Polio (poliomyelitis) is an infectious disease that can lead to paralysis and even death. Most people who are infected do not experience symptoms, but can pass the virus on to others. Polio is transmitted person-to-person primarily through contact with feces, so people living in places with poor sanitation are at highest risk. One in about 200 infections leads to paralysis. The disease mainly affects young children, and wild poliovirus is endemic in Afghanistan and Pakistan.
Today, the world is close to eradicating wild polio. In 2018, only 33 new cases of wild polio were reported globally which is nearly a 99% drop since 1988. Despite these tremendous gains, challenges remain in eradicating all forms of the virus. People with weak immune systems can excrete vaccine-derived poliovirus after being immunized with the live oral vaccine. Finally, health systems in low-income countries that are dependent on polio eradication funding could be threatened after the disease is eradicated.
The Task Force for Global Health has been involved in supporting polio eradication for more than 20 years. In 2016, The Task Force supported the synchronized “switch” to a safer form of oral polio vaccine for use in 155 countries, which represented a critical step in the eradication effort. Currently, The Task Force supports the Global Polio Eradication Endgame Strategy through efforts to develop polio antivirals and to contain potentially infectious samples in U.S. laboratories. The Task Force is also supporting “last mile” efforts to eradicate wild-type poliovirus and ensure countries that are dependent on polio funding can continue to sustain immunization programs after the disease is eradicated.
Developing Polio Antivirals to Treat People with Immune Deficiencies
While the world has made great progress toward eradicating wild poliovirus, vaccine-derived poliovirus will remain a threat to eradication of all forms of the disease. This is due to the fact that people with certain immune deficiencies can excrete virulent vaccine-derived poliovirus after being immunized and can potentially infect others. The Task Force’s Polio Antivirals Initiative is working with partners to develop antiviral drugs to treat and stop excretion of vaccine-derived poliovirus in these people. The drugs are soon entering clinical trials and are expected to be available for treatment in 2020-21.
Containing Polio Samples in U.S. Laboratories
The Task Force’s Poliovirus Containment project is assisting the U.S. Department of Health and Human Services with polio eradication in the United States by serving as the Secretariat for the U.S. National Containment Certification Committee. This work reviews and certifies U.S. government efforts to limit and contain poliovirus samples held in U.S. research institutions and laboratories to ensure that poliovirus is not reintroduced into the population.
Supporting the “Last Mile” of Polio Eradication in Pakistan
The Task Force’s TEPHINET program is supporting the “last mile” of polio eradication in Pakistan where transmission of wild-type poliovirus persists. TEPHINET provides logistical support to Pakistan’s National Stop Transmission of Polio (N-STOP) program that is working to ensure all 37 million children in the country are immunized. TEPHINET helps N-STOP assure the quality and effectiveness of immunization campaigns and post-campaign monitoring activities. The program also provides support for surveillance of new polio cases through N-STOP’s work with eight Emergency Operations Centers and response units around Pakistan.
Transitioning Polio Assets to Other Health Priorities
Significant resources have been devoted to polio eradication. In some developing countries, polio eradication funding represents a significant portion of the annual budgets of health systems. The Task Force is supporting the efforts to develop plans to ensure that these health systems can continue functioning effectively after polio eradication. Currently, The Task Force is working with 16 low-income, politically unstable countries to transition resources and infrastructure used to combat polio to other health priorities. The Task Force’s assistance includes assisting countries in identifying other sources of support for immunization programs after polio eradication and developing plans to transition polio assets to other health priorities.
Boosting “Last Mile” Efforts to Eradicate Polio
The Polio Eradication Surge Capacity Support project is a joint CDC effort to boost poliovirus detection and vaccination efforts during the “last mile” of eradication. Though polio cases have been reduced significantly since 1988, there has been a recent spike in cases as the Global Polio Eradication Initiative tries to reach eradication. Supported and in collaboration with the CDC, The Task Force’s Polio Eradication Surge Capacity Support project has been started to increase efforts for a push to tackle this disease.
Help Us End Polio
Fabien Diomande, MD, MSc
Where We Work
Header photo caption: A community health worker gives an oral vaccination to a Pakistani child during a polio vaccination campaign.