WHO's attempts to eradicate polio are thwarted in Africa and Asia
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《英国医生杂志》
Outbreaks of polio in Yemen and Indonesia, and the threat of polio returning to troubled regions of Africa, have dealt a blow to the World Health Organization's polio eradication programme in what was meant to be the final year of a 17 year campaign.
A total of 63 cases of polio have been identified in Yemen, and last week four cases were confirmed in Indonesia.
Bruce Aylward, coordinator of WHO's global polio eradication programme, said that many of the patients in the Yemen were paralysed. "Since polio only paralyses at most one child per 200 people infected, 50 identified cases of paralysis would mean at least 10 000 infections," he said.
The strain of poliovirus causing the new outbreaks originated in Kano province in northern Nigeria. In 2003 Kano was the focal point of a Nigerian Muslim boycott of polio vaccination, after local imams claimed that the vaccine was part of a US plot to spread AIDS or infertility in the Islamic world ( BMJ 2004;328: 485).
Several Nigerian provinces blocked immunisation for months before finally accepting a vaccine manufactured in Indonesia. The boycott was followed by a large outbreak of polio in Nigeria and surrounding countries.
A health official gives a polio vaccine to a boy in West Java after four cases of the disease were confirmed in Indonesia
Credit: IMAM SEWOKO/AP
Dr Aylward no longer expects to meet the WHO target, set in 1988, of eradicating polio by the end of 2005. "We're still pretty confident about meeting the target in Asia, where they've had enormous success recently. Previously, India was the main exporter of poliovirus. We haven't seen an Indian strain pop up abroad for two years."
But the 2003 Nigerian outbreak set back the campaign in Africa, he said. "Unfortunately the virus is now back in the surrounding countries. We're worried about much of western and central Africa and the Horn of Africa."
"We'll have a clearer picture after this summer, the high season for polio. Whatever happens, the low season of early 2006 will give us the chance to have a really good crack at it," said Dr Aylward.
"Twenty years from now, when polio is long gone, I don't think anyone will be worrying whether we missed the target by six months. The important thing is not to let up now that we're so nearly there. We have a $50m shortfall in funding for the rest of the year. If that's not made up somehow, we'll again have to abandon vaccination programmes in disease free areas. That's what we did last time we were short of funds, in the very areas where polio is now cropping up again."(Owen Dyer)
A total of 63 cases of polio have been identified in Yemen, and last week four cases were confirmed in Indonesia.
Bruce Aylward, coordinator of WHO's global polio eradication programme, said that many of the patients in the Yemen were paralysed. "Since polio only paralyses at most one child per 200 people infected, 50 identified cases of paralysis would mean at least 10 000 infections," he said.
The strain of poliovirus causing the new outbreaks originated in Kano province in northern Nigeria. In 2003 Kano was the focal point of a Nigerian Muslim boycott of polio vaccination, after local imams claimed that the vaccine was part of a US plot to spread AIDS or infertility in the Islamic world ( BMJ 2004;328: 485).
Several Nigerian provinces blocked immunisation for months before finally accepting a vaccine manufactured in Indonesia. The boycott was followed by a large outbreak of polio in Nigeria and surrounding countries.
A health official gives a polio vaccine to a boy in West Java after four cases of the disease were confirmed in Indonesia
Credit: IMAM SEWOKO/AP
Dr Aylward no longer expects to meet the WHO target, set in 1988, of eradicating polio by the end of 2005. "We're still pretty confident about meeting the target in Asia, where they've had enormous success recently. Previously, India was the main exporter of poliovirus. We haven't seen an Indian strain pop up abroad for two years."
But the 2003 Nigerian outbreak set back the campaign in Africa, he said. "Unfortunately the virus is now back in the surrounding countries. We're worried about much of western and central Africa and the Horn of Africa."
"We'll have a clearer picture after this summer, the high season for polio. Whatever happens, the low season of early 2006 will give us the chance to have a really good crack at it," said Dr Aylward.
"Twenty years from now, when polio is long gone, I don't think anyone will be worrying whether we missed the target by six months. The important thing is not to let up now that we're so nearly there. We have a $50m shortfall in funding for the rest of the year. If that's not made up somehow, we'll again have to abandon vaccination programmes in disease free areas. That's what we did last time we were short of funds, in the very areas where polio is now cropping up again."(Owen Dyer)