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November 2000

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Early gains in Africa’s ‘biggest ever’ attack on polio

IN the largest synchronized peacetime operation the region has ever seen, 17 countries in West and Central Africa have begun a campaign to immunize 70 million children against polio. With the second round due to start in late November, the early results from the first round, conducted during October, indicate that the campaign has reached a higher proportion of children than any before it.

"Now countries are really getting up to the levels where they can interrupt the transmission of the virus," said Bruce Aylward, coordinator of the Global Polio Eradication Campaign at WHO in Geneva. "No countries have ever cooperated on this scale except in times of war, and that is extremely exciting."

For the first time, many of the countries involved did house-to-house visits, using hundreds of thousands of volunteers to immunize children and then mark the houses. Compared with previous years, the first round has reached 5% to 20% more children than had ever been immunized before.

Political commitment at the highest level was key to the operation’s success, said Deo Nshimirimana, regional coordinator for WHO in Abidjan. "President Konare of Mali launched the first day and he stayed all morning, vaccinating the children himself," he said. The campaign went ahead even in countries disrupted by conflict.


Chalk it up: a volunteer marks a house in Sokoto, Nigeria, in the first round last month

The organizers also targeted national borders, where migrants and victims of conflict tend to miss out on polio immunization. "These synchronized campaigns are an opportunity for peace-building," said Carl Tinstman, UNICEF’s senior advisor for polio eradication.

Despite the success, there is still room for improvement, said Nshimirimana. "We still have villages that were not covered in hard-to-reach areas, and we need to do more to train some of the volunteers." A third round will follow early next year in some countries.

The success of a coordinated and synchronized cross-border campaign could be adapted for other public health purposes, said Aylward, including malaria control or even anti-smoking programmes.

The countries involved are: Benin, Burkina Faso, Cameroon, Chad, Côte d’Ivoire, Gambia, Ghana, Guinea, Guinea Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone and Togo. Key to the effort is Nigeria, the largest remaining reservoir of endemic polio in the region.

Phyllida Brown


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