Dr Matshidiso Moeti In 1995, polio affected all countries across Africa and paralysed more than 75,000 children for life. The following year, former South African President Nelson Mandela launched a new campaign: ‘Kick Polio Out of Africa.’ His hope was that polio would follow the only human disease ever consigned to the history books: smallpox. Today we are one step closer to achieving that goal. On 11 August, for the first time in history, the whole of Africa reached one year without a single case of wild poliovirus being confirmed. Just three years ago, Nigeria was home to more than half of all global cases of wild poliovirus, and outbreaks in the Horn of Africa and central Africa in 2013 made some question the feasibility of global eradication. Nigeria is the only remaining country in Africa still on the polio endemic list. However, there hasn’t been a recorded case since July 2014. Last month, President Muhammadu Buhari committed to ending polio in Nigeria and sent a powerful message across the country by vaccinating his own granddaughter. Once all the lab samples for the past year have been checked and surveillance standards are fully satisfied –Nigeria could be removed from the polio-endemic list. Africa now stands on the brink of being polio-free. Our collective efforts to combat polio have left behind important lessons that we must build upon to ensure that no child dies from vaccine-preventable diseases. First, government leadership at all levels is critical to success. Leaders across Africa prioritised and resourced the fight against polio. We now have a blueprint to tackle other health and developmental challenges. To protect the health and improve the lives of our citizens across the region, it is crucial for African leaders to deliver on the 2001 Abuja Declaration commitment to spend 15 percent of national budgets on public health. Innovation is also crucial. In Nigeria, major investment in seven Emergency Operations Centres and a strengthened surveillance system enabled early identification of new cases and enabled a quicker response. The infrastructure set up for polio proved invaluable when Nigeria was confronted with an incipient Ebola threat and was able to quickly snuff it out in its largest city, Lagos. Health workers have been the true heroes of Africa’s polio programme. Daily, they overcome conflict, trek through marshlands to reach remote villages and build trust with communities to ensure that all children receive lifesaving polio vaccines. Community ownership and social mobilization have also been vital. Across Africa, we need to invest in and empower health workers, making sure they have the training, skills and incentives to continue delivering for our communities. Another model of success has been the unique public-private partnership that has driven progress against polio. Working with governments across Africa and around the world, Rotary International, the World Health Organization, Unicef, the Center for Disease Control and Prevention and the Bill & Melinda Gates Foundation have helped generate public, political and financial support for polio eradication. Final and lasting success of the polio campaign in Nigeria and across Africa will not be possible without lifesaving vaccines. With the eradication of polio closer than ever before, leaders must commit to financing polio eradication, strengthening surveillance and improving routine immunization performance. The first-ever Continental Ministerial Conference on Immunisation in Addis Ababa, Ethiopia, this November will call upon every African health minister to ensure that lifesaving vaccines – against polio and other preventable diseases – reach all children. The polio campaign in Africa has shown us that when we invest in health systems, strong leadership, health workers and vaccines, overcoming even the most difficult health challenge is achievable. A year with no new confirmed cases of wild polio in Africa is a step in the right direction for the entire continent – and certainly a cause for celebration. However, we cannot become complacent. Now is the time for us to redouble our efforts. We have an unprecedented opportunity to make good on Mandela’s vision and create not only a polio-free Africa, but also an Africa where children survive and communities thrive.Let’s do it together. The writer is the World Health Organization’s Regional Director for Africa.
