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Gunmen kill polio vaccinator in southwestern Pakistan

Al Jazeera

Islamabad, Pakistan - Unidentified gunmen have killed at least one polio vaccination worker in the southwestern Pakistani area of Chaman, government officials say, bringing the death toll from a drive this week to eradicate the virus to at least three. Gunmen opened fire on a team of vaccination workers in the remote village of Sultan Zai, about 100km northwest of the provincial capital Quetta, on Thursday, said Sami Agha, a local government official. "The body of the killed polio worker and another person who was wounded have been transferred to hospital," Agha said in a statement. Security forces have launched a search operation in the area, and the polio vaccination drive in near Sultan Zai has been temporarily suspended, the statement said. Polio, a highly infectious debilitating virus that targets the nervous system of children, has been wiped out across the world, but remains endemic in Pakistan, Afghanistan and Nigeria.

Fighting Taliban And Mistrust, Pakistan Marks One Year Polio-free

International Business Times

Bathed in crisp morning light, Sidra Hussain grips a cooler stacked with glistening vials of polio vaccine in northwest Pakistan. In concert they begin their task -- going door-to-door on the outskirts of Mardan city, dripping bitter doses of rose-coloured medicine into infants' mouths on the eve of a major milestone for the nation's anti-polio drive. The last infection of the wild poliovirus was recorded on January 27, 2021, according to officials, and Friday marks the first time in Pakistan's history that a year has passed with no new cases. Friday marks the first time in Pakistan's history that a year has passed with no new polio cases Photo: AFP / Aamir QURESHI To formally eradicate the disease, a nation must be polio-free for three consecutive years -- but even 12 months is a long time in a country where vaccination teams are in the crosshairs of a simmering insurgency. Since the Taliban takeover of neighbouring Afghanistan, the Pakistan version of the movement has become emboldened and its fighters frequently target polio teams.

Afghanistan-wide Polio Vaccination Starts Next Month: UN

International Business Times

Afghanistan will kick off its first countrywide polio immunisation campaign in years next month to protect millions of unvaccinated children, the UN said Monday. The United Nations' health and children's agencies said the campaign to vaccinate against the crippling and potentially fatal disease would begin on November 8, with full support from the Taliban leadership. "WHO and UNICEF welcome the decision by the Taliban leadership supporting the resumption of house-to-house polio vaccination across Afghanistan," they said in a statement. Since the Taliban swept back into power two months ago, the UN had been talking with the group's leadership to address the towering health challenges in the country, the statement said. "The Taliban leadership has expressed their commitment for the inclusion of female frontline workers," it said.

Africa to be declared free of wild polio in 'milestone'

BBC News

Africa is to be declared free from wild polio by the independent body, the Africa Regional Certification Commission. Polio usually affects children under five, sometimes leading to irreversible paralysis. Death can occur when breathing muscles are affected by the paralysis. There is no cure but the polio vaccine protects children for life. The disease is now only found in Afghanistan and Pakistan.

Polio vaccinators are back after pandemic pause


> Science's COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation In a sad knock-on effect of the COVID-19 pandemic, the Global Polio Eradication Initiative (GPEI) abruptly halted all mass vaccination campaigns in March, worried they could inadvertently spread the novel coronavirus. The move further imperiled the troubled 3-decade drive to wipe out polio. But now, armed with new data and perspective, GPEI and the countries it supports are resuming vaccination campaigns. Burkina Faso was first in early July; Pakistan followed this week. Polio cases are surging in many countries, and models paint a “pretty bleak picture” if campaigns don't restart soon, says Michel Zaffran, who heads the effort at the World Health Organization (WHO). For now, countries will only be responding to outbreaks; preventive campaigns remain on hold. Back in March, when COVID-19 began to spread around the world, no one knew whether door-to-door polio campaigns would make things worse, says Hil Lyons, a statistician at the Institute for Disease Modeling (IDM) in Bellevue, Washington. Without answers, “The default was to shut things down,” he says. The cost was enormous. “There's a growing sense that the collateral damage [of pausing campaigns] is really substantial,” says Nick Grassly of Imperial College London (ICL), who heads one of the groups modeling the impact of the pause and how best to respond. In “urgent” recommendations in late May, GPEI said it expected circulation of polioviruses “to increase exponentially during the upcoming high season,” raising the possibility of “uncontrolled multi-country outbreaks.” IDM models also suggest the effect of polio campaigns on the pandemic is likely small in places where the virus is already raging. “The outbreak has its own momentum and acceleration,” Lyons explains. In areas where COVID-19 has yet to hit, however, the risks are substantial. To lower them, vaccinators will be screened for COVID-19, wear masks, use hand sanitizer, and practice physical distancing as much as possible. Most important, says Hamid Jafari, WHO's head for polio eradication in Pakistan and Afghanistan, teams will work in their own communities. “We don't want to bring workers from infected areas to uninfected areas,” he says. The polio campaign was in a rut even before COVID-19. In Pakistan and Afghanistan, the last bastions of the wild virus, cases of wild-type polio shot up last year to 176, from 33 in 2018. So far this year, the two countries have confirmed 87 wild polio cases, compared with 64 at this time last year. The real number is likely higher because the pandemic has hampered surveillance. Now, Pakistan and Afghanistan are battling outbreaks of vaccine-derived polio virus as well—the only two countries facing that double challenge. Such outbreaks occur when the weakened virus used in the oral polio vaccine (OPV)—usually the type 2 component of the three polio virus serotypes—mutates and regains its ability to paralyze and spread. Type 2 vaccine-derived cases in Pakistan and Afghanistan soared from 16 at this time in 2019 to 79 so far. Mathematical models from Grassly's team suggest the two countries will see “truly explosive” outbreaks of vaccine-derived virus, Jafari says, “going up to the thousands of cases, if we don't intervene.” (Wild cases will rise as well, but into the hundreds, he says.) The reason is that most children under age 5 have little or no immunity to vaccine-derived virus type 2 because the world stopped using OPV2 in 2016—a first step toward pulling OPV from use altogether in hopes of preventing vaccine-derived outbreaks. That hasn't worked, and now the number of vulnerable kids is growing every year. To fight vaccine-derived outbreaks, GPEI relies on a version of the same vaccine that gave rise to them in the first place, known as monovalent OPV2 (mOPV2), which can create a never-ending cycle. A new vaccine, designed to have a much lower chance of reverting, could help turn the situation around, but the pandemic has delayed its rollout until September and at first its use will be limited. The revived Pakistan and Afghanistan programs will have to overcome the suspicions and refusals that derailed them last year. Addressing the many other health issues poor communities face—for example by distributing soap and teaching people how to stem the spread of COVID-19—could help build trust, Jafari says. Africa is free of the wild virus, but it, too, is mired in a battle against vaccine-derived virus, and there's a strong risk of “explosive growth” on the continent, says ICL's Isobel Blake. So far this year, Africa has reported 133 type 2 cases in 14 countries, up from 47 at this time last year. Chad alone recorded 23 cases in 1 week in June and now has 42 cases. The highest risk areas are those that have recorded just a few cases of type 2 polio this year but were unable to respond because of the pause, modeling by Blake shows. Hot spots include Ivory Coast and parts of Chad, Mali, Ghana, Togo, Burkina Faso, and Niger. Surprisingly, the places that had the worst vaccine-derived outbreaks in the past are at lower risk, Blake says. Nigeria, for example, conducted multiple rounds of vaccination with mOPV2 before the pandemic pause, and now has “quite good immunity in a sea of quite poor immunity,” Grassly says. It won't resume polio campaigns yet. Zaffran says there's no question that the pandemic has compounded the eradication effort's long-standing problems. Getting back on track “will take more time than it did in the past, and it will be more complicated.”