An epic public health journey could be coming to an end – with a great result

A child being vaccinated against polio.
Image: REUTERS/Thierry Gouegnon
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Last month, I traveled across Machakos County in Kenya, a picturesque green hilly area, which sharply contrasts the images of a dry arid terrain mostly depicted because of popular safari tourism. Despite Kenya not having had a case of polio since 2013 and the African continent having gone more than 18 months without a case, I was in Kenya as part of an epic global public health journey that has moved the world even closer to consigning polio to the history books.
I traveled with Julie, a public health specialist from Emory University, and Anne, the County Immunization logistician, who ensures the vaccines, people, finances, and transport are in the right place at the right time at the appropriate quality,condition and cost . Our joint mission was to ensure that an old vaccine that has been incredibly successful in reducing global polio cases over the last thirty years was replaced with one that specifically targets the remaining strains of the virus.
So, let me explain that a bit more: there are three strains of poliovirus conveniently called types 1, 2 and 3. There hasn’t been a case of type 2 polio since 1999 and the World Health Organization (WHO) declared the strain eradicated last year.

By removing the type 2 strain from the vaccine, we boost protection against the two remaining strains of the virus that still pose a threat to humans –types 1 and 3. We can also prevent the incredibly small risk of the type 2 virus contained in the vaccine from mutating and causing paralysis. It’s a small risk but because eradication means we have to get to zero, there’s no margin for error.
Kenya is one of 155 countries that switched vaccines simultaneously and this great graphic created by the WHO shows the true scale of the effort. Selected independent monitors pulled from various parts of the health system in Kenya were trained to identify old vaccine and safely dispose of them, so I joined a national monitor training where we ran through the process of how to switch out a vaccine quickly and effectively.
Polio will be only the second human disease to be eradicated, smallpox being the first, and as we drove from village to village checking that vaccines had been switched successfully, Anne shared stories about her community, her family and her home, which gave me a glimpse into the huge challenges that Kenya overcame on its path to ending polio.
As I left Machakos County with Julie and Anne to return to the capital, Nairobi, I was filled with hope that we, humankind, can reach this audacious goal when we put our minds to it. And with people like Anne and the other health workers I met on this trip, who work tirelessly every day to protect every child in their community against polio and other vaccine preventable diseases, I know we are going to eradicate polio.
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