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Polio eradication programme 'in danger'

Thursday July 29th 2021

The drive to rid the world of polio could be in trouble after the World Health Organization (WHO) fired 500 staff on the polio programme, it is claimed today.

Writing in The BMJ, journalist Robert Fortner warns that getting rid of staff “perhaps ending a decades long, multibillion dollar crusade engineered by some of the most powerful actors in global health.”

He also says not even the Bill & Melinda Gates Foundation, which has spent billions of dollars on global polio initiatives, knew about WHO’s plan.

Since the effort to eradicate polio began in 1988, the Global Polio Eradication Initiative (GPEI) has slashed polio cases by 99.99%.

Fortner writes the GPEI has been on the cusp of success for years, but cases surged and the COVID-19 pandemic stopped polio efforts for several months last year.

In December, WHO decided to speed up integration of the polio programme into existing immunisation services, which has always been avoided because the GPEI separated them because polio eradication requires 90% plus coverage rates.

Then, WHO’s regional office for Africa (AFRO) laid off about 500 polio programme staff, which is said to have surprised GPEI’s partner groups and donor nations including the UK’s Foreign, Commonwealth & Development Office, and the US Agency for International Development (USAID).

Aidan O’Leary, who took over as director for polio eradication at WHO after the December transition decision had been taken, describes GPEI partners’ commitment to eradication as “pretty unequivocal”.

But Fortner says funding cuts and challenges in Afghanistan and Pakistan, the two remaining countries where polio remains endemic, could sink any hopes of eradication.

Professor Nicholas Grassly, an epidemiologist at Imperial College London and an independent adviser to GPEI, told him that integrated delivery has “not ever really been tested for an eradication programme”, while a paper published in The Lancet earlier this year, titled Polio eradication at the crossroads, suggested that eradication of all polioviruses from the planet has never actually been possible.

Professor Zulfiqar Bhutta, a paediatrician at Aga Khan University, added that GPEI “may need to call the new reality the new eradication.”

Fortner R. Has the billion dollar crusade to eradicate polio come to an end? The BMJ 29 July 2021; doi: 10.1136/bmj.n1818

[abstract]

Tags: Flu & Viruses | World Health

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