Obstacles preventing us from eradicating polio

History of Polio

Polio is a viral infection caused by the poliovirus type 1, 2, and 3. Polio at first mimics flu-like symptoms, and in its most severe form it can cause paralysis and death. It is likely that polio has been infecting humans for thousands of years because an Egyptian carving from 1400 BCE depicts a young man with a leg deformity. Polio infected humans at low levels throughout the 1800s, but in the the early 1900s, polio became an epidemic in even developed countries. In 1953, Jonas Salk developed the first polio vaccine and by 1988, there was a 99% decrease in polio cases. Polio was eliminated from the Western Hemisphere in 1994, but polio remains endemic in Afghanistan, Pakistan, and Nigeria (see image below). The World Health Organization (WHO) aims to eliminate polio off of the face of the earth, which would make it the third disease to be eradicated after smallpox and rinderpest.

Image from CDC

Polio is almost gone, but there are huge obstacles to overcome in Pakistan

On World Polio Day (October 24), WHO formally certified the eradication of wild poliovirus type 3. That day marked a major feat in global health because now there’s only one type of the virus left in the world: poliovirus type 1. Poliovirus type 2 was officially eradicated in 2015. Poliovirus type 1 is still circulating in Pakistan, Afghanistan, and Nigeria. Polio is still present in these countries due to lack of trust in immunization campaigns. Specific to Pakistan, poor sanitation allows the virus to spread, and poliovirus has been found in sewage samples in several cities including the capital Islamabad. Hard-core Islamists perceive vaccinations to be a Western effort to sterilize Muslims. The CIA using a vaccination team to track Osama bin Laden in 2011 also created resistance and mistrust towards vaccination campaigns. The resistance to vaccines in Pakistan is very hostile, for mobs have burnt down health facilities, healthcare workers have been attacked and accused of being spies, and recently a gunman shot and killed a healthcare worker. Large organizations like the Bill and Melinda Gates Foundation, are funding vaccines and making them more accessible, but money and accessibility aren’t the only obstacles we need to worry about. If the people don’t trust the vaccines or healthcare workers, all this funding is for nothing.

Recent Outbreak in the Philippines

In 2018, polio only existed in Pakistan, Afghanistan, and Nigeria, but just this month there has been an outbreak of polio in the Philippines. Poliovirus type 2 was eradicated in 2015, but this month four cases of poliovirus type 2 were confirmed in the Philippines. The fourth polio case was in a three-year-old female who did not receive the polio vaccine. Stool samples were sent to the National Institute of Infectious Diseases, and tests revealed that the virus was immunodeficiency-related. The outbreak of polio in the Philippines is as a result of low immunization coverage and poor sanitation and hygiene. Fixing the malnutrition and poor sanitation require long-term solutions, so the Philippines quickly responded to the outbreak by launching a massive vaccine campaign in November. So far, 16,295 children have been vaccinated.

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