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Europe cannot ignore the risk of losing wild-polio free status | View

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The 53 countries that make up the World Health Organization’s European Region were officially declared wild polio-free in June 2002 – a remarkable achievement that has been sustained each year since.

Recently, the United Kingdom announced its detection of vaccine-derived poliovirus (VDPV), a variant of the poliovirus that can emerge in under-immunised communities, in sewage samples in London.

This news is a stark reminder that until all forms of polio are gone globally every country remains at risk.

While sustaining a wild-polio-free status for the 20th year will be a victory – underlining the power of vaccines, the tireless efforts of ministries of health and health professionals to offer the benefits of vaccines to their populations amidst other public health priorities, and the level of commitment of the Region’s Member States to eradicate polio – it is not the end of the story. Our job is not done.

High vaccination coverage has reduced polio cases globally by 99% since 1988, successfully wiping out two of the three wild poliovirus strains globally.

But today, the world faces a double burden. Serious programmatic and systemic challenges allow pockets of wild poliovirus to persist in Afghanistan and Pakistan, sometimes with the virus spilling over to other countries, including most recently into Malawi and Mozambique.

At the same time, outbreaks of vaccine-derived poliovirus (VDPV) continue to be reported, particularly across Africa, but also in Europe. In addition to the VDPV recently detected in sewage in London, Israel, Tajikistan and Ukraine have all seen VDPV outbreaks in the last 12 months. Meanwhile, we’re witnessing declining immunisation rates in the European Region – to levels below those considered necessary to protect the population.

Vaccines remain our best defence against polio. Until all forms of poliovirus are gone, every unvaccinated child, every un- and under-vaccinated community, is at risk. This is not the time to be complacent.

Looking back at what was required to achieve polio-free status in the European Region – and ahead at the tools available to address the challenges of the coming decade – we have good reason to be cautiously optimistic.

Lessons learned from the COVID-19 vaccination rollout, including engaging with communities and addressing misinformation and vaccine hesitancy have strengthened this hand.

Thanks to strong collaboration, effective vaccines and the European Immunization Agenda 2030: an apt instrument adopted by all 53 Member States in the Region, it is within our reach to sustain the Region’s polio-free status for as long as it takes to achieve global eradication of the disease. To do this, we cannot ignore what happens overseas, hoping it won’t reach our shores. Within WHO’s European Programme of Work, Member States need to ensure that every child in the Region is vaccinated and thereby protected from this devastating disease.

Indeed, the key to ending polio for good – everywhere – is robust primary health care capable of achieving and sustaining high polio vaccination coverage and quickly detecting and responding to an outbreak.

Eradication will require significant resources, but without continued efforts, hundreds of thousands of polio cases could emerge over the next decade resulting in tragic and avoidable health outcomes and costs.

No one person, country or region can eradicate polio alone – we need to join forces. The stakes are high, but so are the social and economic benefits of eradication.

This year the Global Polio Eradication Initiative (GPEI), a public-private partnership led by national governments – with WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC), UNICEF, the Bill & Melinda Gates Foundation, and GAVI, the Vaccine Alliance – launched a US$4.8 billion ask to fund its new five-year strategy, vaccinate some 370 million children multiple times every year, and stop polio transmission once and for all.

Countries can pledge their support to the GPEI at the World Health Summit in Berlin this October. This moment presents a historic opportunity for the European Region to step up and establish itself on the world stage as a champion in the fight to protect the world’s children.

Building upon the solidarity demonstrated during the COVID-19 pandemic, countries in the European Region are well-placed to champion childhood immunisation and equity. Every contribution counts. We call on every government, in the Region and beyond, to expand political and financial support to GPEI’s efforts to end all forms of the poliovirus.

Two decades after Europe was first certified as wild-polio-free by the European Regional Certification Commission for Poliomyelitis Eradication, this status is to be confirmed in October, for 2021 and 2022.

Let us not squander what we’ve worked so hard for. Instead, let’s commit ourselves and lead the way toward a world in which no child is ever again paralysed by this preventable disease.

Dr Marc Danzon was the World Health Organization’s Regional Director for Europe from 2000 to 2010 and Dr Hans Henri P. Kluge has been the World Health Organization’s Regional Director for Europe since 2020.

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