Date Published: 9 September 2006

Horn of Africa countries jointly bolster drive to eradicate polio

Countries in the Horn of Africa are increasing their level of planning, coordination and streamlining their polio eradication strategies to cut the corridor of transmission of the poliovirus. Somalia, Ethiopia and Kenya will simultaneously vaccinate millions of children under five years of age from 9-12 September in the largest-ever synchronized vaccination campaign in the Horn of Africa.

In Ethiopia, the polio vaccination campaign will administer two drops of Oral Polio Vaccine (OPV) to 956,886 children, from the two regions of Somali and Afar that border Somalia and parts of Kenya. On the Somali side of the border, vaccinators will aim to reach a total of 1.7 million children in a nation-wide campaign, with exceptional concentration on regions bordering Ethiopia and Kenya. In northern Kenya, a total of 240,000 children will be targeted in five districts bordering Somalia and Ethiopia.

The Horn of Africa Technical Advisory Group (TAG), which convened in Ethiopia in August 2006, stressed that the polio eradication drive is now at a critical stage, where most countries are working together to pull out the best approaches to the effective deployment of people, mobilization of authorities, local communities, households, and the participation of the international donor community to ensure high-quality surveillance and supplemental immunization activities.

Polio-free for almost three years, Somalia became re-infected last year with a poliovirus imported from Yemen. To date, there are a total of 215 confirmed cases, and 14 out of Somalia's 19 regions have been infected. Since its re-infection in December 2004, Ethiopia has reported a total of 37 polio cases with four out of 11 regions infected. The high-risk areas remain the cross-border region of Somali, Ethiopia and north/central areas of Somalia. Kenya has been polio-free for the last 22 years.

For the synchronized campaign, every effort will be made to ensure that no child is missed. Vaccinators and social mobilizers are strategically positioned throughout the countries.

Teams on the ground will ensure that each and every child is vaccinated, by moving from house to house, in cities, towns, and villages, and in hard to reach areas, using all transportation means possible, such as camels, horses and donkeys. Vaccinators have been trained and sensitized to ensure that there is no discrimination in immunization between those children living in poor or wealthy neighborhoods, as the virus does not distinguish between rich and poor.

The polio eradication effort in the Horn also involves religious and community leaders, women's groups, youth associations, schools, and governmental and non-governmental organizations, all working to prevent the paralysis of children.

The complex operating and unstable environments, exacerbated by recurrent drought and floods in Somalia and heavy rains in Ethiopia, continue to hamper the implementation of high-quality polio immunization campaigns. International and national staff have difficulties accessing conflict zone areas to regularly supervise staff working at the district level.

For Ethiopia, the areas where challenges due to insecurity are most acute are in the Somali and Gambella Regions. This, coupled with the poor health infrastructure, and low routine immunization coverage rates place both countries at risk for continued transmission or spread. In addition, Ethiopia, Somalia and northern Kenya are host to large populations of nomadic pastoralists, who are more difficult to consistently reach in immunization campaigns. Setting up highly sensitive polio surveillance systems in these populations is also challenging.

Countries in the Horn of Africa are confident that they can kick out polio again as they successfully did in the past despite the difficult environments they work in. ?We've done it once, we can do it again,' has become the motto for mobilizing troops in the region.

Depending on the availability of funds, three synchronized campaigns are planned for this year, in September, November and December in the Horn of Africa. Globally, there is a funding gap of US$50 million for 2006, which must be filled urgently by October to ensure the implementation of planned activities through the end of the year. If these funds are not mobilized, immunization campaigns may need to be scaled back, which would result in more children being paralyzed.

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