction with international health partners, the government has put in place a national polio emergency plan. This includes focusing technical support teams on high-risk areas, such as the greater N’Djamena region. These teams will help to ensure vaccinators are properly trained, so they don’t miss families or order too few vaccines or ice packs. In some remote areas, communities can be unaware when children should be immunized and vaccinators need to go house to house.
To ensure coverage rates are improved, heads of districts will be charged with overseeing progress and reporting to the Ministry of Health, which will compile monthly reports. International agencies are also suggesting that new approaches might be applied in Chad to overcome any social resistance. For example, a “godmother” scheme has been used elsewhere, where women visit communities regularly to discuss the disease and identify children needing vaccination. If new tactics are tried and the government remains committed to more thorough vaccination coverage of the country’s children, the GPEI spokesman expressed a belief that “polio could be eliminated [from Chad] in six months”.